A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid State Diode Arrays

7/27/2019 A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid State Diode Arrays

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A Randomised Controlled Study for the

Treatment of Acne Vulgaris using High

Intensity 414nm Solid State Diode Arrays

Caerwyn Ash
http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=x9X7W1T0mAPxeM&tbnid=jBAlX8sARcwmgM:&ved=0CAUQjRw&url=http://www.ubergizmo.com/2012/09/topical-virus-cream-spread-on-the-face-could-fight-acne/acne-cream-virus-fighting/&ei=jN6RUcHjIIT50gXF4oGwCw&bvm=bv.46471029,d.ZG4&psig=AFQjCNHuTDZcApLWX0xFsfHZ_nscJWyFmA&ust=1368600579900077http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=x9X7W1T0mAPxeM&tbnid=jBAlX8sARcwmgM:&ved=0CAUQjRw&url=http://www.ubergizmo.com/2012/09/topical-virus-cream-spread-on-the-face-could-fight-acne/acne-cream-virus-fighting/&ei=jN6RUcHjIIT50gXF4oGwCw&bvm=bv.46471029,d.ZG4&psig=AFQjCNHuTDZcApLWX0xFsfHZ_nscJWyFmA&ust=1368600579900077http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=8sQQiXseQ8HbkM&tbnid=1ZCgTljoQJ5sqM:&ved=0CAUQjRw&url=http://blackriver-mathesonchamberofcommerce.com/index.php/how-to-avoid-acne/&ei=S96RUamvEuis0QWtyYHQBA&bvm=bv.46471029,d.ZG4&psig=AFQjCNG4s2GZudBXvPmGIl2nVqsPa-6AKg&ust=1368600459598872http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=8sQQiXseQ8HbkM&tbnid=1ZCgTljoQJ5sqM:&ved=0CAUQjRw&url=http://blackriver-mathesonchamberofcommerce.com/index.php/how-to-avoid-acne/&ei=S96RUamvEuis0QWtyYHQBA&bvm=bv.46471029,d.ZG4&psig=AFQjCNG4s2GZudBXvPmGIl2nVqsPa-6AKg&ust=1368600459598872


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Declaration

The following potential conflict of interest relationships

are germane to my presentation:

Salary

Travel expenses

Clinical study funded by

Equipment supplied

by The Dezac Group, Cheltenham, UK
http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=x9X7W1T0mAPxeM&tbnid=jBAlX8sARcwmgM:&ved=0CAUQjRw&url=http://www.ubergizmo.com/2012/09/topical-virus-cream-spread-on-the-face-could-fight-acne/acne-cream-virus-fighting/&ei=jN6RUcHjIIT50gXF4oGwCw&bvm=bv.46471029,d.ZG4&psig=AFQjCNHuTDZcApLWX0xFsfHZ_nscJWyFmA&ust=1368600579900077http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=x9X7W1T0mAPxeM&tbnid=jBAlX8sARcwmgM:&ved=0CAUQjRw&url=http://www.ubergizmo.com/2012/09/topical-virus-cream-spread-on-the-face-could-fight-acne/acne-cream-virus-fighting/&ei=jN6RUcHjIIT50gXF4oGwCw&bvm=bv.46471029,d.ZG4&psig=AFQjCNHuTDZcApLWX0xFsfHZ_nscJWyFmA&ust=1368600579900077http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=8sQQiXseQ8HbkM&tbnid=1ZCgTljoQJ5sqM:&ved=0CAUQjRw&url=http://blackriver-mathesonchamberofcommerce.com/index.php/how-to-avoid-acne/&ei=S96RUamvEuis0QWtyYHQBA&bvm=bv.46471029,d.ZG4&psig=AFQjCNG4s2GZudBXvPmGIl2nVqsPa-6AKg&ust=1368600459598872http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=8sQQiXseQ8HbkM&tbnid=1ZCgTljoQJ5sqM:&ved=0CAUQjRw&url=http://blackriver-mathesonchamberofcommerce.com/index.php/how-to-avoid-acne/&ei=S96RUamvEuis0QWtyYHQBA&bvm=bv.46471029,d.ZG4&psig=AFQjCNG4s2GZudBXvPmGIl2nVqsPa-6AKg&ust=1368600459598872


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Study Objective

Objective: This study is designed to quantify

the effectiveness of using a blue light device

in a combination therapy with proprietary

regimen creams in a self-treat investigation.

