Novel and Emerging Strategies
Hyaluronic Acid Injection
Hyaluronic acid has become very popular in skin treatments and products. It may be effective as an injected treatment for acne scars, as scars are the result of abnormal formation of collagen structures that are associated with skin wound healing. Microinjections of hyaluronic acid gel into severe acne scars resulted in immediate cosmetic improvement in a small-scale trial (Halachmi 2013). Therefore, these injections may be used to "fill out" and thus improve the appearance of acne scars (Lee, Kim 2010).
The bacteria P. acnes, which play a major role in acne-related inflammation, are sensitive to certain wavelengths of light, especially blue and red light (Gold, Andriessen, Biron, Andriessen 2009). Experimental evidence shows that exposure to blue light suppresses P. acnes, and in one study, blue light therapy reduced acne lesions by 64% after 5 weeks of treatment (Kawada 2002). In a separate study, blue light therapy reduced inflammatory acne lesions by 34%, while topical 1% clindamycin solution achieved only a 14% reduction (Gold 2005).
Blue-light-emitting devices can be used at home (Gold, Andriessen, Biron 2009; Gold, Andriessen, Biron, Andriessen 2009). Studies have shown that self-administered blue light therapy can reduce acne lesions over an 8-week period (Gold, Andriessen, Biron, Andriessen 2009). A study at Cornell University found that blue and red light in combination significantly reduced acne lesion counts following self-administered treatment with a hand-held light-emitting diode (LED) device. The treatment was administered for 4 weeks and acne lesion counts declined during treatment and for 4 weeks following treatment, reaching a final reduction of 69% at 8 weeks (Sadick 2008).
Overall, light therapy is a very effective acne treatment option with minimal side effects. A review of published evidence found that as many as 85% of patients who undergo light therapy achieve at least a 50% reduction in acne severity. Moreover, one-fifth of treated individuals experience a reduction in acne severity of up to 90%. The authors who conducted the review concluded “Amelioration of acne by light therapy, although comparable to the effects of oral antibiotics, offers faster resolution and fewer side effects and leads to patient satisfaction” (Elman 2004).