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Early acne scar intervention with 1064 nm picosecond laser in patients receiving oral isotretinoin: a randomized split-face controlled pilot study

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Abstract

Early acne scar intervention is important. Oral isotretinoin is widely used in patients with moderate to severe acne. Picosecond laser has shown a promising effect on scar clearance. However, there is a lack of reports on the efficacy and safety of early acne scar management by using 1064-nm picosecond laser in patients receiving low-dose oral isotretinoin. Twenty-four patients with atrophic acne scars of Fitzpatrick skin type III to V were enrolled. All patients were receiving low-dose oral isotretinoin (0.12–0.22 mg/kg/day) during the treatment. The face of the participants was randomly assigned to receive 2 sessions of fractional picosecond 1064 nm Nd: YAG laser (FxPico) treatment and 2 follow-ups, with an interval of 1 month (month 0–3). Clinical efficacy and safety were assessed by photographs, ECCA grading scale, the number of scar lesions melanin and erythema indexes (MI and EI), TEWL, DLQI, and patient satisfaction and the adverse events were recorded on every visit. FxPico significantly decreased the ECCA score and showed higher improvement in the ECCA score. FxPico treated side achieved a significant reduction in all acne scar types, while only boxcar scars and rolling scars showed higher improvement. TEWL but not MI or EI were significantly improved. DLQI and patient satisfaction were higher with the FxPico-treated side than control side. No adverse effects were observed and all the side effects observed were temporary and tolerable. Early intervention by FxPico on patients receiving low-dose oral isotretinoin is a safe and effective modality to improve atrophic acne scars.

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Data Availability

All data generated or analyzed during this study are included in this article. Further inquiries can be directed to the corresponding author.

Abbreviations

DLQI:

Questionnaire of Dermatology Life Quality Index

ECCA grading scale:

Échelle d’évaluation clinique des cicatrices d’acné

EI:

Erythema index

FxPico:

Fractional picosecond 1064 nm Nd: YAG laser

GAGS:

Global acne grading system

LIOB:

Laser-induced optical breakdown

MI:

Melanin index

PIH:

Post-inflammatory hyperpigmentation

TEWL:

Transepidermal water loss

VAS:

Visual analogue scale

References

  1. Connolly D, Vu HL, Mariwalla K, Saedi N (2017) Acne scarring-pathogenesis, evaluation, and treatment options. J Clin Aesthet Dermatol 10:12–23

    PubMed  PubMed Central  Google Scholar 

  2. Cohen BE, Brauer JA, Geronemus RG (2016) Acne scarring: a review of available therapeutic lasers. Lasers Surg Med 48:95–115. https://doi.org/10.1002/lsm.22410

    Article  PubMed  Google Scholar 

  3. Fabbrocini G, Annunziata MC, D'Arco V, De Vita V, Lodi G, Mauriello MC, Pastore F, Monfrecola G (2010) Acne scars: pathogenesis, classification and treatment. Dermatol Res Pract 2010:893080. https://doi.org/10.1155/2010/893080

  4. Tanghetti EA (2016) The histology of skin treated with a picosecond alexandrite laser and a fractional lens array. Lasers Surg Med 48:646–652. https://doi.org/10.1002/lsm.22540

    Article  PubMed  Google Scholar 

  5. Graber EM, Tanzi EL, Alster TS (2008) Side effects and complications of fractional laser photothermolysis: experience with 961 treatments. Dermatol Surg 34:301–5. https://doi.org/10.1111/j.1524-4725.2007.34062.x. (discussion 305-7)

    Article  CAS  PubMed  Google Scholar 

  6. Wu DC, Goldman MP, Wat H, Chan HHL (2021) A systematic review of picosecond laser in dermatology: evidence and recommendations. Lasers Surg Med 53:9–49. https://doi.org/10.1002/lsm.23244

