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Investigation of the mechanism of action of nonablative pulsed‐dye laser therapy in photorejuvenation and inflammatory acne vulgaris
Author(s) -
Seaton E.D.,
Mouser P.E.,
Charakida A.,
Alam S.,
Seldon P.E.,
Chu A.C.
Publication year - 2006
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/j.1365-2133.2006.07429.x
Subject(s) - propionibacterium acnes , acne , cytokine , medicine , dermatology , inflammation , keratinocyte , scars , chemistry , immunology , pathology , in vitro , biochemistry
Summary Background Nonablative lasers are widely used for treatment of wrinkles, atrophic scars and acne. These lasers stimulate dermal remodelling and collagen production, but the early molecular stimulus for this is unknown. The mechanism of nonablative lasers in inflammatory acne is variously suggested to be damage either to sebaceous glands or to Propionibacterium acnes . Their effects on cytokine production are unknown. Objectives To assess the in vivo effects of a short pulse duration nonablative pulsed‐dye laser (NA‐PDL) previously used for photorejuvenation and treatment of acne, on cytokine production, P. acnes colonization density and sebum excretion rate (SER). Methods We examined the effect of NA‐PDL (NliteV ® ; Chromogenex Light Technologies, Llanelli, U.K.) on P. acnes colonization before and after laser therapy using a scrub‐wash technique and culture at 0 and 24 h ( n = 15), on SER using absorptive tape at 0, 2, 4, 8 and 12 weeks ( n = 19) and on cytokine mRNA using reverse transcription–polymerase chain reaction from skin biopsies at 0, 3 and 24 h ( n = 8). Results NA‐PDL had no effect on P. acnes or SER. Transforming growth factor (TGF)‐ β 1 mRNA increased fivefold after 24 h and 15‐fold in two subjects ( P = 0·012). Conclusions TGF‐ β is known to be a potent stimulus for neocollagenesis and a pivotal immunosuppressive cytokine which promotes inflammation resolution. Its upregulation by NA‐PDL provides a possible unifying molecular mechanism linking stimulation of dermal remodelling in photorejuvenation with inhibition of inflammation in acne. Damage to P. acnes or sebaceous glands cannot explain the effect of this device in acne.