Research Article of American Journal of Dermatological Research and Reviews
The Effectiveness of Pulsed Dye Laser in Management of Acne Vulgaris: A Systematic review and meta-analysis
Maya Rahmanita*1, Retno Indar Widayati1, Puguh Riyanto1, Asih Budiastuti1, Diah Adriani Malik1, Muslimin1, Hardian2
1Departement of Dermatovenereology, Faculty of Medicine, Diponegoro University / Dr. Kariadi Hospital, Dr. Sutomo street No. 16 Semarang-Indonesia.2Department of Physiology, Faculty of Medicine, Diponegoro University.
Background: Acne vulgaris is one of the most prevalent skin diseases, affecting up to 85% of teenagers and young adults. Multiple treatment options including topical, systemic or physical therapies. However, the effects of conventional therapies are limited due to antibi-otic resistance and adverse effects such as irritation and teratogenicity of isotretinoin. Light-based therapy is an alternative and/or adjuvant therapy in patients who cannot tolerate or unresponsive to conventional therapies that may provide fewer side effects, patient com-fort, fast onset of action, and with equal or greater effectiveness. We aimed to assess the effectiveness of using Pulsed Dye Laser as a treatment option for acne vulgaris. A systemat-ic Review and Meta-analysis was peformed of randomized clinical trials assessing the ef-fectiveness of Pulsed Dye Laser in management of acne vulgaris.
Methods: Medline Pubmed, Scopus, Cochrane library, the reference list, conference pro-ceedings, researchers in field of eligible studies were searched. Eight studies (n=275 sub-jects) were included in qualitative analysis of which six studies (n=190 subjects) were in-cluded in meta-analysis. The mean age of the participant was 21,94 years old. Intervention using application of Pulsed dye laser as monotherapy or combination in acne vulgaris pa-tients with follow-up at least 12 weeks. and the outcomes is a decrease mean of acne vul-garis lesions counts after received pulsed dye laser therapy.
Results: Pooling of data using random effects model showed that the group that received PDL therapy alone or in combination had a lower number of acne lesions than the control group with the mean difference was -0.593 (95% CI = -1.290 to 0.104), the z value was -1.668 with p = 0.095. This shows that the number of lesions in the group that received sin-gle or combined PDL therapy was lower than the control group. However the difference is insignificant.
Conclusion. From the results of the systematic review conducted, it can be concluded that in the group given Pulsed Dye Laser therapy there was a decrease in the total number of acne vulgaris lesions compared to before treatment, and the decrease, which was indicated by the difference in the mean number of acne lesions, was significantly greater compared to the control who was only given placebo. Pulsed Dye Laser therapy can be an alternative treatment option for acne vulgaris in patients who are unresponsive to previous treatment or conditions where there are contraindications to systemic therapy.
Keywords: pulsed dye laser; acne vulgaris
How to cite this article:
Maya Rahmanita, Retno Indar Widayati, Puguh Riyanto, Asih Budiastuti, Diah Adriani Malik, Muslimin,Hardian. The Effectiveness of Pulsed Dye Laser in Management of Acne Vulgaris: A Systematic review and meta-analysis. American Journal of Dermatological Research and Reviews, 2021, 4:41. DOI: 10.28933/ajodrr-2021-04-0205
1. Susanto S. Epidemiologi Akne Vulgaris. In: Seminar dan Workshop Penanganan Akne Vulgaris. Semarang.
2. KSDKI. Pedoman Tata Laksana Akne di Indonesia. edisi 2nd. Wasitaatmadja SM, Arimuko A, Norawati L, Bernadette I, Legiawati L, editors. Jakarta: KSDKI; 2016.
3. Carolyn Goh, Carol Cheng, George Agak, Andrea L Zaenglein, Emmy M Graber, Diane M Thiboutot JK. Acne Vulgaris. In: Kang S, Amagai M, Bruckner AL, Enk AH, Margolis DJ, McMichael AJ, et al., editors. Fitzpatrick’s Dermatology. 9th ed. new york: McGraw Hill; 2019. p. 1391–412.
4. Bernadette I. Patogenesis Akne Vulgaris. In: Wasitaatmadja SM, editor. Akne. Jakarta: FK UI; 2018. p. 1–6.
5. Group W, Zaenglein AL, Pathy AL. Guidelines of care for the management of acne vulgaris. J Am Dermatology. 2007;56:651–63.
6. Thiboutot D, Gollnick H, Alliance G, Diane M, Finlay A, et al. New insights into the management of acne : An update from the Global Alliance to Improve Outcomes in Acne Group. J Am Acad Dermatol. 2009;60(5).
