A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid...
-
Upload
caerwyn-ash -
Category
Documents
-
view
216 -
download
0
Transcript of A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid...
-
7/27/2019 A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid State Diode Arrays
1/29
A Randomised Controlled Study for the
Treatment of Acne Vulgaris using High
Intensity 414nm Solid State Diode Arrays
Caerwyn Ash
http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=x9X7W1T0mAPxeM&tbnid=jBAlX8sARcwmgM:&ved=0CAUQjRw&url=http://www.ubergizmo.com/2012/09/topical-virus-cream-spread-on-the-face-could-fight-acne/acne-cream-virus-fighting/&ei=jN6RUcHjIIT50gXF4oGwCw&bvm=bv.46471029,d.ZG4&psig=AFQjCNHuTDZcApLWX0xFsfHZ_nscJWyFmA&ust=1368600579900077http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=x9X7W1T0mAPxeM&tbnid=jBAlX8sARcwmgM:&ved=0CAUQjRw&url=http://www.ubergizmo.com/2012/09/topical-virus-cream-spread-on-the-face-could-fight-acne/acne-cream-virus-fighting/&ei=jN6RUcHjIIT50gXF4oGwCw&bvm=bv.46471029,d.ZG4&psig=AFQjCNHuTDZcApLWX0xFsfHZ_nscJWyFmA&ust=1368600579900077http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=8sQQiXseQ8HbkM&tbnid=1ZCgTljoQJ5sqM:&ved=0CAUQjRw&url=http://blackriver-mathesonchamberofcommerce.com/index.php/how-to-avoid-acne/&ei=S96RUamvEuis0QWtyYHQBA&bvm=bv.46471029,d.ZG4&psig=AFQjCNG4s2GZudBXvPmGIl2nVqsPa-6AKg&ust=1368600459598872http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=8sQQiXseQ8HbkM&tbnid=1ZCgTljoQJ5sqM:&ved=0CAUQjRw&url=http://blackriver-mathesonchamberofcommerce.com/index.php/how-to-avoid-acne/&ei=S96RUamvEuis0QWtyYHQBA&bvm=bv.46471029,d.ZG4&psig=AFQjCNG4s2GZudBXvPmGIl2nVqsPa-6AKg&ust=1368600459598872 -
7/27/2019 A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid State Diode Arrays
2/29
Declaration
The following potential conflict of interest relationships
are germane to my presentation:
Salary
Travel expenses
Clinical study funded by
Equipment supplied
by The Dezac Group, Cheltenham, UK
http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=x9X7W1T0mAPxeM&tbnid=jBAlX8sARcwmgM:&ved=0CAUQjRw&url=http://www.ubergizmo.com/2012/09/topical-virus-cream-spread-on-the-face-could-fight-acne/acne-cream-virus-fighting/&ei=jN6RUcHjIIT50gXF4oGwCw&bvm=bv.46471029,d.ZG4&psig=AFQjCNHuTDZcApLWX0xFsfHZ_nscJWyFmA&ust=1368600579900077http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=x9X7W1T0mAPxeM&tbnid=jBAlX8sARcwmgM:&ved=0CAUQjRw&url=http://www.ubergizmo.com/2012/09/topical-virus-cream-spread-on-the-face-could-fight-acne/acne-cream-virus-fighting/&ei=jN6RUcHjIIT50gXF4oGwCw&bvm=bv.46471029,d.ZG4&psig=AFQjCNHuTDZcApLWX0xFsfHZ_nscJWyFmA&ust=1368600579900077http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=8sQQiXseQ8HbkM&tbnid=1ZCgTljoQJ5sqM:&ved=0CAUQjRw&url=http://blackriver-mathesonchamberofcommerce.com/index.php/how-to-avoid-acne/&ei=S96RUamvEuis0QWtyYHQBA&bvm=bv.46471029,d.ZG4&psig=AFQjCNG4s2GZudBXvPmGIl2nVqsPa-6AKg&ust=1368600459598872http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=8sQQiXseQ8HbkM&tbnid=1ZCgTljoQJ5sqM:&ved=0CAUQjRw&url=http://blackriver-mathesonchamberofcommerce.com/index.php/how-to-avoid-acne/&ei=S96RUamvEuis0QWtyYHQBA&bvm=bv.46471029,d.ZG4&psig=AFQjCNG4s2GZudBXvPmGIl2nVqsPa-6AKg&ust=1368600459598872 -
7/27/2019 A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid State Diode Arrays
3/29
Study Objective
Objective: This study is designed to quantify
the effectiveness of using a blue light device
in a combination therapy with proprietary
regimen creams in a self-treat investigation.
A Randomised Controlled Study
-
7/27/2019 A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid State Diode Arrays
4/29
Home Use Acne Treatment
Sufferers may be too embarrassed
to seek medical treatment.
