Evaluation of the effectiveness of intense pulse light vs topical benzoyl peroxide 2.5% gel in patients of inflammatory acne receiving oral azithromycin pulse therapy: a randomized control trial

Background: Acne vulgaris is a chronic inflammatory condition of the pilosebaceous unit, primarily affecting adolescents and young adults. Conventional treatments, including topical and systemic therapies, often lead to inconsistent outcomes, resistance, and poor compliance, contributing to psychological distress and scarring. Light-based therapies, particularly Intense Pulsed Light (IPL), have emerged as effective non-invasive alternatives, improving patient adherence and delivering faster results. Given the limited comparative studies between IPL and benzoyl peroxide 2.5% gel, this study aims to evaluate their efficacy in treating inflammatory acne. Methods: This randomized controlled trial was conducted at a tertiary care dermatology center, enrolling 60 patients who met specific inclusion and exclusion criteria. Patients were randomly assigned to IPL therapy or topical benzoyl peroxide 2.5% gel, with both groups receiving oral azithromycin 250 mg thrice weekly for two months. Lesion assessment was performed using the Michaelson Severity Index (MSI), along with erythema grading and photographic analysis. Results: The results showed greater improvement in lesion severity with IPL, with higher moderate and good resolution at the 4th sitting compared to benzoyl peroxide. Although IPL patients experienced more transient erythema (32%), they had fewer overall adverse effects. Statistical analysis confirmed significant improvements in acne severity with IPL, indicating superior effectiveness in reducing inflammatory acne lesions. Conclusions: IPL showed superior efficacy in reducing inflammatory acne with fewer adverse effects. Keywords: Intense Pulse Light, Topical Benzoyl Peroxide 2.5% Gel, Inflammatory Acne, Oral Azithromycin Pulse Therapy