Medical Devices in the Treatment of Acne

Acne is the most common skin disease in the United States. Approximately 25% of all visits to a dermatologist are for acne. Since the introduction of Accutane in 1982, there have not been significant advances in the treatment of acne. Various topical and systemic antibiotics have been released in new formulations or new pill sizes, and various topical agents have been released in combinations or in new bases with claims that these were significant improvements. Nothing dramatic has been evident.

There have been multiple medical devices that have been claimed to be effective in treating acne. Among these are blue light and Levulan, a photosensitizer. This chemical has also been combined with the intense pulsed light and the pulsed dye laser in the treatment of acne. The studies do show that this treatment is effective in producing good improvement, but it has not become a first line treatment. Part of the problem is that the treatment is relatively expensive and insurance does not cover it. Another part of the problem is that the treatment does not produce the dramatic improvement that is seen with a drug like Accutane.
Various lasers and perhaps lights, used alone, have also been shown to benefit acne. In the current issue of Dermatologic Surgery there is a report of using a diode laser to treat resistant acne. Several treatments were given and there was moderate improvement in some individuals, but not total clearing. The results persisted three or more months in some. The authors suggest that this treatment may be useful in individuals who want less medical therapy. Other lasers, such as the pulsed dye laser, have produced similar results. In our practice we have been able to use the Medlite C6 laser as an adjunctive treatment for acne. We have managed to keep the cost reasonable, since the treatment does not require the use of aditional expensive chemicals.

Although new devices continue to be introduced, there is no word of a potential home run on the horizon.

Gerald N. Bock MD
California Skin & Laser Center
Stockton & Lodi, CA