Statistically 70% of people have had
acne, both genders, all skin types.
This co ndi t ion that so
undermines self ass urance and
self esteem hits ado lescence at
suc h a vulnerable t imein life.
-
7/27/2019 A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid State Diode Arrays
5/29
Pathogenesis of Acne
-
7/27/2019 A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid State Diode Arrays
6/29
Pathogenesis of Acne
BLUE
Light
-
7/27/2019 A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid State Diode Arrays
7/29
Wavelengths used in current treatment
414 nm LED
IPL
585 nm Dye laser
KTP laser
White light
Blue & Red light sources
Nd:YAG laser1450 nm diode laser
http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=RJt5423ch7zWGM&tbnid=-zMX9V6P6bxa9M:&ved=0CAUQjRw&url=http://clairemaythehedgehog.deviantart.com/art/Rainbow-Gradient-318042922&ei=IOwyUravE-Ob0QWY-YGYDQ&bvm=bv.52164340,d.ZGU&psig=AFQjCNHfZ0ROGCwS_CJDX-XohL3CDSi7CQ&ust=1379155342912706http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=RJt5423ch7zWGM&tbnid=-zMX9V6P6bxa9M:&ved=0CAUQjRw&url=http://clairemaythehedgehog.deviantart.com/art/Rainbow-Gradient-318042922&ei=IOwyUravE-Ob0QWY-YGYDQ&bvm=bv.52164340,d.ZGU&psig=AFQjCNHfZ0ROGCwS_CJDX-XohL3CDSi7CQ&ust=1379155342912706http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=RJt5423ch7zWGM&tbnid=-zMX9V6P6bxa9M:&ved=0CAUQjRw&url=http://clairemaythehedgehog.deviantart.com/art/Rainbow-Gradient-318042922&ei=IOwyUravE-Ob0QWY-YGYDQ&bvm=bv.52164340,d.ZGU&psig=AFQjCNHfZ0ROGCwS_CJDX-XohL3CDSi7CQ&ust=1379155342912706 -
7/27/2019 A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid State Diode Arrays
8/29
Why blue (414 nm)?
In-Vitro Dose response
Investigative Study (2011)
Mechanism of Propionibacterium acne Necrosis by initiation of Reactive Oxygen Species (ROS) by Porphyrin Absorption Ash C, Harris L, Maffeis T
-
7/27/2019 A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid State Diode Arrays
9/29
Why blue (414 nm)?
Scanning Electron Microscope of Propionibacterium
Investigative Study (2011)
Mechanism of Propionibacterium acne Necrosis by initiation of Reactive Oxygen Species (ROS) by Porphyrin Absorption Ash C, Harris L, Maffeis T
-
7/27/2019 A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid State Diode Arrays
10/29
Mode of Action
Prepare skin
Exfoliate
Chemical peel
Illuminate Skin
Photochemical Absorption
Bacteria Death
Wound healing
Heat
Capillaries
Vasodilator creams
1. 2. 3.
Pre-treatment
Facial Wash
Weak Chemical peel
Salicylic Acid
Glycolic Acid
Lactic Acid
Treatment
414 nm light source
220J over 6cm2 over 3 mins
Post-treatment
Moisturiser
Salicylic Acid
Glycolic Acid
Lactic Acid
Menthol
Niacin
-
7/27/2019 A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid State Diode Arrays
11/29
Study Design
Aimed for 50% Males, 50% Females6 Males, 33 Females
Ages ranged 16-37, average 22.1
Cream's weighted at each session
45 subjects assessed
for eligibility
41 subjects accepted
4 subjects did not
meet inclusion criteria
26 subjects
TREATMENT
15 subjects
CONTROL
26 subjects
Completed 12 weeks
15 subjects
Completed 12 weeks
26 subjects
Analysis &Questionnaire
15 subjects
Analysis &Questionnaire
Baseline at assessmentBaseline at assessment
BaselineBaseline + Device
Week 1 PhotographyWeek 1 Photography
Week 2 PhotographyWeek 2 Photography
Week 4 PhotographyWeek 4 Photography
Week 8 PhotographyWeek 8 Photography
Week 12 PhotographyWeek 12 Photography
Recruitment
Recruitment took place between
December 2012 and January 2013 so
that confounding effects of summer
sunlight were avoided.
-
7/27/2019 A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid State Diode Arrays
12/29
Inclusion Criteria This ethics committee approved study recruited subjects aged
between 16 and 45 years with mild-to-moderate facial inflammatory
acne
Male and Female
Able to give informed consent and from whom written informed
consent has been obtained.
Following restrictions during the study:
No change in facial wash product
No medicated facial products
No heavy foundation
No makeup for each assessment at centre
Male subjects to shave daily
-
7/27/2019 A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid State Diode Arrays
13/29
Exclusion Criteria Exclusion criteria were history of photosensitivity and
pregnancy or lactation within the previous 3 months
Subjects who had excessive facial exposure to sunlight or
artificial UV-light within three months prior the study were
excluded.
