Investigation of the mechanism of action of nonablative pulsed-dye laser therapy in photorejuvenation and inflammatory acne vulgaris

Investigation of the mechanism of action of nonablative pulsed-dye laser therapy in photorejuvenation and inflammatory acne vulgaris
Published article online:
07 Jul 2006
Issue online:
07 Jul 2006
Accepted for publication 23 April 2006
To cite this article: E.D. Seaton, P.E. Mouser, A. Charakida, S. Alam, P.E. Seldon, A.C. Chu (2006)
Investigation of the mechanism of action of nonablative pulsed-dye laser therapy in photorejuvenation and inflammatory acne vulgaris
British Journal of Dermatology 155 (4), 748Ò755.
doi:10.1111/j.1365-2133.2006.07429.x
Blackwell Synergy

E.D. Seaton, P.E. Mouser, A. Charakida, S. Alam, P.E. Seldon and A.C. Chu

Department of Dermatology, Hammersmith Hospital, Imperial College, London W12 0NN, U.K.

Edward D. Seaton, Royal Free Hospital, London NW3 2QG, U.K.
E-mail: edwardseaton@hotmail.co.uk

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 transcriptionÒpolymerase 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)-β1 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.

Conflicts of interest
A.C.C. acts as a consultant for the device manufacturers. The other authors have no conflicts of interest.

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