    Article  PubMed  Google Scholar 

  7. Bernstein EF, Schomacker KT, Basilavecchio LD, Plugis JM, Bhawalkar JD (2017) Treatment of acne scarring with a novel fractionated, dual-wavelength, picosecond-domain laser incorporating a novel holographic beam-splitter. Lasers Surg Med 49:796–802. https://doi.org/10.1002/lsm.22734

    Article  PubMed  PubMed Central  Google Scholar 

  8. Brauer JA, Kazlouskaya V, Alabdulrazzaq H, Bae YS, Bernstein LJ, Anolik R, Heller PA, Geronemus RG (2015) Use of a picosecond pulse duration laser with specialized optic for treatment of facial acne scarring. JAMA Dermatol 151:278–284. https://doi.org/10.1001/jamadermatol.2014.3045

    Article  PubMed  Google Scholar 

  9. Chayavichitsilp P, Limtong P, Triyangkulsri K, Pratumchart N (2020) Comparison of fractional neodymium-doped yttrium aluminum garnet (Nd:YAG) 1064-nm picosecond laser and fractional 1550-nm erbium fiber laser in facial acne scar treatment. Lasers Med Sci 35:695–700. https://doi.org/10.1007/s10103-019-02891-5

    Article  PubMed  Google Scholar 

  10. Dai YX, Chuang YY, Chen PY, Chen CC (2020) Efficacy and safety of ablative resurfacing with a high-energy 1,064 Nd-YAG picosecond-domain laser for the treatment of facial acne scars in Asians. Lasers Surg Med 52:389–395. https://doi.org/10.1002/lsm.23151

    Article  PubMed  Google Scholar 

  11. Haimovic A, Brauer JA, Cindy Bae YS, Geronemus RG (2016) Safety of a picosecond laser with diffractive lens array (DLA) in the treatment of Fitzpatrick skin types IV to VI: a retrospective review. J Am Acad Dermatol 74:931–936. https://doi.org/10.1016/j.jaad.2015.12.010

    Article  PubMed  Google Scholar 

  12. Manuskiatti W, Punyaratabandhu P, Tantrapornpong P, Yan C, Cembrano KAG (2021) Objective and long-term evaluation of the efficacy and safety of a 1064-nm picosecond laser with fractionated microlens array for the treatment of atrophic acne scar in Asians. Lasers Surg Med 53:899–905. https://doi.org/10.1002/lsm.23368

    Article  PubMed  Google Scholar 

  13. Bernestein LJ, Geronemus RG (1997) Keloid formation with the 585-nm pulsed dye laser during isotretinoin treatment. Arch Dermatol 133:111–112

    Article  CAS  PubMed  Google Scholar 

  14. Kar BR, Tripathy S, Panda M (2013) Comparative study of oral isotretinoin versus oral isotretinoin + 20% salicylic acid peel in the treatment of active acne. J Cutan Aesthet Surg 6:204–208. https://doi.org/10.4103/0974-2077.123403

    Article  PubMed  PubMed Central  Google Scholar 

  15. Spring LK, Krakowski AC, Alam M, Bhatia A, Brauer J, Cohen J, Del Rosso JQ, Diaz L, Dover J, Eichenfield LF, Gurtner GC, Hanke CW, Jahnke MN, Kelly KM, Khetarpal S, Kinney MA, Levy ML, Leyden J, Longaker MT, Munavalli GS, Ozog DM, Prather H, Shumaker PR, Tanzi E, Torres A, Velez MW, Waldman AB, Yan AC, Zaenglein AL (2017) Isotretinoin and timing of procedural interventions: a systematic review with consensus recommendations. JAMA Dermatol 153:802–809. https://doi.org/10.1001/jamadermatol.2017.2077

    Article  PubMed  Google Scholar 

  16. Goldsmith LA, Bolognia JL, Callen JP, Chen SC, Feldman SR, Lim HW, Lucky AW, Reed BR, Siegfried EC, Thiboutot DM, Wheeland RG (2004) American Academy of Dermatology Consensus Conference on the safe and optimal use of isotretinoin: summary and recommendations. J Am Acad Dermatol 50:900–6. https://doi.org/10.1016/j.jaad.2004.02.012