A Randomised Controlled Study


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Home Use Acne Treatment

Sufferers may be too embarrassed

to seek medical treatment.

Statistically 70% of people have had

acne, both genders, all skin types.

This co ndi t ion that so

undermines self ass urance and

self esteem hits ado lescence at

suc h a vulnerable t imein life.


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Pathogenesis of Acne


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Pathogenesis of Acne

BLUE

Light


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Wavelengths used in current treatment

414 nm LED

IPL

585 nm Dye laser

KTP laser

White light

Blue & Red light sources

Nd:YAG laser1450 nm diode laser
http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=RJt5423ch7zWGM&tbnid=-zMX9V6P6bxa9M:&ved=0CAUQjRw&url=http://clairemaythehedgehog.deviantart.com/art/Rainbow-Gradient-318042922&ei=IOwyUravE-Ob0QWY-YGYDQ&bvm=bv.52164340,d.ZGU&psig=AFQjCNHfZ0ROGCwS_CJDX-XohL3CDSi7CQ&ust=1379155342912706http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=RJt5423ch7zWGM&tbnid=-zMX9V6P6bxa9M:&ved=0CAUQjRw&url=http://clairemaythehedgehog.deviantart.com/art/Rainbow-Gradient-318042922&ei=IOwyUravE-Ob0QWY-YGYDQ&bvm=bv.52164340,d.ZGU&psig=AFQjCNHfZ0ROGCwS_CJDX-XohL3CDSi7CQ&ust=1379155342912706http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=RJt5423ch7zWGM&tbnid=-zMX9V6P6bxa9M:&ved=0CAUQjRw&url=http://clairemaythehedgehog.deviantart.com/art/Rainbow-Gradient-318042922&ei=IOwyUravE-Ob0QWY-YGYDQ&bvm=bv.52164340,d.ZGU&psig=AFQjCNHfZ0ROGCwS_CJDX-XohL3CDSi7CQ&ust=1379155342912706


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Why blue (414 nm)?

In-Vitro Dose response

Investigative Study (2011)

Mechanism of Propionibacterium acne Necrosis by initiation of Reactive Oxygen Species (ROS) by Porphyrin Absorption Ash C, Harris L, Maffeis T


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Why blue (414 nm)?

Scanning Electron Microscope of Propionibacterium

Investigative Study (2011)

Mechanism of Propionibacterium acne Necrosis by initiation of Reactive Oxygen Species (ROS) by Porphyrin Absorption Ash C, Harris L, Maffeis T


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Mode of Action

Prepare skin

Exfoliate

Chemical peel

Illuminate Skin

Photochemical Absorption

Bacteria Death

Wound healing

Heat

Capillaries

Vasodilator creams

1. 2. 3.

Pre-treatment

Facial Wash

Weak Chemical peel

Salicylic Acid

Glycolic Acid

Lactic Acid

Treatment

414 nm light source

220J over 6cm2 over 3 mins

Post-treatment

Moisturiser

Salicylic Acid

Glycolic Acid

Lactic Acid

Menthol

Niacin


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Study Design

Aimed for 50% Males, 50% Females6 Males, 33 Females

Ages ranged 16-37, average 22.1

Cream's weighted at each session

45 subjects assessed

for eligibility

41 subjects accepted

4 subjects did not

meet inclusion criteria

26 subjects

TREATMENT

15 subjects

CONTROL

26 subjects

Completed 12 weeks

15 subjects

Completed 12 weeks

26 subjects

Analysis &Questionnaire

15 subjects

Analysis &Questionnaire

Baseline at assessmentBaseline at assessment

BaselineBaseline + Device

Week 1 PhotographyWeek 1 Photography





Recruitment

Recruitment took place between

December 2012 and January 2013 so

that confounding effects of summer

sunlight were avoided.


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Inclusion Criteria This ethics committee approved study recruited subjects aged

between 16 and 45 years with mild-to-moderate facial inflammatory

acne

Male and Female

Able to give informed consent and from whom written informed

consent has been obtained.

Following restrictions during the study:

No change in facial wash product

No medicated facial products

No heavy foundation

No makeup for each assessment at centre

Male subjects to shave daily


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Exclusion Criteria Exclusion criteria were history of photosensitivity and

pregnancy or lactation within the previous 3 months

Subjects who had excessive facial exposure to sunlight or

artificial UV-light within three months prior the study were

excluded.

