Qin Xiaolei, Huang Haiyan, Zou Yanfen, Yu Bo, Tu Ping
Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, China.
Deyue Clinic, Shenzhen, China.
J Cosmet Dermatol. 2023 Nov;22(11):3168-3175. doi: 10.1111/jocd.15897. Epub 2023 Aug 17.
The current standard recommendation is to initiate the cosmetic therapies after discontinuing taking oral isotretinoin for at least 6 months. However, this recommendation has been questioned in several recent publications, and it is difficult to operate in clinical practice as early initiation of effective treatment is desirable for patients with acne sequelae.
The purpose of this study is to evaluate the efficacy and safety of chemical peeling and light/laser or radiofrequency treatments combined with oral isotretinoin for patients with acne vulgaris and acne scars.
A retrospective study of 511 patients on/or recently administered with isotretinoin treated with glycolic acid, intense pulsed light, nonablative fractional laser, fractional radiofrequency, and ablative carbon dioxide laser. A total of 1352 interventions were performed. The medical follow-up lasted for at least 1 year. The efficacy and safety of different procedures were evaluated.
A total of 511 patients, who were treated with isotretinoin orally or stopped for <6 months, received 477 sessions of glycolic acid chemical peeling treatment, 588 sessions of intense pulsed light treatment, 61 sessions of nonablative fractional laser treatment, 101 sessions of fractional radiofrequency treatment, and 125 sessions of ablative fractional carbon dioxide laser treatment. No hypertrophic scars and keloids were found, and the incidence of serious adverse reactions such as scarring, erythema, blisters, and postinflammatory hyperpigmentation did not increase.
It is safe to perform skin procedures in patients with acne and acne scars during or after discontinuation of isotretinoin for <6 months. Invasive treatments such as ablative fractional carbon dioxide laser treatment can be performed, as appropriate, by an experienced physician. The guideline of avoiding chemical and physical procedures in such patients taking oral isotretinoin should to revised.
目前的标准建议是在停用口服异维A酸至少6个月后开始进行美容治疗。然而，这一建议在最近的几篇出版物中受到了质疑，并且在临床实践中难以操作，因为对于痤疮后遗症患者而言，尽早开始有效治疗是可取的。
本研究旨在评估化学剥脱术、光/激光或射频治疗联合口服异维A酸治疗寻常痤疮和痤疮瘢痕患者的疗效和安全性。
对511例正在服用或最近服用过异维A酸的患者进行回顾性研究，这些患者接受了乙醇酸、强脉冲光、非剥脱性分次激光、分次射频和剥脱性二氧化碳激光治疗。共进行了1352次干预。医学随访持续至少1年。评估了不同治疗方法的疗效和安全性。
511例口服异维A酸或停药时间<6个月的患者接受了477次乙醇酸化学剥脱治疗、588次强脉冲光治疗、61次非剥脱性分次激光治疗、101次分次射频治疗和125次剥脱性分次二氧化碳激光治疗。未发现增生性瘢痕和瘢痕疙瘩，瘢痕形成、红斑、水疱和炎症后色素沉着等严重不良反应的发生率也未增加。
在异维A酸停药<6个月期间或之后，对痤疮和痤疮瘢痕患者进行皮肤治疗是安全的。经验丰富的医生可酌情进行剥脱性分次二氧化碳激光治疗等侵入性治疗。对于正在服用口服异维A酸的此类患者，应修订避免进行化学和物理治疗的指南。
