A luz como forma de tratamento da acne vulgar: uma revisão sistemática
DOI:
https://doi.org/10.33233/fb.v19i2.1319Abstract
A acne vulgar é uma desordem da unidade pilosebácea que apresenta alta prevalência e incidência, principalmente em adolescentes. Atualmente, existem diversas intervenções terapêuticas, porém os dispositivos de baixa intensidade têm ganhado destaque. Frente a isso, foi realizada uma revisão sistemática sobre os efeitos da luz de baixa intensidade no tratamento da acne vulgar e investigado os parâmetros adequados para esta aplicação. Uma pesquisa bibliográfica foi conduzida no período de maio a junho de 2017, em quatro bases de dados (Medline, PEDro database, Lilacs e PubMed). Foram incluídos estudos experimentais, publicados no período entre janeiro de 1970 a junho de 2017, nas línguas inglesa e portuguesa. Avaliou-se a qualidade metodológica e os parâmetros luminosos. A pesquisa resultou em 21 artigos. Destes, apenas 4 foram estudos randomizados. Na escala PEDro (0 a 10), um estudo recebeu nota 10, 2 receberam nota 8 e os demais receberam notas de 0 a 5. Nos parâmetros luminosos, os comprimentos de ondas mais utilizados foram 415 nm e 633 nm e a fluência mais utilizada foi 48 J/cm². No presente estudo, alguns parâmetros variaram significativamente, não sendo possível estabelecer qual dose seria a mais adequada para o manejo da acne vulgar. Desta forma, conclui-se que a luz terapêutica de baixa intensidade tem vantagens no tratamento da acne, porém são necessários novos estudos com amostragens maiores, controlados e randomizados, para melhor determinar os parâmetros adequados.
Palavras-chave: acne vulgar, terapia com luz de baixa intensidade, fototerapia.
References
Bhambri S, Del Rosso JQ, Bhambri A. Pathogenesis of acne vulgaris: recent advances. J Drugs Dermatol 2009;8(7):615-8.
Strauss JS, Krowchuk DP, Leyden JJ, Lucky AW, Shalita AR, Siegfried EC et al. Guidelines of care for acne vulgaris management. J Am Acad Dermatol 2007;56(4):651-63.
Paschoal FM, Ismael APPB. A ação da luz no tratamento da acne vulgar. Surg Cosmet Dermatol 2010;2(2):117-23.
Charakida A, Seaton ED, Charakida M, Mouser P, Avgerinos A, Chu AC. Phototherapy in the treatment of acne vulgaris: what is its role? Am J Clin Dermatol 2004;5(4):211-6.
Costa A, Alchorne MMA., Goldschmidt MCB. Fatores etiopatogênicos da acne vulgar. An Bras Dermatol 2008;83(5):451-9.
Rotunda AM, Bhupathy AR, Rohrer TE. The new age of acne therapy: light, lasers, and radiofrequency. J Cosmet Laser Ther 2004;6(4):191-200.
Hamilton FL, Car J, Lyons C, Car M, Layton A, Majeed A. Laser and other light therapies for the treatment of acne vulgaris: systematic review. Br J Dermatol 2009;160(6):1273-85.
Laubach HJ, Astner S, Watanabe K, Clifford J, Rius-Diaz F., Zurakowski D, Manstein D. Effects of a 1,450 nm diode laser on facial sebum excretion. Lasers Surg Med 2009 (Feb);41(2):110-5.
Jung JY, Choi YS, Yoon MY, Min SU, Suh DH. Comparison of a pulsed dye laser and a combined 585/1,064-nm laser in the treatment of acne vulgaris. Dermatol Surg 2009; 35(8):1181-7.
Cunliffe WJ. Acne. London: Dunitz; 1989.
Sigurdsson V, Knulst AC, Van Weelden H. Phototherapy of acne vulgaris with visible light. Dermatology 1997;194(3):256-60.
Elman M, Lebzelter J. Light therapy in the treatment of acne vulgaris. Dermatol Surg 2004;30(2 Pt 1):139-46.
Moseley AM, Herbert RD., Sherrington C, Maher CG. Evidence for physiotherapy practice: A survey of the Physiotherapy Evidence Database (PEDro). Aust J Physiother 2002;48(1):43-9.
Reid S, Rivett D. Manual therapy treatment of cervicogenic dizziness: a systematic review. Man Ther 2005;10:4-13.
Tuner J, Hode L. The laser therapy handbook. Tallinn: Prima Books AB; 2004.
Papageorgiou P, Katsambas A, Chu A. Phototherapy with blue (415 nm) and red (660 nm) light in the treatment of acne vulgaris. Br J Dermatol 2000;142(5):973-8.
Gold MH, Sensing W, Biron JA. Clinical efï¬cacy of home-use blue-light therapy for mild-to moderate acne. J Cosmet Laser Ther 2011;13(6):308-14.
