Clinical trials

A number of other clinical trials are worth reviewing for completeness in the blue light field, and other blue light sources are also worthy of mention. Papageorgiou et al11 used a light system that was mixed blue and red light (415 nm and 660 nm) in one patient group, a blue light treatment group, and a group who received white light therapy. They were able to demonstrate that the combination of blue and red light decreased inflammatory acne lesions by 76% compared with 58% clearance in the blue light treatment group, and both were more effective than treatment with white light alone, which showed only a 25% clearance. Meffert et al used a high-energy broad-spectrum blue light source that combined both blue light and UVA light, and noted a marked improvement in patients with pustular inflammatory acne vulgaris after a total of 10 treatments 12.

Figure 1a Before blue light treatment for inflammatory acne vulgaris

Figure 1a Before blue light treatment for inflammatory acne vulgaris

The second blue light source available in the US for the treatment of inflammatory acne vulgaris, and still currently available today, is known commercially as the Blu-U (Dusa Pharmaceuticals, MA, USA). This is a low-intensity blue light source that has also shown its safety and efficacy in treating individuals with inflammatory acne vulgaris. Goldman et al13 first reported on its effectiveness in acne vulgaris in a series of 12 patients. In their study, they were able to document a 40% reduction in papular acne lesions, a 65% reduction in pustular acne lesions, and a 62% reduction in comedonal acne lesions. This was one of the first significant publications that noted not only an improvement in the inflammatory component of acne vulgaris with blue light, but also an improvement in the non-inflammatory acne lesions. These improvements were seen from as early as 2 weeks of therapy, similar to that reported with the high-intensity blue light systems. Gold et al 14 followed-up on the previous report and looked at a comparison clinical trial of topical 1% clindamycin solution versus the blue light therapy in patients with mild-to-moderate inflammatory acne vulgaris. They demonstrated that blue light therapy was more effective than topical clindamycin in reducing inflammatory acne lesions.

Figure 1b Blue light treatment for inflammatory acne vulgaris, after twice weekly treatments for 4 weeks

Figure 1b Blue light treatment for inflammatory acne vulgaris, after twice weekly treatments for 4 weeks

A recent clinical evaluation looking at blue light therapy with the Blu-U and its effect on acne — with or without a topical photosensitiser — demonstrated that blue light alone was statistically significant in improving severe inflammatory acne vulgaris, leading to a supplemental FDA filing that was granted for this claim15. A clinical example for  using the Blu-U is shown in Figure 1.

A third blue light source developed for the treatment of inflammatory acne vulgaris is called the OmniLux Blue™ PhotoTherapeutics System (OmniLux, Manchester, UK). Clinical studies have also shown its effectiveness in treating inflammatory acne vulgaris. It uses LED blue light arrays with a peak irradiance of 410–420 nm and has shown acne lesion reductions of up to 74% in reported clinical trials16.

Home blue light therapy devices for acne vulgaris

For completeness in this article, it has been decided to briefly mention the home-use acne market for medical devices. This has been thoroughly reviewed elsewhere and will not be done here. It is important to note that all home blue light sources for acne vulgaris (as well as for rejuvenation) are different in that their light energy output is real in some cases, and not so real, as reported, in other cases. Patients must rely on reliable companies with reliable clinical data in making a proper determination on which home blue light source is right for them.

A number of years ago, the author reported on the Tanda Blue Light System and the Tanda Zap for home use17,18. These are small, portable devices that have shown effectiveness in improving inflammatory acne vulgaris. Others, such as the Tria Blue are also effective in treating inflammatory acne vulgaris, and at this time, these remain the most popular of the take-home blue light sources. Again, the literature has reviewed this topic in detail.

Conclusions

Blue light therapy for inflammatory acne vulgaris is a true and tried method for improving the outcomes of those suffering from acne vulgaris. While some offices embrace this therapy and use it for many patients on a regular basis, others still have not come to realise how useful it can be. For many years, clinical trials have supported its usefulness and showed its safety and efficacy in helping patients.