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Objectives: Our study aimed to analyze the effects of ethosome gold photothermal therapy for acne.

Introduction: Acne, a prevalent skin disease primarily observed during adolescence, is characterized by the involvement of pilosebaceous units. Although numerous treatment options are available for acne, they often come with undesirable side effects such as antibiotic resistance, teratogenicity, and skin irritation. Therefore, there is a compelling need to develop alternative treatments that are more effective and safe for managing acne.

Materials / method: A total of 24 patients with moderate to severe acne vulgaris, who visited the dermatologic clinic, were enrolled in this study. All patients received three successive treatments at 2 to 3-week intervals. The patients were randomly divided into two groups. The first group underwent CO2 fractional laser treatment on the acne lesions on the face before applying an ethosome gold nanoparticle ampule. An ethosome gold nanoparticle ampule was applied with sonophoresis for the second group without a CO2 fractional laser. Subsequently, for all patients, long-pulsed Nd:YAG laser treatment was irradiated

Results: Significant reductions in acne lesions were observed after using gold photothermal therapy in both groups. According to the Physician Global Assessment, all patients showed an average improvement of more than 50% in their condition. Histopathological findings revealed decreased inflammatory cell infiltration and fibrotic changes in the dermis after ethosome gold photothermal therapy. In patients who underwent blood sampling, the gold levels in the blood were below the detection limit. (<3.0 ㎍/kg)

Conclusion: Ethosome gold photothermal therapy showed significant clinical and histological improvements in acne vulgaris in Asians without serious adverse effects. Using the CO2 fractional laser to accelerate the gold nanoparticles will be another option for the treatment.

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Objectives: To simplifly acne treatment based on my classification of staging with the use of various cosmeceutical, desmosomalytic peels, comedone extraction and new antioxidants to kill Cuticumbacterium acnes and other bacteria.

Introduction: By this technique, oral antibiotic topical drugs or retinoids are not required except patients with Gram negative bacilli or cystic acne.

Materials / method: Details of the ingredients in cosmeceuticals and desmosomalytic peels will be elucidated.

Results: 90% of the cases, acne lesions can be clear in 2-3 months without the use of oral antibiotics, lights & lasers, or retinoids.
The rest of patients required the conventional therapy.
Acne lesions of the back and steroid on the back which in fact are pityrosporon folliculitis required the anti-yeast cosmeceuticals and TCA peel.

Conclusion: This combination techniques yield rapid clearing of acne lesions without the side effects of systemic antibiotics and retinoid and also reduce the cost of treatment.

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Objectives: To define, describe, and differentiate causes of acne scarring like acne fulminans, rosacea fulminans and acne conglobata.
To discuss laser remodelling of moderate to severe acne scars.
To discuss ideal management of post-inflammatory hyperpigmentation (PIH) and post-inflammatory erythema (PIE) in brown skin.

Introduction: The successful treatment of acne fulminans, rosacea fulminans and flares of acne conglobata requires a successful management of the inflammatory phase of these diseases. When the disease activity is already controlled, assessment of the type and severity of scarring is recommended and a logical treatment plan should be created.

Materials / method: Case studies of moderate to severe acne scarring in Filipinos with Skin phototype IV will be presented. The treatment of the inflammatory phase will be discussed. This will be followed by an evaluation how PIH, PIE, and scars will be treated with topical agents and laser remodelling. Baseline and post-treatment photos will be presented.

Results: 8 cases of Filipinos (6 males, 2 females) were carefully diagnosed with any of the following conditions: Acne fulminans, Rosacea fulminans, and Acne conglobata. The inflammatory phase was treated with a combination of any of the following: Methylprednisolone; oral antibiotics; and oral isotretinoin. Light emitting diode (blue light (40-495 nm) was used in very severe cases twice weekly for 6 weeks. Post-inflammatory hyperpigmentation was treated with a combination of non-irritating skin lightening agents . Erbium:YAG resurfacing and 577 nm lasers were used for skin resurfacing and PIH/PIE.

Conclusion: The treatment to moderate to severe acne scarring should be well-planned-addressing the inflammatory phase first, then the PIH, PIE and scarring after. Non-irritating new generation skin lightening agents are recommended. A combination of fractional Er:YAG laser and 577 nm yellow lasers is recommended for skin resurfacing and remodelling of the scars.

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