A Prospective, Multicenter, Study of Laser-Activated Gold Microparticles for Treating Patients Using Concomitant Topical Retinoids for Mild-to-Moderate Inflammatory Acne

November 2023 | Volume 22 | Issue 11 | 1094 | Copyright © November 2023


Published online October 29, 2023

doi:10.36849/JDD.7744

Jill Waibel MDa, Emmy Graber MDb, Ted Lain MD MBAc, Aron Gewirtzman MDc,d, Christina Feser MDe, William Werschler MDf

aMiami Dermatology and Laser Institute, Miami, FL
bDermatology Institute of Boston, Boston, MA
cSanova Dermatology, Austin, TX
dAustin Dermatology Associates & Aesthetics, Austin, TX
eNashville Skin, Nashville, TN 
fSpokane Dermatology Clinic, Spokane, WA

Abstract
Gold microparticles are indicated as an accessory to 1064 nm lasers to facilitate photo-thermal heating of sebaceous glands for treating mild-to-moderate inflammatory acne vulgaris (Sebacia Microparticles, Coronado Aesthetics LLC, Southlake, TX). The following study assessed the safety and clinical benefit of gold microparticles/laser therapy when used together with commercially available topical acne products. Healthy patients, 12 to 45 years old with mild-to-moderate inflammatory facial acne were prescribed a topical pre-treatment retinoid for 3 to 4 weeks. The gold microparticle suspension was then applied to the entire face and massaged into the skin. The laser procedure was performed with commercially available 1064 nm Nd:YAG lasers with fluence in the 20 to 35 J/cm2 range, a 30 ms pulse duration, and direct cooling. Among participants completing the study (N=52), the mean percent change in inflammatory lesion counts (ILC) was -55% at month 2, reaching -68% at month 12. At that time, 86% of participants achieved a 40% decrease in ILC and 75% achieved a 60% decrease in ILC. Mean Investigator's Global Assessment (IGA) Scale scores decreased by 41.6% from 2.4 at day 0 to 1.4 at month 12. The percentage of participants with clear or almost clear skin increased from 7% at day 0 to 59% at month 12. Acne therapy with topically applied gold microparticles followed by 1064 nm laser irradiation is an effective treatment for moderate to moderately severe acne. The treatment was well-tolerated with a high degree of participant satisfaction.

J Drugs Dermatol. 2023;22(11):1088-1094     doi:10.36849/JDD.7744

INTRODUCTION

Acne vulgaris is a chronic inflammatory skin disease affecting the pilosebaceous follicles.1 It is estimated that 40 to 50 million individuals in the US have acne with an 85% prevalence rate among those aged 12 to 24 years old.1 Most patients affected by acne present with a combination of inflammatory and non-inflammatory lesions. Non-inflammatory acne lesions include open and/or closed comedones, while inflammatory lesions manifest as papules, pustules, nodules, and/or cysts.2,3 The disease is associated with a prolonged, remitting, and relapsing course, generally beginning in adolescence and sometimes continuing into adulthood.4 Physical scars and dyschromias in the skin are also common in the disease.5 Understandably, acne imparts a serious psychological burden on affected individuals, including anxiety, depression, and social withdrawal.6,7 

Sebaceous gland differentiation and sebum production are regulated by a complex interplay of hormones, especially androgens.8,9 At the cellular level, peroxisome proliferator-activated receptors located on sebocytes increase sebaceous gland lipogenesis and sebum production.10 Together with the stratum corneum, sebum is important to the integrity and normal function of the skin, acting as a lubricant and barrier to the external environment; however, excess sebum production facilitates Cutibacterium acnes proliferation by providing nutrients and creating an anaerobic environment for bacterial growth. As a result, excess sebum is an important contributor to the inflammatory processes underlying the development of acne vulgaris.11
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