Efficacy of photodynamic therapy combined with minocycline for treatment of moderate to severe facial acne vulgaris and influence on quality of life

Abstract

Background:Acne vulgaris is a prevalent skin disorder impairing both physical and psychosocial health. This study was designed to investigate the effectiveness of photodynamic therapy (PDT) combined with minocycline in moderate to severe facial acne and influence on quality of life (QOL).Methods:Ninety-five patients with moderate to severe facial acne (Investigator Global Assessment [IGA] score 3–4) were randomly treated with PDT and minocycline (n = 48) or minocycline alone (n = 47). All patients took minocycline hydrochloride 100 mg/d for 4 weeks, whereas patients in the minocycline plus PDT group also received 4 times PDT treatment 1 week apart. IGA score, lesion counts, Dermatology Life Quality Index (DLQI), and safety evaluation were performed before treatment and at 2, 4, 6, and 8 weeks after enrolment.Results:There were no statistically significant differences in characteristics between 2 treatment groups at baseline. Minocycline plus PDT treatment led to a greater mean percentage reduction from baseline in lesion counts versus minocycline alone at 8 weeks for both inflammatory (−74.4% vs −53.3%; P < .001) and noninflammatory lesions (−61.7% vs −42.4%; P < .001). More patients treated with minocycline plus PDT achieved IGA score <2 at study end (week 8: 30/48 vs 20/47; P < .05). Patients treated with minocycline plus PDT got significant lower DLQI at 8 weeks (4.4 vs 6.3; P < .001). Adverse events were mild and manageable.Conclusions:Compared with minocycline alone, the combination of PDT with minocycline significantly improved clinical efficacy and QOL in moderate to severe facial acne patients.

Efficacy of photodynamic therapy for the treatment of inflammatory acne vulgaris: A systematic review and meta‐analysis

“…According to our retrieval strategy, 786 potential articles were obtained. After screening, 13 trials [12][13][14][15][16][17][18][19][20][21][22][23][24] were enrolled in our meta-analysis, and the sample sizes in PDT and visible phototherapy alone or drug groups were 399 and 406, respectively. Figure 1 summarizes the article screening process.…”

“…Of the 13 reports, four 12,16,19,23 had mentioned ALA combined with red light, three 17,21,22 mentioned ALA combined with IPL, two…”

“…In total, among the 13 RCTs, 7 (54%) 13,15,16,[19][20][21]23 had reported random sequence generation, 4 (31%) 13,19,21,23 reported the use of allocation concealment methods, only 2 (5%) 19,20 reported the blinding methods for participants and personnel, and 9 (69%) I 2 = 85.4%). One study (13) and there was significant heterogeneity (P = .0005; I 2 = 72%).…”

Combined Antimicrobial Activity of Photodynamic Inactivation and Antimicrobials–State of the Art

“…Skin abscesses caused by M. fortuitum were effectively healed during the combined treatment, and no adverse reaction was observed after 3 months (Gong et al, 2016 ). Next, the bactericidal effectiveness of combined therapy using 5-ALA and antibiotics (minocycline) in acne vulgaris treatment was presented by Xu et al ( 2017 ) in 2017. Forty eight patients were treated with minocycline (100 mg/day for 4 weeks) and once a week lesions were irradiated with light dose of 120 J/cm 2 after skin incubation with 5% 5-ALA. Second group of patients was administered only with minocycline 100 mg/day for 4 weeks.…”

“…Forty eight patients were treated with minocycline (100 mg/day for 4 weeks) and once a week lesions were irradiated with light dose of 120 J/cm 2 after skin incubation with 5% 5-ALA. Second group of patients was administered only with minocycline 100 mg/day for 4 weeks. Eight weeks after the treatment the effectiveness of combined therapy was higher than in case of minocycline monotherapy reaching the 80% reduction of inflammatory lesions (the reduction of lesions in minocycline monotherapy reached 50%) (Xu et al, 2017 ).…”