Affiliation:
1. Department of Dermatology, West China Hospital Sichuan University Chengdu China
2. Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease‐related Molecular Network, West China Hospital Sichuan University Chengdu China
3. Laser Research Centre, Faculty of Health Science University of Johannesburg Doornfontein South Africa
Abstract
AbstractBackground and ObjectiveA 6‐month interval between systemic isotretinoin (ISO) and the initiation of energy‐based interventions has been recommended, due to concerns about keloid formation and delayed wound healing. While this postponement goes against the current trend of early intervention for acne scarring. This systematic review evaluates the efficacy, safety, and patient satisfaction of combinations of ISO with energy‐based devices (EBD).Study Design/Methods and MaterialsPubMed, Embase, Web of Science, Cochrane Library, and Cochrane Central Register of Controlled Trials were comprehensively searched up to April 2023 according to PRISMA guidelines. Two independent reviewers screened the titles and abstracts to select articles. The quality of the literature was assessed for each study design.ResultsA total of 16 studies addressing the efficacy and safety of energy‐based modalities combined with ISO were identified, including six randomized controlled trials (RCTs), two case series, seven cohort studies, and one case report. ISO combinations with intense pulsed light (IPL), fractional ablative CO2 laser, pulsed dye laser (PDL), non‐ablative fractional laser (NAFL) and fractional microneedle radiofrequency (FMRF) have been tested for improving acne severity, acne scarring and erythema.ConclusionThe current evidence does not justify delaying the use of EBDs for patients who have recently undergone or are currently receiving ISO treatment. Evidence‐based treatments such as PDL, NAFL, and FMRF etc. are suggested relatively safe and effective in treating acne and acne scarring.