7. Fox L, Csongradi C, Aucamp M, Du Plessis J, Gerber M. Treatment modalities for acne. Molecules. 2016;21(8):1–20.
8. Orringer JS, Kang S, Hamilton T, Schumacher W, Cho S, Hammerberg C, et al. Treatment of Acne Vulgaris With a Pulsed Dye Laser. Am Med Assoc. 2004;291(23).
9. Seaton ED, Charakida A, Mouser PE, Grace I, Clement RM, Chu AC. Pulsed-dye laser treatment for inflammatory acne vulgaris : randomised controlled trial. Lancet. 2003;362:1347–52.
10. Leheta TM. Role of the 585-nm pulsed dye laser in the treatment of acne in comparison with other topical therapeutic modalities. J Cosmet Laser Ther. 2009;11(2):118–24.
11. Mohamed M, Samy NA, Salem AE. Comparison of pulsed dye laser versus combined pulsed dye laser and Nd : YAG laser in the treatment of inflammatory Acne Vulgaris. Jon Cosmet Laser Ther. 2016;4172(December).
12. Moher D, Liberati A, Tetzlaff J, Altman DG, Altman D, Antes G, et al. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Med. 2009;6(7).
13. Higgins J TJ. Collecting data – form for RCTs only. In: Higgins J TJ, editor. Cochrane Handbook for Systematic Reviews of Interventions Version 510 [Internet] [Internet]. The Cochrane Collaboration; 2011. Available from: https://training.cochrane.org/data-collection-form-rcts
14. Higgins JPT, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011;343(7829):1–9.
15. Suva MA, Patel AM, Sharma N. A Brief Review on Acne Vulgaris : Pathogenesis , Diagnosis and Treatment. STM Journals. 2016;4 (3)(January 2015).
16. Rajabi-Estarabadi A, Eber AE, Nouri K.Laser and light therapies for acne. Lasers dermatology Med dermatologic Appl. 2018;227–36.
17. Liu A, Moy RL, Victor Ross E, Hamzavi I, Ozog DM. Pulsed dye laser and pulsed dye laser-mediated photodynamic therapy in the treatment of dermatologic disorders. Dermatologic Surg. 2012;38(3):351–66.
18. Forbat E, Al-Niaimi F. Nonvascular uses of pulsed dye laser in clinical dermatology. J Cosmet Dermatol. 2019;18(5):1186–201.
19. Karsai S, Roos S, Hammes S, Raulin C. Pulsed dye laser: What’s new in non-vascular lesions? J Eur Acad Dermatology Venereol. 2007;21(7):877–90.
20. Pei S, Inamadar AC, Adya KA, Tsoukas MM. Light ‑ based therapies in acne treatment. Indian Dermatol Online J. 2015;6(3):145–58.
21. Orringer JS, Sachs DL, Bailey E, Kang S, Hamilton T, Voorhees JJ. Photodynamic therapy for acne vulgaris: A randomized, controlled, split-face clinical trial of topical aminolevulinic acid and pulsed dye laser therapy. J Cosmet Dermatol. 2010;9(1):28–34.
22. Voravutinon N, Rojanamatin J, Sadhwani D, Iyengar S, Alam M. A comparative split-face study using different mild purpuric and subpurpuric fluence level of 595-nm pulsed-dye laser for treatment of moderate to severe acne vulgaris. Dermatologic Surg. 2016;42(3):403–9.
23. Harto A, García-Morales I, Beldar P, Jaén P. Pulsed Dye Laser Treatment of Acne. Study of Clinical Efficacy and Mechanism of Action. Actas Dermo-Sifiliográficas (English Ed [Internet]. 2007;98(6):415–9.
24. García-Morales I, Harto A, Fernández-Guarino M, Jaén P. Photodynamic therapy for acne: Use of the pulsed dye laser and methylaminolevulinate. Actas Dermosifiliogr [Internet]. 2010;101(9):758–70.
25. Soliman M, Salah M, Fadel M, Nasr M, El-Azab H. Contrasting the efficacy of pulsed dye laser and photodynamic methylene blue nanoemulgel therapy in treating acne vulgaris. Arch Dermatol Res [Internet]. 2020;(0123456789).
26. Wafaa H. Borhan HAH and NHA. Efficacy of Pulsed Dye Laser on Acne Vulgaris. Implement Sci. 2014;10(3):67–73.
This work and its PDF file(s) are licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.