Intense pulsed light vs. pulsed-dye laser in the treatment of facial acne: a randomized split-face trial

Background Various laser and light therapy have been increasingly used for the treatment of acne vulgaris. Patients and methods Twenty patients with facial acne were treated using intense pulsed light (IPL) on one side of the face and pulsed dye laser (PDL) on the other to compare the efficacy and safety of IPL and PDL. Treatment was performed 4 times at 2-week intervals. Treatment effectiveness was determined using lesion counts, acne severity, patient subjective self-assessments of improvement, and histopathological examinations, which included immunohistochemical staining for transforming growth factor-beta (TGF-beta). Results Numbers of total acne lesions decreased following both treatments. For inflammatory lesions such as papules, pustules and nodules, IPL-treated sides showed an earlier and more profound improvement than PDL-treated sides. However, at 8 weeks after the 4th treatment, a rebound aggravation of acne was observed on IPL-treated sides. On the contrary, PDL produced gradual improvements during the treatment sessions and these improvements lasted 8 weeks after the 4th treatment. Non-inflammatory lesions as open and closed comedones also showed improvement following both treatments and PDL-treated sides showed better improvement as the study proceeded. Histopathological examinations showed amelioration in inflammatory reactions and an increase in TGF-beta expression after both treatments, which were more prominent for PDL-treated sides. Conclusion Both PDL and IPL were found to treat acne effectively, but PDL showed a more sustained effect. TGF-beta might play a key role in the resolution of inflammatory acne lesions.