Acne vulgaris, commonly known as acne, pimples, and pimples, is a chronic inflammatory skin disease of hair follicles and sebaceous glands commonly seen in young men and women during adolescence. The author used E light to treat 60 cases of acne vulgaris from August 2007 to August 2009, and achieved better efficacy with fewer adverse reactions, and the results are reported below.
1. Clinical data
1.1 General data 60 outpatients with acne vulgaris met the diagnostic criteria for acne vulgaris [1]. There were 38 female cases and 22 male cases, aged 14 to 35 years. The disease classification was based on the Pilsbury modified classification [1]. Grade I: predominantly acne with a few papules and pustules and less than 30 total lesions; Grade II: acne and moderate amount with papules and pustules and between 30 and 50 total lesions; Grade III: a large number of papules and pustules with large inflammatory lesions, between 51 and 100 total lesions and <3 nodules/cysts; Grade IV: nodules/cysts or coalescence, >100 total lesions and >3 nodules/cysts. There were 18 cases of grade I, 24 cases of grade II, 12 cases of grade III, and 6 cases of grade IV among the patients.
1.2 Exclusion criteria
①Face with inflammatory skin disease other than acne;
②Persons with chronic or severe diseases;
③Pregnant and lactating women;
④There had been systematic use or topical application of anti-acne medication such as retinoic acid within 3 months before treatment, and there was no history of application of glucocorticoids or antibiotics within two weeks; ⑤Allergic to medication or intolerant to treatment.
1.3 Treatment method
The HONKONE light therapy instrument was used, with wavelengths of 530 to 1200 nm, 4 pulses, pulse width of 2.9 to 3.3 ms, pulse interval of 4 to 5 ms, energy density of 26 to 40 J/cm2, and RF energy of 15 to 19 J/cm2. Special eye shields cover both eyes, the E light treatment head and cold gel gently contact, irradiation, starting with low energy from the bottom up, from the outside to the inside of the treatment in turn, until the patient’s skin appears obvious prickly heat and observed local skin slightly red for the degree, after the end of treatment wash out the gel. The operator records the treatment parameters and the skin condition during the procedure, and instructs the patient to avoid light and photosensitive foods and medications after the procedure. The treatment was performed once a week, and 4 times was considered as a course of treatment.
1.4 Efficacy determination criteria [2]
Basic healing: lesion regression of 90% or more; effective: lesion regression of 60%-89%; effective: lesion regression of 30%-59%; ineffective: lesion regression of less than 30% or aggravation.
2.Results
2.1 Treatment results: 60 patients were observed after 4 times of treatment, 14 cases were basically cured, 26 cases were effective, 20 cases were effective, and 0 cases were invalid, with a total effective rate of 66.67%. See Table 1.
2.2 Adverse effects: The patients tolerated the treatment process, among which 2 cases showed slight facial redness after treatment and 3 cases showed dry skin, which lasted for several hours to several days and resolved on their own;
3. Discussion
Acne vulgaris is a chronic inflammatory skin disease of the sebaceous glands of hair follicles, which often occurs on the face and chest and back. Its pathogenesis is mainly due to the increase of sebaceous glands under the influence of androgens. Currently, the systematic application of retinoic acid or antibiotics for the treatment of acne is associated with many adverse reactions. In addition, the resistance of Propionibacterium acnes to antibiotics has increased, adding to the difficulty of acne treatment, and the application of E light for acne treatment is a new therapy.
E light technology is a new treatment technology that combines IntensePulsedLight (IPL) with bipolar radiofrequency energy (RF) on the basis of traditional photons, using the selective absorption of light energy by the skin to cause the difference in impedance between the target tissue and normal skin, and strengthening the absorption of RF energy by the target tissue under the condition of lower light energy intensity, which greatly eliminates the side effects and discomfort that may be caused by the excessive heat of light energy. E light uses IPL visible light to act on the endogenous porphyrins of the metabolites of Propionibacterium acnes, releasing monomorphic (or free) oxygen ions, while the thermal effect of the treatment instrument causes more oxygen to enter the pores, and the growth of Propionibacterium acnes is inhibited in the aerobic environment, and monomorphic oxygen can also effectively kill Propionibacterium acnes, which, together with the photothermal effect, promotes the absorption and reduction of inflammation [4].
Intense pulsed light penetrates the skin and is absorbed by hemoglobin, and the heat energy is transmitted to the blood vessel wall, causing damage to the blood vessels and the formation of thrombi, which are finally absorbed and subside. It also increases skin elasticity, refines pores, reduces sebaceous gland secretion, reduces facial greasiness, and decreases the recurrence rate of acne. e light is effective for purulent, inflammatory, and cystic acne with no significant adverse effects [4].
In conclusion, E light is more effective in treating common facial acne with fewer adverse effects, and is worthy of clinical application.