  17. Saluja SS, Walker ML, Summers EM, Tristani-Firouzi P, Smart DR (2017) Safety of non-ablative fractional laser for acne scars within 1 month after treatment with oral isotretinoin: a randomized split-face controlled trial. Lasers Surg Med 49:886–890. https://doi.org/10.1002/lsm.22711

    Article  PubMed  Google Scholar 

  18. Gold MH, Manturova NE, Kruglova LS, Ikonnikova EV (2020) Treatment of moderate to severe acne and scars with a 650-microsecond 1064-nm laser and isotretinoin. J Drugs Dermatol 19:646–651. https://doi.org/10.36849/JDD.2020.M5108

  19. Kim HW, Chang SE, Kim JE, Ko JY, Ro YS (2014) The safe delivery of fractional ablative carbon dioxide laser treatment for acne scars in Asian patients receiving oral isotretinoin. Dermatol Surg 40:1361–1366. https://doi.org/10.1097/DSS.0000000000000185

    Article  CAS  PubMed  Google Scholar 

  20. Yoon JH, Park EJ, Kwon IH, Kim CW, Lee GS, Hann SK, Kim KH, Kim KJ (2014) Concomitant use of an infrared fractional laser with low-dose isotretinoin for the treatment of acne and acne scars. J Dermatolog Treat 25:142–146. https://doi.org/10.3109/09546634.2013.768758

    Article  CAS  PubMed  Google Scholar 

  21. Chandrashekar BS, Varsha DV, Vasanth V, Jagadish P, Madura C, Rajashekar ML (2014) Safety of performing invasive acne scar treatment and laser hair removal in patients on oral isotretinoin: a retrospective study of 110 patients. Int J Dermatol 53:1281–1285. https://doi.org/10.1111/ijd.12544

    Article  CAS  PubMed  Google Scholar 

  22. Li Y, Zhu J, Zhang Y, Liu X, Ye J (2021) Isotretinoin plus 420 nm intense pulsed light versus isotretinoin alone for the treatment of acne vulgaris: a randomized, controlled study of efficacy, safety, and patient satisfaction in Chinese subjects. Lasers Med Sci 36:657–665. https://doi.org/10.1007/s10103-020-03113-z

    Article  PubMed  Google Scholar 

  23. Xia J, Hu GL, Hu D, Geng SM, Zeng WH (2018) Concomitant use of 1,550-nm nonablative fractional laser with low-dose isotretinoin for the treatment of acne vulgaris in Asian patients: a randomized split-face controlled study. Dermatol Surg 44:1201–1208. https://doi.org/10.1097/Dss.0000000000001546

    Article  CAS  PubMed  Google Scholar 

  24. Ye D, Xue H, Huang S, He S, Li Y, Liu J, Wang Z, Zeng W (2022) A prospective, randomized, split-face study of concomitant administration of low-dose oral isotretinoin with 30% salicylic acid chemical peeling for the treatment of acne vulgaris in Asian population. Int J Dermatol. https://doi.org/10.1111/ijd.16127

    Article  PubMed  Google Scholar 

  25. Karmisholt KE, Haerskjold A, Karlsmark T, Waibel J, Paasch U, Haedersdal M (2018) Early laser intervention to reduce scar formation - a systematic review. J Eur Acad Dermatol Venereol 32:1099–1110. https://doi.org/10.1111/jdv.14856

    Article  CAS  PubMed  Google Scholar 

  26. Finlay AY, Khan GK (1994) Dermatology Life Quality Index (DLQI)–a simple practical measure for routine clinical use. Clin Exp Dermatol 19:210–216. https://doi.org/10.1111/j.1365-2230.1994.tb01167.x

