Intense pulsed light may improve inflammatory acne through TNF-α down-regulation.

BACKGROUND: Despite many studies on the action of yellow light in acne, its efficacy and mechanisms of action are still unclear. OBJECTIVES: To determine if IPL can cause a clinical improvement in acne and whether it modifies TLR2 and TNFα expression. METHODS: Twenty-one patients with mild to moderate acne involving their backs received 530 nm IPL treatments once every 2 weeks. Assessments at baseline and after the fourth treatment included lesion counts, Leeds grading and SER. Biopsies from the treatment area were taken at three time points. TLR2 expression was determined using immunohistochemistry, and TaqMan Low Density Arrays were used to measure TNFα, IL-8 and IL-10. RESULTS: Inflamed lesion counts fell significantly by 28.0% (p = 0.002) but not the Leeds score, SER or non-inflamed lesions. A reduction in TNFα expression of 17.6% (p = 0.031) weakly correlated with the change in lesion counts. TLR2 expression fell by 2.6% (p < 0.001) but did not correlate with lesion counts. Neither IL-10 nor IL-8 expression was significantly altered. CONCLUSIONS: 530 nm IPL significantly reduces inflammatory lesions, where its efficacy will need optimising to make it a viable treatment option. Its mechanism seems to include a novel anti-TNFα effect, independent of IL-10 up-regulation.

Pathways to inflammation: acne pathophysiology.

Acne vulgaris affects as much as 80% of the adolescent population and persists in approximately 3% of middle-aged adults. Only a percentage of these persons seek medical help, however, acne can cause levels of anxiety and depression akin to a chronic illness. A recurring question from patients who seek help from various healthcare professionals - their pharmacist, family doctor or dermatologist, is "why?" They also ask questions about a possible familial link, the impact of their diet and the association with their hormones. The following review aims to link these factors with the end result - inflammation.

Hyperandrogenism does not predispose patients to photoepilatory treatment failure: a single-center review.

Studies have suggested that patients with PCOS tend to be more treatment resistant to light-mediated depilation compared with their non-PCOS counterparts. We conducted a retrospective assessment of 29 hirsute patients treated between January 2006 and February 2007 to assess whether those with unsatisfactory hair clearance after treatment with intense pulsed light (IPL) were predominantly hyperandrogenic. The number of IPL sessions was also recorded for those patients failing to improve on treatment. Seventy-six percent had satisfactory hair clearance where hyperandrogenic patients dominated. All patients required an average of six treatments before discharge. Eighty-eight percent of poor responders were normoandrogenic. Our hyperandrogenic cohort appeared more responsive to IPL than the normoandrogenic patients. From our observations, the presence of hyperandrogenism does not indicate treatment resistance. This standpoint is unique and warrants a randomized trial directly comparing the two groups to investigate whether a positive or negative relationship actually exists.