Efficacy and safety of the 589/1319 nm solid-state dual-wavelength laser combined with topical benzoyl peroxide for inflammatory acne vulgaris: a split-face randomized controlled trial

The 589/1319 nm solid-state dual-wavelength (SSDW) laser, which does not require consumable dye, has the potential to target inflammation and sebum production in acne vulgaris pathogenesis. To assess the efficacy and safety of 598/1319 nm SSDW laser as an adjunctive treatment to conventional treatment, 18 patients with bilateral facial acne, with inflammatory papules or pustules, were recruited. Patients were instructed to apply 2.5% benozoyl peroxide (BPO), the drug for inflammatory acne, to their entire face throughout the study. One side of the face was randomly assigned to receive 4 sessions of 589/1319 nm SSDW laser treatments, administered every 2 weeks. After the last laser treatment, 3 monthly follow-ups were scheduled. Inflammatory lesion count (ILC) and acne-related skin parameters, including hemoglobin level, melanin level, skin depression, and skin roughness were measured. Adverse events (AEs) and patients' satisfaction were assessed. At the 3-month follow-up, the ILC reduced by 46% on the adjunctive laser (BPO + laser) side (p = 0.0080), compared with a 29% reduction on the BPO monotherapy side (p = 0.1875). On the adjunctive laser side, the change in ILC positively correlated with the change in melanin level (r = 0.51, p = 0.0301) and showed a trend towards a positive correlation with the change in depression volume (r = 0.45, p = 0.0606) and roughness level (r = 0.42, p = 0.0806). The patients reported a pain score of 3.4 +/- 2.3 on scale of 10. No serious AEs occurred. Patients' satisfaction scores were higher with the adjunctive laser therapy, although this was not statistically significant (p = 0.2758). In conclusion, the 589/1319 nm SSDW laser provided a synergistic effect as an adjunctive treatment to BPO in inflammatory acne in terms of reducing ILC and improving post inflammatory hyperpigmentation without causing discomfort or downtime.