    Article  CAS  PubMed  Google Scholar 

  27. Sadeghzadeh-Bazargan A, Ghassemi M, Goodarzi A, Roohaninasab M, Najar Nobari N, Behrangi E (2021) Systematic review of low-dose isotretinoin for treatment of acne vulgaris: focus on indication, dosage, regimen, efficacy, safety, satisfaction, and follow up, based on clinical studies. Dermatol Ther 34:e14438. https://doi.org/10.1111/dth.14438

  28. Dessinioti C, Zouboulis CC, Bettoli V, Rigopoulos D (2020) Comparison of guidelines and consensus articles on the management of patients with acne with oral isotretinoin. J Eur Acad Dermatol Venereol 34:2229–2240. https://doi.org/10.1111/jdv.16430

    Article  CAS  PubMed  Google Scholar 

  29. Zachariae H (1988) Delayed wound healing and keloid formation following argon laser treatment or dermabrasion during isotretinoin treatment. Br J Dermatol 118:703–706. https://doi.org/10.1111/j.1365-2133.1988.tb02574.x

    Article  CAS  PubMed  Google Scholar 

  30. Li Y, Xia J, Zhu Y, He S, Liu J, Zeng W, Wang Z (2022) Efficacy and safety of low-level light therapy by delicate pulsed light combined with low-dose oral isotretinoin for the treatment of acne vulgaris: a randomized split-face study. Lasers Med Sci 37:3221–3229. https://doi.org/10.1007/s10103-022-03606-z

    Article  PubMed  Google Scholar 

  31. Ye D, Xue H, Huang S, He S, Li Y, Liu J, Wang Z, Zeng W (2022) A prospective, randomized, split-face study of concomitant administration of low-dose oral isotretinoin with 30% salicylic acid chemical peeling for the treatment of acne vulgaris in Asian population. Int J Dermatol 61:698–706. https://doi.org/10.1111/ijd.16127

    Article  CAS  PubMed  Google Scholar 

  32. Mirza FN, Mirza HN, Khatri KA (2020) Concomitant use of isotretinoin and lasers with implications for future guidelines: an updated systematic review. Dermatol Ther 33:e14022. https://doi.org/10.1111/dth.14022

    Article  PubMed  Google Scholar 

  33. Dallon JC, Sherratt JA, Maini PK (2001) Modeling the effects of transforming growth factor-beta on extracellular matrix alignment in dermal wound repair. Wound Repair Regen 9:278–286. https://doi.org/10.1046/j.1524-475x.2001.00278.x

    Article  CAS  PubMed  Google Scholar 

  34. Helbig D, Bodendorf MO, Grunewald S, Kendler M, Simon JC, Paasch U (2009) Immunohistochemical investigation of wound healing in response to fractional photothermolysis. J Biomed Opt 14:064044. https://doi.org/10.1117/1.3275479

    Article  CAS  PubMed  Google Scholar 

  35. Helbig D, Mobius A, Simon JC, Paasch U (2011) Heat shock protein 70 expression patterns in dermal explants in response to ablative fractional phothothermolysis, microneedle, or scalpel wounding. Wounds 23:59–67

    PubMed  Google Scholar 

  36. Helbig D, Moebius A, Simon JC, Paasch U (2010) Nonablative skin rejuvenation devices and the role of heat shock protein 70: results of a human skin explant model. J Biomed Opt 15:038002. https://doi.org/10.1117/1.3449736

    Article  CAS  PubMed  Google Scholar 

  37. Orringer JS, Rittie L, Baker D, Voorhees JJ, Fisher G (2010) Molecular mechanisms of nonablative fractionated laser resurfacing. Br J Dermatol 163:757–768. https://doi.org/10.1111/j.1365-2133.2010.09998.x

    Article  CAS  PubMed  Google Scholar 

  38. Paasch U, Sonja G, Haedersdal M (2014) Synergistic skin heat shock protein expression in response to combined laser treatment with a diode laser and ablative fractional lasers. Int J Hyperthermia 30:245–249. https://doi.org/10.3109/02656736.2014.925590

