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激光和光设备在痤疮治疗中的应用:最新进展。

The Use of Lasers and Light Devices in Acne Management: An Update.

机构信息

Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada.

City Medical Aesthetics Center, Vancouver, BC, Canada.

出版信息

Am J Clin Dermatol. 2021 Nov;22(6):785-800. doi: 10.1007/s40257-021-00624-5. Epub 2021 Jul 21.

Abstract

Acne vulgaris is a disease of the pilosebaceous unit and the most common inflammatory dermatosis worldwide. It is also associated with significant economic burden. Limitations of conventional topical and systemic treatments include long treatment course, intolerable adverse effects, antibiotic resistance, and patient compliance. Therefore, laser and light-based interventions present as alternative options over the past decade and have been used in combination with conventional pharmacological therapies and other physical modalities. An updated overview on the use of lasers and light-based devices in acne management is presented to help clinicians understand the safety and efficacy of these treatment options. The effectiveness of neodymium:yttrium aluminum garnet (Nd:YAG) for treating acne is supported by more high-level studies compared with other laser devices. There is limited evidence to support the use of CO lasers, potassium titanyl phosphate lasers, and 1565-nm non-ablative fractional lasers for treating acne. Among light devices, photodynamic therapy is the most studied, showing higher efficacies than some of the conventional topical and oral acne therapies. Intense-pulsed light and blue light therapies also show favorable outcomes. A limitation is that most studies are non-randomized and lack a control group, and report on a variety of device settings, treatment regimens, and outcome measures, making it challenging to summarize and generalize findings. Although the use of laser and light devices to treat acne is promising, further work with randomized controlled study designs and larger sample sizes will provide improved guidance on the application of these modalities.

摘要

寻常痤疮是一种发生于毛囊皮脂腺单位的疾病,是全球最常见的炎症性皮肤病。它还与巨大的经济负担有关。传统的局部和全身治疗的局限性包括治疗过程长、无法耐受的不良反应、抗生素耐药性和患者依从性。因此,激光和光基介入治疗在过去十年中成为替代选择,并已与传统的药物治疗和其他物理治疗方法联合使用。本文就激光和光基设备在痤疮管理中的应用进行了更新,以帮助临床医生了解这些治疗方案的安全性和有效性。与其他激光设备相比,钕:钇铝石榴石(Nd:YAG)治疗痤疮的有效性得到了更多高级别研究的支持。有有限的证据支持 CO2 激光、钛钾磷酸钾激光和 1565nm 非剥脱性点阵激光治疗痤疮。在光设备中,光动力疗法研究最多,其疗效优于一些传统的局部和口服痤疮治疗方法。强脉冲光和蓝光疗法也显示出良好的效果。一个限制是,大多数研究是非随机的,缺乏对照组,并报告了各种设备设置、治疗方案和结果测量,使得总结和概括发现变得具有挑战性。虽然使用激光和光设备治疗痤疮很有前景,但进一步采用随机对照研究设计和更大的样本量将为这些方法的应用提供更好的指导。

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