Selective photothermolysis of the sebaceous glands for acne treatment

Background and Objectives: The purpose of this study is to evaluate the efficacy of a long pulse diode laser (Cynosure, Inc.) to target and destroy enlarged sebaceous glands that are preloaded with Indocyanine green (ICG) chromophore. Study Design/Materials and Methods: This study was designed in three phases. First, preliminary studies were performed to determine the ability of ICG to penetrate into enlarged sebaceous glands. Once penetration of the sebaceous gland was confirmed, the second phase was to determine the necessary parameters for the diode laser to effectively target the ICG loaded glands. This was done using laser-tissue interaction analysis. The final phase was done with patients that had active acne on their back to determine if selective destruction of the sebaceous glands could be achieved and also to assess the safety and efficacy of this novel treatment for acne. Results: Fluorescence microscopy of biopsy samples show evidence of ICG penetration into the sebaceous glands. Histological examination of biopsy samples from the treated areas finds selective necrosis of the sebaceous glands. Preliminary clinical results demonstrate a decrease in acne noted in the treatment area at 3, 6, and 10 months follow-up. Conclusions: ICG and diode laser treatment is a new approach for the treatment of acne based on experimentally observed selective photothermolysis of the sebaceous glands. (C) 2002 Wiley-Liss, Inc.