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Shining new light on spots and acne


10 May 2012

Acne affects around four out of five teenagers – both male and female – and it can persist for months or even years. Acne commonly starts around puberty, but it is not just teens who suffer. Recent epidemiological studies also point to an increase in adult acne and the fact that the disease is persisting longer, with some patients needing treatment well into the mid-forties. It can also occur for the first time in adulthood, and 25 per cent of adult men and 50 per cent of adult women will experience acne at some time in their lives.

In severe cases, acne can affect the neck, shoulders, back and chest as well as the face and there may be permanent and sometimes severe scarring. But as well as physical effects, researchers have found that acne can have a significant psychological impact, badly affecting the quality of life and self-esteem of sufferers, straining family and social relationships.

Acne and spots may have a number of causes, and factors such as hormones, stress and genetics are all thought to play a part. Some medical conditions, certain medicines and hormone treatments may also trigger acne in adults.

How spots develop

There are four stages in the development of spots and acne:

– An increase in the production of sebum (oil) in the sebaceous follicles of the skin
– Obstruction of these follicles when skin cells are shed and block the follicle n Colonisation of the blocked follicles with Propionibacterium acnes (P. acnes)
– Inflammation of the follicles as a result of the P. acnes colonisation.

OTC and prescription treatments are available to treat spots and acne, including creams, gels, lotions and, in severe cases, GPs or specialists may prescribe antibiotics or systemic retinoid treatments.

These treatments are frequently effective, but they can also be messy and may raise the risk of unwanted side effects including skin irritation, soreness and redness. Antibiotic resistance is also a concern with long-term use.

However, there are now alternative types of treatment available over the counter, which are scientifically shown to treat problem skin effectively.

Skin science – the power of nature

Two substances, Phycosaccharide® AC, derived from brown seaweed, and zinc PCA – a complex of zinc – have both been scientifically shown to be effective in treating problem skin following laboratory research and human trials.

Researchers studying Phycosaccharide® AC believe that it has anti-bacterial, anti-inflammatory effects and sebum regulating properties1, while zinc, a component of Phycosaccharide® AC, is known to inhibit sebum production. Zinc may have antibacterial properties2.

Many reports and scientific studies examine the effects of brown seaweed, zinc and Phycosaccharide® AC in treating spots. Results have been impressive and findings include:

– Sebum levels were found to reduce by 67 per cent after volunteers used a Phycosaccharide® AC preparation for 28 days3.
– A Phycosaccharide® AC preparation improved skin hydration for four hours following application.4
– A double-blind, randomised and placebo-controlled trial conducted at the San Gallicano Institute and Acne Clinic in Rome5, involved 60 volunteers aged 12 to 24 years with mild acne. They used either an active treatment containing Phycosaccharide® AC (a skin wash followed by a balm) or a placebo, night and morning, for 56 days. Results showed that the group using the Phycosaccharide® AC products had a statistically significant reduction in the number of inflammatory acne spots as well as a reduction in whiteheads and blackheads when compared to the placebo group, even after just 14 days. Sebum production was also significantly reduced.

Skin science – the power of light

Light has been used for many years both in diagnosis and therapy and it may take the form of LEDs, lasers, infra-red devices and intense pulse light (IPL).

Dermatologists and cosmetic surgeons have used light therapy for a number of years to treat spots and acne and the use of light in hair removal and skin tightening has received widespread publicity, so many consumers are already familiar with the concept.

But it is only recently that light therapy has become available over the counter, so consumers can use a device to treat problem skin at home.

The application of light therapy varies according to the specific wavelength used. For example, low frequency red light generates heat and may be used in treatments for muscular discomfort.

However, research shows that, for acne, the most effective light therapy is blue light at a wavelength of 413-422 nanometers.6 This is the bandwidth that triggers a biological reaction, activating compounds called porphyrins which are a normal part of the metabolism of P. acnes bacteria. The photodynamic reaction produces singlet oxygen atoms, or free radicals, which damage the bacteria cell wall, causing the bacteria to die. When fewer bacteria are present, inflammation is reduced and this allows skin to heal. If used early enough, inflamed spots may not develop at all.

Within the effective bandwidth, a specific wavelength of 415nm has been shown to be the most effective, targeting only P.acnes bacteria without affecting surrounding healthy cells.

Several studies have evaluated the benefits of blue light in acne:

– Kjeldstad’s study6 in 1986 was an in vitro (laboratory based) study but it clearly showed the wavelength region of 380-440nm able to eradicate P. acnes, with maximum sensitivity around 415nm.
– In 2001, Shalita et al7 studied the effect of blue light on spot counts and on bacterial counts from human skin. After six treatments, 60 per cent of patients in the study showed a significant reduction in the levels of P.acnes (p<0.05). After eight treatments, counts of inflammatory spots decreased by a mean (average) of 60 per cent. Two weeks after the last treatment, the count had further decreased by almost 70 per cent. No side effects of treatment were observed.
– In 2002, Japanese researchers8 conducted an open study in patients with mild to moderate acne who were treated twice a week with blue light for up to five weeks. Acne lesions were reduced by 64 per cent. Overall, this study showed that blue light was effective and well tolerated in patients with acne.
– A further open trial conducted by researchers in Falkirk in 20059 used a blue LED light source in 30 subjects with mild to moderate facial acne. The treatment was well tolerated with adverse events experienced generally rated as being mild and usually self-limiting .
– A US study10 evaluated 45 patients treated with high intensity pure blue light of wavelength 415 nm. Clinical assessment was performed at baseline, and two, four and eight weeks after treatment. The mean (average) improvement score was 3.14 at four weeks and 2.90 at eight weeks. Nine patients experienced complete clearing of lesions at eight weeks. The treatment was well tolerated, with 50 per cent of patients highly satisfied with the treatment.

References:

1. Codif International Phycosaccharide AC Scientific Report, 2001, Data on file
2. Zinc PCA Material Information, Data on File
3. Codif International Phycosaccharide AC PY/ALG013, Data on file
4. Codif International Hydrating Effect of Phycosaccharide AC, 2009, Data on file
5. San Galliano Institute and Acne Clinic, Rome, Italy. Data on file
6. Kjeldstad B, Johnsson A. An action spectrum for blue and near ultraviolet inactivation of Propionibeacterium acnes; with emphasis on a possible prophyrin photosensitization. Photochem Photobiol 1986 43:1:67-70
7. Shalita AR, Harth Y, Elman N. Acne photo clearing using a novel, high-intensity, enhanced, narrow-band, blue light source. Clinical Application Notes 2001; Vol 9, No 1 (ES Sharplan)
8. Kawada A, Aragane Y, Kameyama H. Acne phototherapy with a high-intensity, enhanced, narrow-band, blue light source: an open study and in vitro investigation. J Dermatol Sci 2002;20:129-35.
9. Morton CA, Scholefield RD, Whitehurst C, Birch J. An open study to determine the efficacy of blue light in the treatment of mild to moderate acne. J Dermatolog Treat. 2005;16(4):219-23.
10. Tremblay J, Sire D, Lowe N et al. Light-emitting diode 415 nm in the treatment of inflammatory acne: an open-label, multicentric, pilot investigation. J Cosmet Laser Ther 2006: 8:31-3.

The Mentholatum Company Ltd


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