Kwon HH, Lee JB, Yoon JY, Park SY, Ryu HH, Park BM et al. The clinical and histological effect of home-use, combination blue-red LED phototherapy for mild- to-moderate acne vulgaris in Korean patients: a double- blind, randomized controlled trial. Br J Dermatol 2013;168:1088-94.
Na J, Suh DH. Red light phototherapy alone is effective for acne vulgaris: randomized, single-blinded clinical trial. Dermatol Surg 2007;33(10):1228-33.
Sadick NS. A study to determine the effect of combination blue (415 nm) and near-infrared (830 nm) light-emitting diode (LED) therapy for moderate acne vulgaris. J Cosmet Laser Ther 2009;11(2):125-8.
Sadick NS. Handheld LED array device in the treatment of acne vulgaris. J Drugs Dermatol 2008;7(4):347-50.
Zane C, Capezzera R, Pedretti A, Facchinetti E, Calzavara PP. Non-invasive diagnostic evaluation of phototherapeutic effects of red light phototherapy of acne vulgaris. Photodermatol Photoimmunol Photomed 2008;24(5):244-8.
Lee SY, You CE, Park MY. Blue and red light combination LED phototherapy for acne vulgaris in patients with skin phototype IV. Lasers Surg Med 2007; 39(2):180-8.
Goldberg DJ, RusselL BA. Combination blue (415 nm) and red (633 nm) LED phototherapy in the treatment of mild to severe acne vulgaris. J Cosmet Laser Ther 2006;8(2):71-5.
Assunção D, Stall KR, Castilho LV, Amorim MH, Palma M, Fonseca PB, et al. Tratamento fisioterapêutico da acne por meio do laser. Fisioter Mov 2003;16(4): 11-6.
Ammad S, Gonzales M, Edwards C, Finlay AY, Mills C. An assessment of the efficacy of blue light phototherapy in the treatment of acne vulgaris. J Cosmet Dermatol 2008;7(3):180-8.
Baugh WP, Kucaba WD. Nonablative phototherapy for acne vulgaris using the KTP 532 nm laser. Dermatol Surg 2005;31(10):1290-6.
Gold MH, Rao J, Goldman MP, Bridges TM, Bradshaw VL, Boring MM, Guider AN. A multicenter clinical evaluation of the treatment of mild to moderate inflammatory acne vulgaris of the face with visible blue light in comparison to topical 1% clindamycin antibiotic solution. J Drugs Dermatol 2005;4(1):64-70.
Morton CA, Scholefield RD, Whitehurst C, Birch J. An open study to determine the efficacy of blue light in the treatment of mild to moderate acne. J Dermatolog Treat 2005;16:219-223.
Omi T, Bjerring P, Sato S, Kawana S, Hankins RW, Honda M. 420nm intense continuous light therapy for acne. J Cosmet Laser Ther 2004;6:156-162.
Tremblay JF, Sire DJ, Lowe NJ, Moy RL. Light-emitting diode 415 nm in the treatment of inflammatory acne: an open-label, multicentric, pilot investigation. J Cosmet Laser Ther 2006;8(1):31-3.
Wheeland RG, Koreck A. Safety and effectiveness of a new blue light device for the self-treatment of mild-to-moderate acne. J Clin Aesthet Dermatol 2012;5(5):25-31.
Yilmaz O, Senturk N, Yuksel EP, Aydin F, Ozden MG, Canturk T et al. Evaluation of 532-nm KTP laser treatment efï¬ cacy on acne vulgaris with once and twice weekly applications. J Cosmet Laser Ther 2011;13(6):303-7.
Tzung TY, Wu KW, Huang ML. Blue light phototherapy in treatment of acne. Photodermatol Photoimmunol Photomed 2004;20:266-9.
Arruda LHF, Kodani V, Filho AB, Mazzaro CB. Estudo clÃnico, prospectivo, aberto, randomizado e comparativo para avaliar a segurança e a eficácia da luz azul versus peróxido de benzoÃla 5% no tratamento da acne inflamatória graus II e III. An Bras Dermatol 2009;84(5):463-8.
Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1. The Cochrane Collaboration; 2011. [cited March 2017]. DisponÃvel em: http://handbook-5-1.cochrane.org/.
Bhardwaj SS, Rohrer TE, Arndt K. Lasers and light therapy for acne vulgaris. Semin Cutan Med Surg 2005;24(2):107-12.
Mendez T, Pinheiro A, Pacheco M, Nascimento P, Ramalho L. Dose and wavelength of laser light have influence on the repair of cutaneous wounds. J Clin Laser Med Sur 2004;22(1):19-25.
Rai R, Natarajan K. Laser and light based treatments of acne. Indian J Dermatol Venereol Leprol 2013;79(3):300-9.
Young S, Bolton P, Dyson M, Harvey W, Diamantopoulos C. Macrophage responsiveness to light therapy. Lasers Surg Med 1989;9(5):497-505.
Hamblin MR, Demidova TN. Mechanisms of Low Level Light Therapy - an introduction. Proc SPIE. 2006;6140:614001-12.
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