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Efficacy and safety of lasers versus topical medications for acanthosis nigricans and pseudo-acanthosis nigricans treatment: a systematic review

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Abstract

Acanthosis nigricans (AN) is a cutaneous disorder identified by well-defined pigmented plaques mostly detected on skin folds. Timely diagnosis and treatment of AN is essential as it could be an early manifestation of an underlying condition. The treatment of choice for AN has not been determined yet. Our study aimed to compare the efficacy and safety of various lasers with topical medications, including cream and peel. PubMed, Scopus, and Web of Science databases, as well as the Google Scholar search engine, were thoroughly searched until May 1st, 2023. Study selection was restricted to clinical trials published in English language comparing lasers with topical treatments. This study followed the PRISMA guidelines for systematic reviews and meta-analyses. Out of 1748 studies, Six clinical trials met our inclusion criteria, with 133 patients. We examined laser therapies, including fractional CO2 laser, 1550-nm erbium fiber laser, and long-pulsed alexandrite laser, while the topical treatments comprised glycolic acid (GA) peel, retinoic acid peel, trichloroacetic acid (TCA) peel, and tretinoin cream. In two studies, GA peel demonstrated favorable results compared to fractional CO2 laser. Besides, fractional CO2 laser exhibited efficacy, surpassing TCA peel in AN management. Additionally, a fractional 1550-nm erbium fiber laser displayed superiority over tretinoin cream in reducing average roughness. Similarly, a long-pulsed alexandrite laser demonstrated its effectiveness in axillary AN treatment compared to the combination of tretinoin and ammonium lactate. Overall, the findings revealed that laser therapy was associated with superior results. Moreover, topical treatments are safe and efficacious in AN management.

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Data availability

All data produced in the present study are available upon reasonable request to the authors.

Abbreviations

AN:

Acanthosis nigricans

ANASI:

Acanthosis nigricans area and severity index

CO2:

Carbon dioxide

GA:

Glycolic acid

IGF:

Insulin growth factor

KTP:

Potassium-titanyl-phosphate

MTZ:

Microthermal zones

PCOS:

Polycystic ovary syndrome

PIH:

Post-inflammatory hyperpigmentation

Qs Nd:

Q-switched neodymium-doped

TCA:

Trichloroacetic acid

YAG:

Yttrium aluminum garnet

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Acknowledgements

The authors would like to express their gratitude to the authorities of Rasool Akram Medical Complex Clinical Research Development Center (RCRDC) for their technical and editorial assistance.

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Author notes

  1. Yekta Ghane and Nazila Heidari contributed equally to this work and shared the first authorship.

Authors and Affiliations

  1. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

    Yekta Ghane & Homayoun Pishraft-sabet

  2. School of Medicine, Iran University of Medical Sciences, Tehran, Iran

    Nazila Heidari

  3. School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    SeyedAyin Hosseini

  4. Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran

    Amirhossein Heidari

  5. School of Medicine, Guilan University of Medical Sciences, Rasht, Iran

    Sara Eghbali

  6. Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Sattarkhan Avenue, Niayesh Street, Tehran, 1445613131, Iran

    Azadeh Goodarzi

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Contributions

Equal significant contributions to the current study are NH and YG in the design, database search, screening publications, bias assessment, literature review, and drafting of the manuscript. SaH, AH, and HPs in literature review and drafting the manuscript. SE in revising the manuscript critically. AG in drafting and revising the manuscript critically for the importance of intellectual content. All authors have read and approved the final version to be published and agreed to be accountable for all aspects of the work. All authors agreed on the order in which their names are listed in the manuscript.

Corresponding author

Correspondence to Azadeh Goodarzi.

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Ghane, Y., Heidari, N., Hosseini, S. et al. Efficacy and safety of lasers versus topical medications for acanthosis nigricans and pseudo-acanthosis nigricans treatment: a systematic review. Lasers Med Sci 39, 44 (2024). https://doi.org/10.1007/s10103-024-03986-4

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