Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA.
University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA.
J Cosmet Dermatol. 2024 Oct;23(10):3066-3077. doi: 10.1111/jocd.16466. Epub 2024 Aug 11.
Acne vulgaris (AV) is a widespread inflammatory skin condition associated with increased sebum production, abnormal keratinization, bacterial overgrowth, and inflammation. Overactive sebaceous glands (SGs) produce excess sebum, promote Cutibacterium acnes growth, and affect acne development. Energy-based treatments (EBDs), including light therapy, photodynamic therapy (PDT), lasers, and radiofrequency (RF) devices, have emerged as effective treatment options. As the use of EBDs becomes more widespread, it is imperative to understand their effects on skin parameters, such as sebum, in AV.
Searches were conducted in Embase, PubMed, Web of Science, and the Cochrane Library. The studies included were randomized and nonrandomized trials on facial AV that used EBDs and featured objective casual sebum level (CSL) measurements via Sebumeter. Data synthesis involved percentage reductions in CSL at follow-ups compared to baseline.
Twenty-three studies were analyzed. PDT and RF consistently reduced CSL by 30%-40% and 30%-35%, respectively. Laser therapy showed lesser reductions, whereas light therapy varied significantly and studies had a high risk of bias. All EBD therapies were more effective than no treatment and PDT was superior to light monotherapy. Laser therapy combined with fractional microneedling radiofrequency (FMR) or as a standalone was more effective than laser alone.
Noninvasive sebum measurement provides valuable insights into AV treatment efficacy. PDT, lasers, especially the 1450-nm diode laser, and FMR are promising for reducing sebum. Standardization of measurement techniques and further research are vital for enhancing treatment personalization, reducing side effects, and improving AV management.
寻常痤疮（AV）是一种广泛存在的炎症性皮肤疾病，与皮脂过度分泌、角质形成异常、细菌过度生长和炎症有关。过度活跃的皮脂腺（SG）会产生过多的皮脂，促进痤疮丙酸杆菌的生长，并影响痤疮的发展。基于能量的治疗（EBD），包括光疗、光动力疗法（PDT）、激光和射频（RF）设备，已成为有效的治疗选择。随着 EBD 的应用越来越广泛，了解它们对 AV 皮肤参数（如皮脂）的影响至关重要。
在 Embase、PubMed、Web of Science 和 Cochrane 图书馆中进行了检索。纳入的研究是关于面部 AV 的随机和非随机试验，使用 EBD，并通过 Sebumeter 进行客观的皮脂水平（CSL）测量。数据综合包括与基线相比，随访时 CSL 的百分比降低。
分析了 23 项研究。PDT 和 RF 分别持续降低 CSL 30%-40%和 30%-35%。激光治疗的效果较小，而光疗差异显著，且研究存在高偏倚风险。所有 EBD 疗法均比无治疗更有效，PDT 优于单纯光疗。激光疗法联合微针射频（FMR）或单独使用激光疗法更有效。
非侵入性皮脂测量为 AV 治疗效果提供了有价值的见解。PDT、激光，尤其是 1450nm 二极管激光和 FMR，是减少皮脂的有前途的方法。测量技术的标准化和进一步的研究对于增强治疗个性化、减少副作用和改善 AV 管理至关重要。