Psoriasis or Sandpaper acne
Participated in any clinical study during the previous month
Migraines or seizures triggered by light
Topical anti-spot medications, topical antibiotics or topical
steroid usage
Washout periods for previous treatments were 8 weeks for oral
antibiotics and topical treatments, 12 weeks for contraceptives
containing cyproterone acetate, 52 weeks for oral Isotretinoin.
Acne treatments were not allowed during the study.
-
7/27/2019 A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid State Diode Arrays
14/29
Recruitment
Social media
Gloucester University
Doctor surgery's
Schools (Sixth form) Colleges
http://www.google.co.uk/url?sa=i&rct=j&q=Twitter+logo&source=images&cd=&cad=rja&docid=83l2jZGxZ-9yqM&tbnid=-9pcu7db62D6WM:&ved=0CAUQjRw&url=http://nickbaines.wordpress.com/2009/10/17/blogging-and-the-black-dog/twitter-logo-1-2/&ei=Ud-LUdHSCLL50gW17oDQAw&bvm=bv.46340616,d.bGE&psig=AFQjCNFn0kw6ww4cmMvQoGdzMvaP8wK4Mg&ust=1368207547153939http://www.google.co.uk/url?sa=i&rct=j&q=Twitter+logo&source=images&cd=&cad=rja&docid=83l2jZGxZ-9yqM&tbnid=-9pcu7db62D6WM:&ved=0CAUQjRw&url=http://nickbaines.wordpress.com/2009/10/17/blogging-and-the-black-dog/twitter-logo-1-2/&ei=Ud-LUdHSCLL50gW17oDQAw&bvm=bv.46340616,d.bGE&psig=AFQjCNFn0kw6ww4cmMvQoGdzMvaP8wK4Mg&ust=1368207547153939http://www.google.co.uk/url?sa=i&rct=j&q=Twitter+logo&source=images&cd=&cad=rja&docid=m7arg642PYeihM&tbnid=ET-jOSUFYRT3FM:&ved=0CAUQjRw&url=http://twitter.com/about/resources&ei=Qt-LUdLkF6mf0QXRiIHwDg&bvm=bv.46340616,d.bGE&psig=AFQjCNFn0kw6ww4cmMvQoGdzMvaP8wK4Mg&ust=1368207547153939http://www.google.co.uk/url?sa=i&rct=j&q=Twitter+logo&source=images&cd=&cad=rja&docid=m7arg642PYeihM&tbnid=ET-jOSUFYRT3FM:&ved=0CAUQjRw&url=http://twitter.com/about/resources&ei=Qt-LUdLkF6mf0QXRiIHwDg&bvm=bv.46340616,d.bGE&psig=AFQjCNFn0kw6ww4cmMvQoGdzMvaP8wK4Mg&ust=1368207547153939 -
7/27/2019 A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid State Diode Arrays
15/29
Device and Creams
Subjects given pre-treatment
and post-treatment creams
and device on one week after
initial assessment.
Watched a short video
explaining how to use deviceand creams
Close communication with
subjects
-
7/27/2019 A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid State Diode Arrays
16/29
Familiarity of applying creams
Acnes is very common and treatable, but finding
suitable treatments can be expensive. Consumers arefamiliar with applying a regime of creams
http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=u87OwOBOi2ofKM&tbnid=qFt8TToFitxlzM:&ved=0CAUQjRw&url=http://ilifesotij.mezoka.com/where-can-you-find-sulfur.php&ei=-t6RUeGFComx0QW7kYC4Bw&bvm=bv.46471029,d.ZG4&psig=AFQjCNFEf6-AZEum835FWpOFI-xzWIch_g&ust=1368600670939606http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=u87OwOBOi2ofKM&tbnid=qFt8TToFitxlzM:&ved=0CAUQjRw&url=http://ilifesotij.mezoka.com/where-can-you-find-sulfur.php&ei=-t6RUeGFComx0QW7kYC4Bw&bvm=bv.46471029,d.ZG4&psig=AFQjCNFEf6-AZEum835FWpOFI-xzWIch_g&ust=1368600670939606 -
7/27/2019 A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid State Diode Arrays
17/29
Lesion Count - Photography
Standardised digital Images of four head positions
provided full face analysis
-
7/27/2019 A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid State Diode Arrays
18/29
Lesion Count - Custom Software
lesions from full face images counted using custom
software.
