Article Figures & Data
Figures
- Figure 1
PRISMA chart.
aSee Supplemental Appendix at http://www.annfammed.org/content/17/6/545/suppl/DC1.
- Figure 2
Risk of bias.
The risk of bias for all 14 trials was assessed with the Cochrane Collaboration’s Risk of Bias tool.13
- Figure 3
Mean difference between groups in the mean number of noninflammatory lesions.
BRA = Brazil; USA = United States of America.
- Figure 4
Mean difference between groups in the mean number of inflammatory lesions.
BRA = Brazil; USA = United States of America.
Tables
Study Participants Intervention Comparator Primary Outcome Investigator Assessment Author, Year, Location Unit of Randomization Follow-Upa (Weeks) Mean Age in Years (Range) Acne Severity Mild Moderate Severe N Total Light Wavelength: Blue = 4-500 nm Red = ≥600 nm Total No. of Sessions Duration of Exposure (Weeks) Type Total No. of Sessions Duration of Exposure (Weeks) Gold et al,20 2011 (USA) Lesion ≤1.5 30 (NR) Mild, moderate 30 Blue 4 0.3 Sham device 4 0.3 NR Antoniou et al,16 2016 (GRC) Half-face 12 21 (16-30) Moderate, severe 98 Blue 12 6 No treatment n/a n/a In blue light group, 34% more patients experienced ≥2 IGA grade reductions (P <.0001) Tzung et al,23 2004 (TWN) Half-face 8 21 (15-32) Mild, moderate 31 Blue 8 4 No treatment n/a n/a Patients treated with blue light had greater mean % improvement of overall acne severity (45% vs 12%), P <.05 Elman et al,18 2003, (ISR) Half-face 12 19 (NR) NR 23 Blue 8 4 No treatment n/a n/a NR Gold et al,19 2005 (USA) Individual 4 31 (13-55) mild, moderate 25 Blue 8 4 Topical 1% clindamycin 56 4 Narrative only de Arruda et al,17 2009 (BRA) Individual 6 17 (NR) Moderate, severeb 60 Blue 8 4 Topical BPO 5% 56 4 NR Papageorgiou et al,8 2000c (UK) Individual 12 23, 25, 27d (NR) Mild, moderate 82 a. Blue b. Blue/red 84 12 Topical BPO 5% NR NR Clear or marked improvemente: blue/red: 63% of patients, blue 40%, benzoyl: 35%. P value NR. Kwon et al,3 2013 (KOR) Individual 12 23, 24f (NR) Mild, moderate 35 Blue/red 56 4 Sham device 56 4 Blue/red: 66% more patients rated clear (IGA = 0) or almost clear (IGA = 1), P <.01 Alba et al,15 2017 (BRA) Individual 10 16 (NR) Mild, moderateg 22 Blue/red 10 10 Topical SA peel 10% 10 10 NR Nestor, et al,21 2016 (USA) Individual 12 NR (12-18) Mild, moderate 105 a. Blue/red + cleanser b. Blue/red + cleanser + 1% SA + retinol 84 12 Topical BPO 2.5% + cleanser 168 12 Blue/red + cleanser: 19% improve- ment in IGA scale (P <.001); Blue/red + cleanser + SA + retinol 14%; BPO 5% improvement Ash et al,24 2015 (UK) Individual 12 NR (16-45) Mild, moderate 41 Blue + topical (SA + glycolic and lactic acids) + moisturizer 28 8 “Control” (details NR) NR NR NR Chu,26 1999, NR Individual 12 NR (NR) Mild, moderate 107h a. Blue b. Blue/red 84 12 Topical BPO 5% 168 12 Narrative only Miller et al,27 2017, NR Individual 12 NR (12-40) Mild, moderate NR Blue/red 1i NR Topical BPO 2.5% 2j NR NR Ash et al,25 2013 (UK) Individual NR NR (NR) Mild, moderate 39 Blue + topical creams NR NR “Control” (details NR) NR NR NR BPO = benzoyl peroxide; BRA = Brazil; GRC = Greece; IGA = Investigators’ Global Assessment scale for acne; ISR = Israel; KOR = Korea; n/a = not applicable; NR = not reported; SA = salicylic acid; TWN = Taiwan; UK = United Kingdom; USA = United States of America.
↵a This includes the treatment period.
↵b Acne grade II and III on the Brazilian classification scale. Grade II presents comedones and more inflammatory papules; grade III presents pustules in addition to any of grade II.
↵c Reported here are the blue-light, blue/red-light, and benzoyl peroxide groups, not the cool white group.
↵d In blue-light, blue/red-light, and benzoyl peroxide groups respectively.
↵e Marked improvement defined as overall treatment response of 60% to 89%; clearance defined as 390%.
↵f In blue-light and sham groups, respectively.
↵g Acne grade I and II on the Brazilian classification scale. Grade I represents comedones only; grade II represents comedones and more inflammatory papules.
↵h Total for all 4 groups (blue light, blue/red light, benzoyl peroxide, white light); N for individual groups not reported.
↵i Reported as “1 session per day,” duration NR.
↵j Reported as “2 sessions per day,” duration NR.
Supplemental Appendixes
Supplemental Appendixes
Files in this Data Supplement:
- Supplemental data: Appendixes - PDF file
The Article in Brief
Blue-Light Therapy for Acne Vulgaris: A Systematic Review and Meta-Analysis
Anna Mae Scott , and colleagues
Background Acne is one of the most common reasons for clinical consultations. Market and patient demand is high for light therapy as an alternative to antibiotic approaches to acne treatment. However, conclusions about the effectiveness of blue light therapy for acne are limited.
What This Study Found A new systematic review and meta-analysis of 14 randomized controlled trials of blue-light therapy for acne shows methodological and reporting limitations--including small sample sizes, short intervention periods, and variation in reporting quality for acne outcomes. Only three of the trials reported significant improvements in expert-assessed acne severity with blue-light therapy over a control group. The majority of trials do not provide sufficient evidence to conclude effectiveness.
Implications
- Because evidence for blue-light therapy is not conclusive, patients should discuss with their clinicians the possible benefits, costs, and alternatives for acne treatment. Blue light therapy may be beneficial for some patients, but more research is needed.