    Article  CAS  PubMed  Google Scholar 

  39. Park KY, Oh IY, Seo SJ, Kang KH, Park SJ (2013) Appropriate timing for thyroidectomy scar treatment using a 1,550-nm fractional erbium-glass laser. Dermatol Surg 39:1827–1834. https://doi.org/10.1111/dsu.12355

    Article  CAS  PubMed  Google Scholar 

  40. Qu Y, Wang L, Zhou P, Zhang W (2020) Efficient picosecond laser for tattoo removal in rat models. Med Sci Monit 26:e924583. https://doi.org/10.12659/MSM.924583

    Article  PubMed  PubMed Central  Google Scholar 

  41. Sirithanabadeekul P, Tantrapornpong P, Rattakul B, Sutthipisal N, Thanasarnaksorn W (2021) Comparison of fractional picosecond 1064-nm laser and fractional carbon dioxide laser for treating atrophic acne scars: a randomized split-face trial. Dermatol Surg 47:e58–e65. https://doi.org/10.1097/DSS.0000000000002572

    Article  CAS  PubMed  Google Scholar 

  42. Zhang M, Huang Y, Wu Q, Lin T, Gong X, Chen H, Wang Y (2021) Comparison of 1064-nm and dual-wavelength (532/1064-nm) picosecond-domain Nd:YAG lasers in the treatment of facial photoaging: a randomized controlled split-face study. Lasers Surg Med 53:1158–1165. https://doi.org/10.1002/lsm.23404

    Article  PubMed  Google Scholar 

  43. Feng H, Wu Y, Jiang M, Luo X, Yan S, Lu Z (2021) The efficacy and safety of fractional 1064 nm Nd:YAG picosecond laser combined with intense pulsed light in the treatment of atrophic acne scar: a split-face study. Lasers Surg Med 53:1356–1363. https://doi.org/10.1002/lsm.23428

    Article  PubMed  Google Scholar 

  44. Choi YJ, Kim JY, Nam JH, Lee GY, Kim WS (2019) Clinical outcome of 1064-nm picosecond neodymium-doped yttrium aluminium garnet laser for the treatment of hypertrophic scars. J Cosmet Laser Ther 21:91–98. https://doi.org/10.1080/14764172.2018.1469768

    Article  PubMed  Google Scholar 

  45. Guida S, Pellacani G, Bencini PL (2019) Picosecond laser treatment of atrophic and hypertrophic surgical scars: in vivo monitoring of results by means of 3D imaging and reflectance confocal microscopy. Skin Res Technol 25:896–902. https://doi.org/10.1111/srt.12755

    Article  PubMed  Google Scholar 

  46. Koren A, Niv R, Cohen S, Artzi O (2019) A 1064-nm neodymium-doped yttrium aluminum garnet picosecond laser for the treatment of hyperpigmented scars. Dermatol Surg 45:725–729. https://doi.org/10.1097/DSS.0000000000001917

    Article  CAS  PubMed  Google Scholar 

  47. Kwon HH, Yang SH, Cho YJ, Shin E, Choi M, Bae Y, Jung JY, Park GH (2020) Comparison of a 1064-nm neodymium-doped yttrium aluminum garnet picosecond laser using a diffractive optical element vs. a nonablative 1550-nm erbium-glass laser for the treatment of facial acne scarring in Asian patients: a 17-week prospective, randomized, split-face, controlled trial. J Eur Acad Dermatol Venereol 34:2907–2913. https://doi.org/10.1111/jdv.16643

    Article  CAS  PubMed  Google Scholar 

  48. Goodman GJ (2001) Post-acne scarring: a short review of its pathophysiology. Australas J Dermatol 42:84–90. https://doi.org/10.1046/j.1440-0960.2001.00487.x