-
7/27/2019 A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid State Diode Arrays
19/29
Results Lesion Count
-
7/27/2019 A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid State Diode Arrays
20/29
Results
-
7/27/2019 A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid State Diode Arrays
21/29
Results
23 year old female, Only OTC medication
-
7/27/2019 A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid State Diode Arrays
22/29
Results
26 year old femaleTetracycline 4 years ago
-
7/27/2019 A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid State Diode Arrays
23/29
Results
26 year old female, Tetracycline 2 years ago
l
-
7/27/2019 A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid State Diode Arrays
24/29
Results
18 year old female
l
-
7/27/2019 A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid State Diode Arrays
25/29
Results
All subjects in treatment group improved in lesion
counts after 12 weeks
Inflammatory lesion counts reduced by 50.02% in
treatment group and increased 2.45% in controls.
Reduction in lesion clearance was observed in the first
3 weeks after start of treatment.
Treatment is pain and side effect-free.
S bj F db k
-
7/27/2019 A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid State Diode Arrays
26/29
Subject Feedback
P h l
-
7/27/2019 A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid State Diode Arrays
27/29
Psychological Aspects of Acne Vulgaris and
the role of Social Media
Rebecca Whittall & Caerwyn AshPsychology, Health & Medicine: in press
Psychology
C l i
http://www.google.co.uk/url?sa=i&rct=j&q=mobile+phone&source=images&cd=&cad=rja&docid=Zl5Vk7UioOknBM&tbnid=RhPwh6ib703wQM:&ved=0CAUQjRw&url=http://www.herts.police.uk/advice/crime_prevention/mobile_phone_security.aspx&ei=cxOeUezaNsKvOY_xgCA&psig=AFQjCNGKIrHXEarcd_qL_vkyH3ay-CqYmg&ust=1369400555745382http://www.google.co.uk/url?sa=i&rct=j&q=mobile+phone&source=images&cd=&cad=rja&docid=Zl5Vk7UioOknBM&tbnid=RhPwh6ib703wQM:&ved=0CAUQjRw&url=http://www.herts.police.uk/advice/crime_prevention/mobile_phone_security.aspx&ei=cxOeUezaNsKvOY_xgCA&psig=AFQjCNGKIrHXEarcd_qL_vkyH3ay-CqYmg&ust=1369400555745382http://www.google.co.uk/url?sa=i&rct=j&q=twitter&source=images&cd=&cad=rja&docid=7bqDRz77NqhnrM&tbnid=3kaCk4iKRBKRTM:&ved=0CAUQjRw&url=http://www.dusktilldawnpoker.com/news/ispt-facebook--twitter-freerolls/2331&ei=BxOeUerPLcHMPa7qgIAI&bvm=bv.46865395,d.ZWU&psig=AFQjCNHmZcVDRPvWxIuVDIRvHZScoyX3-g&ust=1369400449060976http://www.google.co.uk/url?sa=i&rct=j&q=twitter&source=images&cd=&cad=rja&docid=7bqDRz77NqhnrM&tbnid=3kaCk4iKRBKRTM:&ved=0CAUQjRw&url=http://www.dusktilldawnpoker.com/news/ispt-facebook--twitter-freerolls/2331&ei=BxOeUerPLcHMPa7qgIAI&bvm=bv.46865395,d.ZWU&psig=AFQjCNHmZcVDRPvWxIuVDIRvHZScoyX3-g&ust=1369400449060976http://www.google.co.uk/url?sa=i&rct=j&q=facebook&source=images&cd=&cad=rja&docid=B0sgUa65DReFtM&tbnid=XzcrgjJ8smX1rM:&ved=0CAUQjRw&url=http://tallships.org/news/facebook/&ei=6xKeUYr2KsX6PLiqgOgB&bvm=bv.46865395,d.ZWU&psig=AFQjCNGUZC1wsbQ4iQKLmcOUfbgeQ3bBNw&ust=1369400420655209http://www.google.co.uk/url?sa=i&rct=j&q=facebook&source=images&cd=&cad=rja&docid=B0sgUa65DReFtM&tbnid=XzcrgjJ8smX1rM:&ved=0CAUQjRw&url=http://tallships.org/news/facebook/&ei=6xKeUYr2KsX6PLiqgOgB&bvm=bv.46865395,d.ZWU&psig=AFQjCNGUZC1wsbQ4iQKLmcOUfbgeQ3bBNw&ust=1369400420655209 -
7/27/2019 A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid State Diode Arrays
28/29
Conclusion Home-use blue light therapy improves inflammatory
facial acne three weeks after first treatment with no
serious adverse effects. An effective, drug freemethod of confronting this issue is presented by this
study.
The blue light device offers a valuable alternative toantibiotics and potentially irritating topical
treatments.
The onset of the effect was observable at week 3,
and maximal between weeks 8 and 12.
Although the device works well as a monotherapy,
its best suited to a combination therapy
-
7/27/2019 A Randomised Controlled Study for the Treatment of Acne Vulgaris using High Intensity 414nm Solid State Diode Arrays
29/29