Psoriasis or Sandpaper acne

Participated in any clinical study during the previous month

Migraines or seizures triggered by light

Topical anti-spot medications, topical antibiotics or topical

steroid usage

Washout periods for previous treatments were 8 weeks for oral

antibiotics and topical treatments, 12 weeks for contraceptives

containing cyproterone acetate, 52 weeks for oral Isotretinoin.

Acne treatments were not allowed during the study.


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Recruitment

Social media

Gloucester University

Doctor surgery's

Schools (Sixth form) Colleges
http://www.google.co.uk/url?sa=i&rct=j&q=Twitter+logo&source=images&cd=&cad=rja&docid=83l2jZGxZ-9yqM&tbnid=-9pcu7db62D6WM:&ved=0CAUQjRw&url=http://nickbaines.wordpress.com/2009/10/17/blogging-and-the-black-dog/twitter-logo-1-2/&ei=Ud-LUdHSCLL50gW17oDQAw&bvm=bv.46340616,d.bGE&psig=AFQjCNFn0kw6ww4cmMvQoGdzMvaP8wK4Mg&ust=1368207547153939http://www.google.co.uk/url?sa=i&rct=j&q=Twitter+logo&source=images&cd=&cad=rja&docid=83l2jZGxZ-9yqM&tbnid=-9pcu7db62D6WM:&ved=0CAUQjRw&url=http://nickbaines.wordpress.com/2009/10/17/blogging-and-the-black-dog/twitter-logo-1-2/&ei=Ud-LUdHSCLL50gW17oDQAw&bvm=bv.46340616,d.bGE&psig=AFQjCNFn0kw6ww4cmMvQoGdzMvaP8wK4Mg&ust=1368207547153939http://www.google.co.uk/url?sa=i&rct=j&q=Twitter+logo&source=images&cd=&cad=rja&docid=m7arg642PYeihM&tbnid=ET-jOSUFYRT3FM:&ved=0CAUQjRw&url=http://twitter.com/about/resources&ei=Qt-LUdLkF6mf0QXRiIHwDg&bvm=bv.46340616,d.bGE&psig=AFQjCNFn0kw6ww4cmMvQoGdzMvaP8wK4Mg&ust=1368207547153939http://www.google.co.uk/url?sa=i&rct=j&q=Twitter+logo&source=images&cd=&cad=rja&docid=m7arg642PYeihM&tbnid=ET-jOSUFYRT3FM:&ved=0CAUQjRw&url=http://twitter.com/about/resources&ei=Qt-LUdLkF6mf0QXRiIHwDg&bvm=bv.46340616,d.bGE&psig=AFQjCNFn0kw6ww4cmMvQoGdzMvaP8wK4Mg&ust=1368207547153939


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Device and Creams

Subjects given pre-treatment

and post-treatment creams

and device on one week after

initial assessment.

Watched a short video

explaining how to use deviceand creams

Close communication with

subjects


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Familiarity of applying creams

Acnes is very common and treatable, but finding

suitable treatments can be expensive. Consumers arefamiliar with applying a regime of creams
http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=u87OwOBOi2ofKM&tbnid=qFt8TToFitxlzM:&ved=0CAUQjRw&url=http://ilifesotij.mezoka.com/where-can-you-find-sulfur.php&ei=-t6RUeGFComx0QW7kYC4Bw&bvm=bv.46471029,d.ZG4&psig=AFQjCNFEf6-AZEum835FWpOFI-xzWIch_g&ust=1368600670939606http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=u87OwOBOi2ofKM&tbnid=qFt8TToFitxlzM:&ved=0CAUQjRw&url=http://ilifesotij.mezoka.com/where-can-you-find-sulfur.php&ei=-t6RUeGFComx0QW7kYC4Bw&bvm=bv.46471029,d.ZG4&psig=AFQjCNFEf6-AZEum835FWpOFI-xzWIch_g&ust=1368600670939606


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Lesion Count - Photography

Standardised digital Images of four head positions

provided full face analysis


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Lesion Count - Custom Software

lesions from full face images counted using custom

software.


