BC01 Isotretinoin plus 420-nm intense pulsed light vs. isotretinoin alone for the treatment of acne vulgaris: a randomized, controlled study of efficacy, safety and patient satisfaction

Abstract The combination of intense pulsed light (IPL) with systemic medication, especially retinoids, has rarely been reported. This study aimed to compare the efficacy, safety and patient satisfaction of isotretinoin plus 420-nm IPL combined treatment for facial acne vulgaris against isotretinoin monotherapy. Forty-seven patients with facial acne of Global Evaluation Acne (GEA) grade 2–4 were randomized to receive isotretinoin plus 420-nm IPL (study group) or isotretinoin monotherapy (control group). The patients in the study group were treated with isotretinoin 0.5–0.75 mg kg−1 per day for 8 weeks, together with biweekly 420-nm IPL treatment for 4 weeks starting on week 0 (total eight sessions). The patients in the control group received the same dose range of only oral isotretinoin for 8 weeks. Topical agents for both groups included adapalene 0.1% gel and fusidic acid 2% cream. Efficacy was evaluated using digital photos taken at baseline and week 12 by an independent dermatologist, including GEA grade, lesion count, lesion reduction percentage and effective rate. All patients completed the Dermatology Life Quality Index (DLQI) and a satisfaction visual analogue scale (VAS) at week 12, and were followed up for another 2 months. Adverse events throughout the study period and follow-up were recorded. Patients in the study group experienced significant reduction in GEA grade, total lesions and inflammatory lesions by week 12, compared with the control group (P < 0.05). In the study group, the effective rates for reduction of total lesions, inflammatory lesions and noninflammatory lesions were 79.2%, 79.2%, and 56.5%, respectively. In the control group, the effective rates for reduction of total lesions, inflammatory lesions and noninflammatory lesions were 65.2% (P < 0.01 vs. the study group), 56.5% (P < 0.01 vs. the study group) and 52.2%, respectively. No significant difference was noticed in the reduction of noninflammatory lesions between the two groups. The patients in the study group reported lower DQLI (P < 0.05) and higher satisfaction VAS (P < 0.05), and experienced a lower incidence of relapse (P < 0.05). More patients in the study group reported ‘erythema relieved’ and ‘lightening of skin tone’ compared with the control group (P < 0.05). For both groups, regular laboratory tests monitoring liver transaminases and serum lipids revealed no abnormalities. No severe adverse events were reported or identified in either group. The isotretinoin plus 420-nm IPL combined treatment had a positive effect that was statistically and clinically significant in terms of acne vulgaris alleviation, compared with the isotretinoin monotherapy. Other major advantages included lightening basic skin tone and relieving erythema. It achieved clinical improvement within a limited treatment duration, and may have a particularly beneficial effect in patients who expect a rapid remission.