Acne Treatment Based on Selective Photothermolysis of Sebaceous Follicles with Topically Delivered Light-Absorbing Gold Microparticles.
The pathophysiology of acne vulgaris depends on active sebaceous glands, implying that selective destruction of sebaceous glands could be an effective treatment. We hypothesized that light-absorbing microparticles could be delivered into sebaceous glands, enabling local injury by optical pulses. A suspension of topically applied gold-coated silica microparticles exhibiting plasmon resonance with strong absorption at 800 nm was delivered into human pre-auricular and swine sebaceous glands in vivo, using mechanical vibration. After exposure to 10-50 J cm(-2), 30 milliseconds, 800 nm diode laser pulses, microscopy revealed preferential thermal injury to sebaceous follicles and glands, consistent with predictions from a computational model. Inflammation was mild; gold particles were not retained in swine skin 1 month after treatment, and uptake in other organs was negligible. Two independent prospective randomized controlled clinical trials were performed for treatment of moderate-to-severe facial acne, using unblinded and blinded assessments of disease severity. Each trial showed clinically and statistically significant improvement of inflammatory acne following three treatments given 1-2 weeks apart. In Trial 2, inflammatory lesions were significantly reduced at 12 weeks (P=0.015) and 16 weeks (P=0.04) compared with sham treatments. Optical microparticles enable selective photothermolysis of sebaceous glands. This appears to be a well-tolerated, effective treatment for acne vulgaris.
Sebacia, Duluth, Georgia USA. Electronic address: dilip@sebacia.com.
Dilip Y
DY
Paithankar
Department of Dermatology, Wellman Center for Photomedicine, Massachusetts General Hospital; Harvard Medical School, Boston Massachusetts, USA.
Fernanda H
FH
Sakamoto
Department of Dermatology, Wellman Center for Photomedicine, Massachusetts General Hospital; Harvard Medical School, Boston Massachusetts, USA.
William A
WA
Farinelli
Department of Dermatology, Wellman Center for Photomedicine, Massachusetts General Hospital; Harvard Medical School, Boston Massachusetts, USA.
Garuna
G
Kositratna
Sebacia, Duluth, Georgia USA.
Richard D
RD
Blomgren
Sebacia, Duluth, Georgia USA.
Todd J
TJ
Meyer
Sebacia, Duluth, Georgia USA.
Linda J
LJ
Faupel
New York Laser & Skin Care, New York, USA.
Arielle N B
ANB
Kauvar
Lloyd Dermatology & Laser Center, Youngstown, Ohio, USA.
Jenifer R
JR
Lloyd
Department of Pathology, University of Arkansas, Little Rock, Arkansas, USA.
Wang L
WL
Cheung
Department of Dermatology, Military Institute of Medicine, Warsaw, Poland.
Witold D
WD
Owczarek
Department of Dermatology, Military Institute of Medicine, Warsaw, Poland.
Anna M
AM
Suwalska
Department of Dermatology, Military Institute of Medicine, Warsaw, Poland.
Katarzyna B
KB
Kochanska
Department of Dermatology, Military Institute of Medicine, Warsaw, Poland.
Agnieszka K
AK
Nawrocka
Department of Dermatology, Military Institute of Medicine, Warsaw, Poland.
Elwira B
EB
Paluchowska
Department of Dermatology, Jagiellonian University, Krakow, Poland.
Katarzyna M
KM
Podolec
Department of Dermatology, Jagiellonian University, Krakow, Poland.
Magdalena M
MM
Pirowska
Department of Dermatology, Jagiellonian University, Krakow, Poland.
Anna B
AB
Wojas-Pelc
Department of Dermatology, Wellman Center for Photomedicine, Massachusetts General Hospital; Harvard Medical School, Boston Massachusetts, USA.
R Rox
RR
Anderson
D000152:Acne Vulgaris / Q000175:diagnosis / Q000628:therapy*; D000287:Administration, Topical; D000818:Animals; D004195:Disease Models, Animal; D005500:Follow-Up Studies; D006046:Gold / Q000627:therapeutic use*; D018859:Hair Follicle / Q000187:drug effects / Q000473:pathology; D006801:Humans; D010316:Particle Size; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000494:pharmacology*; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012627:Sebaceous Glands / Q000187:drug effects* / Q000473:pathology; D012869:Skin Absorption / Q000187:drug effects; D013552:Swine; D016896:Treatment Outcome
D017319:Photosensitizing Agents; D006046:Gold