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Results Lesion Count


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Results


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Results

23 year old female, Only OTC medication


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Results

26 year old femaleTetracycline 4 years ago


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Results

26 year old female, Tetracycline 2 years ago

l


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Results

18 year old female

l


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Results

All subjects in treatment group improved in lesion

counts after 12 weeks

Inflammatory lesion counts reduced by 50.02% in

treatment group and increased 2.45% in controls.

Reduction in lesion clearance was observed in the first

3 weeks after start of treatment.

Treatment is pain and side effect-free.

S bj F db k


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Subject Feedback

P h l


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Psychological Aspects of Acne Vulgaris and

the role of Social Media

Rebecca Whittall & Caerwyn AshPsychology, Health & Medicine: in press

Psychology

C l i
http://www.google.co.uk/url?sa=i&rct=j&q=mobile+phone&source=images&cd=&cad=rja&docid=Zl5Vk7UioOknBM&tbnid=RhPwh6ib703wQM:&ved=0CAUQjRw&url=http://www.herts.police.uk/advice/crime_prevention/mobile_phone_security.aspx&ei=cxOeUezaNsKvOY_xgCA&psig=AFQjCNGKIrHXEarcd_qL_vkyH3ay-CqYmg&ust=1369400555745382http://www.google.co.uk/url?sa=i&rct=j&q=mobile+phone&source=images&cd=&cad=rja&docid=Zl5Vk7UioOknBM&tbnid=RhPwh6ib703wQM:&ved=0CAUQjRw&url=http://www.herts.police.uk/advice/crime_prevention/mobile_phone_security.aspx&ei=cxOeUezaNsKvOY_xgCA&psig=AFQjCNGKIrHXEarcd_qL_vkyH3ay-CqYmg&ust=1369400555745382http://www.google.co.uk/url?sa=i&rct=j&q=twitter&source=images&cd=&cad=rja&docid=7bqDRz77NqhnrM&tbnid=3kaCk4iKRBKRTM:&ved=0CAUQjRw&url=http://www.dusktilldawnpoker.com/news/ispt-facebook--twitter-freerolls/2331&ei=BxOeUerPLcHMPa7qgIAI&bvm=bv.46865395,d.ZWU&psig=AFQjCNHmZcVDRPvWxIuVDIRvHZScoyX3-g&ust=1369400449060976http://www.google.co.uk/url?sa=i&rct=j&q=twitter&source=images&cd=&cad=rja&docid=7bqDRz77NqhnrM&tbnid=3kaCk4iKRBKRTM:&ved=0CAUQjRw&url=http://www.dusktilldawnpoker.com/news/ispt-facebook--twitter-freerolls/2331&ei=BxOeUerPLcHMPa7qgIAI&bvm=bv.46865395,d.ZWU&psig=AFQjCNHmZcVDRPvWxIuVDIRvHZScoyX3-g&ust=1369400449060976http://www.google.co.uk/url?sa=i&rct=j&q=facebook&source=images&cd=&cad=rja&docid=B0sgUa65DReFtM&tbnid=XzcrgjJ8smX1rM:&ved=0CAUQjRw&url=http://tallships.org/news/facebook/&ei=6xKeUYr2KsX6PLiqgOgB&bvm=bv.46865395,d.ZWU&psig=AFQjCNGUZC1wsbQ4iQKLmcOUfbgeQ3bBNw&ust=1369400420655209http://www.google.co.uk/url?sa=i&rct=j&q=facebook&source=images&cd=&cad=rja&docid=B0sgUa65DReFtM&tbnid=XzcrgjJ8smX1rM:&ved=0CAUQjRw&url=http://tallships.org/news/facebook/&ei=6xKeUYr2KsX6PLiqgOgB&bvm=bv.46865395,d.ZWU&psig=AFQjCNGUZC1wsbQ4iQKLmcOUfbgeQ3bBNw&ust=1369400420655209


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Conclusion Home-use blue light therapy improves inflammatory

facial acne three weeks after first treatment with no

serious adverse effects. An effective, drug freemethod of confronting this issue is presented by this

study.

The blue light device offers a valuable alternative toantibiotics and potentially irritating topical

treatments.

The onset of the effect was observable at week 3,

and maximal between weeks 8 and 12.

Although the device works well as a monotherapy,

its best suited to a combination therapy


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Documents

A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid State Diode Arrays