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. 2022 May;12(5):1147-1156.
doi: 10.1007/s13555-022-00719-9. Epub 2022 Apr 12.

Intense Pulsed Light Therapy Improves Acne-Induced Post-inflammatory Erythema and Hyperpigmentation: A Retrospective Study in Chinese Patients

Xianglei Wu #  1 , Xue Wang #  2 , Xiujuan Wu #  3 , Qingqing Cen  4 , Wenjing Xi  4 , Ying Shang  1 , Zhen Zhang  2 , Xiaoxi Lin  5   6
Affiliations

Intense Pulsed Light Therapy Improves Acne-Induced Post-inflammatory Erythema and Hyperpigmentation: A Retrospective Study in Chinese Patients

Xianglei Wu et al. Dermatol Ther (Heidelb). 2022 May.

Abstract

Introduction: Post-inflammatory erythema (PIE) and post-inflammatory hyperpigmentation (PIH) are the most common acne-related sequelae with no effective treatments. By combining different cut-off filters, intense pulsed light (IPL) therapy can effectively treat these conditions with few side effects. While the safety and effectiveness of IPL for treating post-burn hyperpigmentation is well known, there is little evidence for its benefits for acne-related PIH. In this article, we evaluate the efficacy and safety of IPL for the treatment of acne-related PIE and PIH.

Methods: This retrospective study evaluated 60 patients with more than 6 months of PIE and PIH treated by the same IPL device and similar protocols. The treatment included three to seven sessions at 4-6-week intervals, and three cut-off filters (640 nm, 590 nm and 560 nm) were used sequentially in each session. Using the Global Aesthetic Improvement Scale (GAIS), Cardiff Acne Disability Index (CADI), and Erythema Assessment Scale (EAS), patients were evaluated on the basis of their facial photographs. The facial brown spots and red areas were visualised and analysed using the VISIA-CR system. Six months after the last treatment, the patients were assessed for acne relapse or any side effects.Please check and confirm that the authors and their respective affiliations have been correctly processed and amend if necessary.Checked and confirmed. No further corrections.

Results: On the basis of the GAIS, 49 of 60 patients (81.7%) showed complete or partial clearance of erythema and hyperpigmentation. The CADI and EAS scores showed significant improvement (p < 0.01) after IPL treatment compared with pre-treatment. A significant reduction (p < 0.01) in the facial brown spots and red areas was seen after IPL treatment. While no long-term side effects were reported, seven patients (11.7%) experienced acne relapse at follow-up.

Conclusion: IPL is an effective and safe treatment for acne-related PIE and PIH.

Keywords: Acne; Intense pulsed light; Post-inflammatory erythema; Post-inflammatory hyperpigmentation.

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Figures

Fig. 1
Fig. 1
Improvement of facial PIE and PIH. Photographs before (a, c) and after (b, d) IPL treatment show improvement in facial PIE and PIH. In addition, visual examination shows clearance of PIE and PIH, reduced acne lesions, and improvement in skin texture and tone. 1A, GAIS = 1, exceptional improvement; 1B, GAIS = 2, marked improvement; 1C, GAIS = 3; improvement. IPL intense pulsed light, PIE post-inflammatory erythema, PIH post-inflammatory hyperpigmentation, GAIS Global Aesthetic Improvement Scale
Fig. 2
Fig. 2
Changes in CADI and EAS scores following IPL treatment. The CADI (a) and EAS (b) scores before and after IPL treatment are shown. Since these scores did not conform to a normal distribution, the data are shown using median (IQR) and were compared using the Wilcoxon signed-rank test. **p < 0.01. IPL intense pulsed light, CADI Cardiff Acne Disability Index, EAS Erythema Assessment Scale
Fig. 3
Fig. 3
Representative VISIA-CR images. Shown are the red areas and brown spots before (a, b) and after (c, d) treatment
Fig. 4
Fig. 4
Improvement in PIE and PIH after IPL treatment. Statistical analysis shows an improvement in the red areas (a) and brown spots (b). The brown spots did not conform to a normal distribution and were compared using Wilcoxon signed-rank test. The red areas conformed to a normal distribution and were compared using paired t-test. **p < 0.01
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