Post‐acne erythema treatment: A systematic review of the literature

Abstract

Post-acne erythema (PAE) is a common sequela of acne inflammation, and it refers to telangiectasia and erythematous lesions remaining after the acne treatment. Although some PAE lesions may improve over time, persisting PAE might be esthetically undesirable for patients. The efficacy of various treatment options for PAE has been investigated in many studies but there exists no gold standard treatment modality. In this study, we aimed to give a systematic literature review on various treatment options for PAE, the advantage of each modality, and compare their efficacy, safety, and feasibility. By using the selected keywords, we carried out a systematic search for articles published from the inception to 28 April 2021 in PubMed/Medline and Embase databases. Of the 5796 initially retrieved articles, 18 of them were fully eligible to be enrolled in our study. In this study, we found that light and laser-based devices were the most frequently used treatments for PAE. Generally, pulsed-dye lasers were the most commonly used laser devices for PAE. Neodymium:yttrium aluminum-garnet lasers were the second most commonly used modalities in treating PAE. Topical treatments such as oxymetazoline, tranexamic acid, and brimonidine tartrate are promising treatments in reducing PAE lesions. In our study, no severe side effects were found. In conclusion, both laser devices and topical agents seem to be effective for PAE lesions; however, further randomized clinical trials are needed in this field.

The role of the topical nasal decongestant oxymetazoline as a novel therapeutic option for post‐acne erythema: A split‐face, double‐blind, randomized, placebo‐controlled trial

“…To date, various therapeutic options for PAE have demonstrated various clinical outcomes and side effects 1 . The most common modalities are light‐ and laser‐based therapies, including pulsed‐dye lasers, 5,6 Q‐switched neodymium:yttrium aluminum garnet (Nd:YAG) lasers, 7,8 erbium glass fractional lasers, 9 alexandrite lasers, 10 pro‐yellow lasers, 25 high‐power optically pumped semiconductor lasers (HOPSLs), 26 fractional photothermolysis, 27 and intense pulsed light (IPL) devices 28 .…”

“…PAE occurs from the release of inflammatory cytokines, such as interleukin (IL)-6 and tumor necrosis factor (TNF)α, that remain after resolution of inflammatory acne lesions, resulting in the dilation of microvascular structures and aggregations of erythrocytes in the capillaries. 1,2,32 Oxymetazoline hydrochloride (the molecular mass, 296.84) 33 is a synthetic sympathomimetic agonist with a high affinity for α 1A -adrenergic receptors and a partial affinity for α 2A -adrenergic receptors. Activation of these postsynaptic adrenoceptors promotes superficial cutaneous vasoconstriction.…”

“…Up to now, effective PAE treatments remain limited. Various treatment modalities have demonstrated a wide range of clinical outcomes and side effects 1,2 . Studies on light and laser‐based therapies are the most frequently reported to show promising PAE reduction.…”

“…It consists of telangiectatic and erythematous macules, which occur as a result of inflammatory cytokines and dilatation of microcapillaries within the papillary dermis. 1,2 Although some lesions may resolve spontaneously over time, some may persist for up to 6 months, resulting in disfigurement, loss of selfesteem, and psychological distress. 3,4 Up to now, effective PAE treatments remain limited.…”

“…Various treatment modalities have demonstrated a wide range of clinical outcomes and side effects. 1,2 Studies on light and laser-based therapies are the most frequently reported to show promising PAE reduction. However, the procedures are painful, expensive, limited to certain clinics, require multiple sessions to achieve satisfactory results, and demand extended downtime.…”