Abstract

Objective: Acne vulgaris is a common chronic inflammatory disease of the skin. In the treatment of acne vulgaris, the first-line treatment (a 6- or 8-week trial of combined oral antibiotics and topical retinoid with benzoyl peroxide) fails, oral isotretinoin is recommended as additional therapy. However, it is necessary to prepare solutions other than isotretinoin in advance, because isotretinoin is a teratogen and has other undesirable effects. Blue and red light-emitting diodes (LED) irradiation is a well-established treatment for acne vulgaris with the antibacterial and sebocytes inhibitory effects. However, it has not yet been considered whether LED therapy is equivalent to isotretinoin therapy. In this report, treatment with blue, red, and infrared LEDs was used as additional therapy instead of isotretinoin in a patient with refractory acne vulgaris, and the efficacy was evaluated.
Methods: LED irradiation was performed once a week for 20 minutes. The whole of his face including the mandibular lines was irradiated with blue (405–415 nm), red (620–630 nm), and infrared (850 nm) LEDs simultaneously, using a N-LED 5000DK (Aderans Medical Research Co., Ltd., Tokyo, Japan). The integrated illuminance of each LED was as follows: blue, 4.72 J/cm²; red, 2.63 J/cm²; and infrared, 6.61 J/cm².
Results: The improving changes of skin lesion was confirmed 4 weeks after the starting LED therapy, and the oral minocycline was able to be discontinued. Eight weeks after the starting LED therapy, the skin lesions revealed more significant improvement even after discontinued minocycline.
Conclusion: Red and infrared LEDs have inhibitory effects on toll-like receptor 2, a novel target factor in the treatment of acne vulgaris. It may be becoming clear that blue, red, and infrared LED therapy is much more involved in acne vulgaris than previous concepts that rely on antibacterial and sebum-suppressing effects. If this report triggers research on LED treatment for refractory acne vulgaris further, evidence may be obtained whether it is as effective as isotretinoin.

Keywords

isotretinoin, light-emitting diodes, refractory acne vulgaris, substitute, therapeutic