Combo of low dose-isotretinoin and picosecond lasers prevents and treats acne scars

According to the authors, the paper is the first to show scar improvement by early low-dose-isotretinoin intervention with or without the combination of FxPico. They suggest early intervention with oral low-dose isotretinoin effectively prevents and treats acne scars; combined therapy with FxPico can achieve better outcomes.

In patients with moderate to severe acne, acne scars are common. For these patients, isotretinoin is the first-line treatment, but there needs to be more clarity on whether oral isotretinoin can improve acne scars. Picosecond lasers have been shown to improve acne scars. Therefore, Huan Xue MB, Xi'an Jiaotong University, Xi'an, Shaanxi, China, and colleagues aimed to evaluate the clinical efficacy of low-dose isotretinoin with or without FxPico treatment for acne scars.

For this purpose, the investigators enrolled 48 patients with acne scars. They were randomly assigned to receive low-dose oral isotretinoin or no oral therapy. For all patients in both treatment groups, one side of the face was assigned randomly to be treated with a picosecond laser. Global Acne Grading System (GAGS) score, melanin and erythema indexes, Acne Scar Clinical Rating Scale (ECCA), number of lesions, and transepidermal water loss were assessed at months 0, 1, 2, and 3. The Dermatology Life Quality Index (DLQI), side effects, and satisfaction were recorded before and after the study.

The study revealed the following findings:

• A total of 44 patients completed the study (24 received oral low-dose isotretinoin, and 20 did not).
• Low dose oral isotretinoin-treated group showed significant improvement in ECCA (from 112.5 to 105), GAGS score (from 12.6 ± 3.3 to 10.1 ± 3.0), the count of papules (from 4.3 ± 3.7 to 1.0 ± 1.5) than the blank group, and more significant improvement were noticed after isotretinoin combined with FxPico.
• All the side effects were temporary and tolerable; no adverse effects were observed.
• Higher DLQI and patient satisfaction were achieved by oral isotretinoin alone and isotretinoin combined with FxPico.

The researchers found that the combination therapy of FxPico and isotretinoin demonstrated the most significant improvement in acne scarring and the highest patient satisfaction scores.

"This is the first paper that revealed the improvement of scars by early low dose-isotretinoin intervention with or without the combination of picosecond laser," the researchers wrote. "Early intervention with oral low-dose isotretinoin effectively treats and prevents acne scars; the combined therapy with FxPico can achieve better outcomes."

Reference:

The study titled "Efficacy and safety of low-dose oral isotretinoin monotherapy versus combined therapy with picosecond laser for the treatment of acne scars in Asian population" was published in Lasers in Surgery and Medicine.

DOI: https://doi.org/10.1002/lsm.23646