    Article  CAS  PubMed  Google Scholar 

  49. Coates P, Adams CA, Cunliffe WJ, McGinley KT, Eady EA, Leyden JJ, Ravenscroft J, Vyakrnam S, Vowels B (1997) Does oral isotretinoin prevent Propionibacterium acnes resistance? Dermatology 195(Suppl 1):4–9. https://doi.org/10.1159/000246012. (discussion 38-40)

    Article  PubMed  Google Scholar 

  50. Falcon RH, Lee WL, Shalita AR, Suntharalingam K, Fikrig SM (1986) In vitro effect of isotretinoin on monocyte chemotaxis. J Invest Dermatol 86:550–552. https://doi.org/10.1111/1523-1747.ep12355006

    Article  CAS  PubMed  Google Scholar 

  51. Skroza N, Tolino E, Balduzzi V, Bernardini N, Mambrin A, Marchesiello A, Marraffa F, Rossi G, Volpe S, Proietti I, Potenza C (2021) Advantages of tailored isotretinoin treatment in moderate to severe acne: real-life data. Front Pharmacol 12:733526. https://doi.org/10.3389/fphar.2021.733526

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. Dispenza MC, Wolpert EB, Gilliland KL, Dai JP, Cong Z, Nelson AM, Thiboutot DM (2012) Systemic isotretinoin therapy normalizes exaggerated TLR-2-mediated innate immune responses in acne patients. J Invest Dermatol 132:2198–2205. https://doi.org/10.1038/jid.2012.111

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Profyris C, Tziotzios C, Do Vale I (2012) Cutaneous scarring: pathophysiology, molecular mechanisms, and scar reduction therapeutics Part I. The molecular basis of scar formation. J Am Acad Dermatol 66:1–10. https://doi.org/10.1016/j.jaad.2011.05.055. (quiz 11-2)

    Article  CAS  PubMed  Google Scholar 

  54. Zaleski-Larsen LA, Jones IT, Guiha I, Wu DC, Goldman MP (2018) A comparison study of the nonablative fractional 1565-nm Er: glass and the picosecond fractional 1064/532-nm Nd: YAG lasers in the treatment of striae alba: a split body double-blinded trial. Dermatol Surg 44:1311–1316. https://doi.org/10.1097/dss.0000000000001555

    Article  CAS  PubMed  Google Scholar 

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Funding

This work was funded by the National Natural Science Foundation of China (NSFC) (81172590) and Natural Science Basic Research Program of Shaanxi (2020SF-178) to Weihui Zeng; NSFC (82003325) to Jing Liu; and National Natural Science Foundation of China (NSFC) (82201966) to Zhao Wang.

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Authors and Affiliations

  1. Department of Dermatology, the Second Affiliated Hospital of Xi’an Jiaotong University, 157 Xiwu Road, Xi’an, 710004, China

    Huan Xue, Dan Ye, Shi-Liu Huang, Shu-Juan He, Jing Liu, You-Bao Li, Guang-Lei Hu, Die Hu, Zhao Wang & Wei-Hui Zeng

  2. Department of Burn and Plastic Surgery, Shaanxi Provincial People’s Hospital, Xi’an, China

    Sheng-Zhi Mu

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  1. Huan Xue
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Contributions

Design: ZWH; experiments: XH, YD, HSL, HSJ, LJ, MSZ, LYB, HGL, HD; data analysis/writing: XH, WZ; manuscript revision: WZ, ZWH; supervision: ZWH, WZ; funding acquisition: ZWH. All authors approved this final version.

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Correspondence to Zhao Wang or Wei-Hui Zeng.

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Xue, H., Ye, D., Huang, SL. et al. Early acne scar intervention with 1064 nm picosecond laser in patients receiving oral isotretinoin: a randomized split-face controlled pilot study. Lasers Med Sci 38, 40 (2023). https://doi.org/10.1007/s10103-022-03702-0

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