***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The high prevalence of acne vulgaris in teenagers has increased comorbidities . Lasers offer alternative options for acne treatment because they have rapid action , low systemic adverse effects , and do not require everyday treatment . To study the efficacy and patients ' satisfaction of 595-nm pulse dye laser ( PDL ) treatment of acne vulgaris and acne erythema in adolescents and early adulthood , we design ed a blocked-r and omized , split-faced 595-nm PDL ( fluence 8 J/cm3 pulse duration 10 ms , spot size 7 mm , 2 session every 2 weeks ) study in patients with mild to moderate acne by comparing the laser-treated and non-treated side . The acne lesion counts , acne erythema grading , and acne severity grading were evaluated at baseline and 2 , 4 , and 8 weeks . Thirty patients were recruited . The results showed no statistically significant difference except the papule count at week 4 which was -1.828 on the treated side and 0.103 on the non-treated side of the face , P-value 0.0018 . There was no statistically significant difference of acne severity grading and acne erythema grading between both sides of the face . The mean scores of patients ' satisfaction on the laser-treated side were 75 , 81 , and 81 % , respectively . The PDL treatment in this study reveals no significant improvement in acne therapy ; however , the patients were satisfied with this laser treatment Abstract Introduction : The aim was to compare the treatment effectiveness of intense pulsed light ( IPL ) and vacuum versus IPL with placebo for mild to moderate comedonal and inflammatory acne . Patients and methods : We r and omized 180 patients with mild to moderate comedonal and inflammatory acne into three groups : Group A – 60 patients treated with vacuum and IPL  , Group V – 60 patients treated with IPL  , and Group 0 ( control group ) – 60 patients who received topical treatment with Sebium H2O Micellaire Solution .  We evaluated the results using the Leeds revised acne-grading system and Cardiff Acne Disability Index . Results : There was a significant reduction in the number of papules , pustules , and comedones in Groups A and V compared with those in the control group ( p < 0.001 ) with a more rapid decrease of the papules from Group A compared with that from Group V. We found an improvement in the clinical aspect ( p < 0.001 ) when we compared Groups A and V with controls . Patients belonging to Group A were more satisfied compared with those belonging to Group V ( p = 0.004 ) and significantly more satisfied compared with those belonging to Group 0 ( p < 0.001 ) . In conclusion , we consider that both the devices are efficient , the combination of vacuum and IPL representing a therapeutic option for the comedonal acne BACKGROUND Various forms of laser therapy including the pulsed-dye laser ( PDL ) have been reported to reduce acne lesion counts . OBJECTIVE In this study , the benefits and complications when using a 595-nm PDL for the treatment of acne vulgaris were evaluated when comparing a subpurpuric ( low ) fluence level with a purpuric ( high ) fluence level . MATERIAL S AND METHODS This study was a prospect i ve , single-blinded split-face clinical trial . Inclusion criteria included subjects with moderate to severe facial acne . All participants were treated with PDL , with each half of the face receiving either high or low fluence at 3-week intervals for a total of 4 treatments . St and ardized facial photographs were obtained and blindly evaluated . RESULTS Sixty-two subjects were enrolled with a mean age of 22.3 years . Fifty-five patients completed the study . The results showed a significant decrease in lesion counts compared with baseline after all treatments . However , the study did not demonstrate a statistically significant difference between the fluence parameters . The only treatment-related adverse event was temporary hyperpigmentation . CONCLUSION This study demonstrates that PDL is effective in reducing acne lesions using purpuric and subpurpuric fluences . However , there was no statistically significant difference in acne lesion count between the higher and lower fluences INTRODUCTION Chemical peeling is a well-identified therapeutic modality for acne vulgaris ( AV ) .  Jessner 's solution ( JS ) is a known peeling agent for acne since more than 100 years . Salicylic acid ( SA ) peel is a well-established peeling agent for acne . There is paucity of literature comparing the current peeling agents of choice , that is , SA with the older peeling agents , that is , JS for acne . OBJECTIVE To compare the efficacy and safety of 30 % SA vs. JS peels in treatment of mild-to-moderate facial acne in Indian patients . MATERIAL S AND METHOD A total of 40 patients with mild-to-moderate AV were enrolled for 12 weeks and were r and omly divided into two groups : group 1 , 30 % SA peels and group 2 , JS peels were performed 2 weeks apart with total of six peels in 12-week duration . Clinical improvement was assessed objective ly using Michaelsson acne scores ( MAS ) and clinical photographs . Side effects were observed at each visit . RESULTS At the end of therapy , improvement in MAS and percentage decrease in MAS were significantly higher in group 1 as compared to group 2 . Likewise , decrease in mean comedone counts in group 1 was significantly higher as compared to group 2 . However , there was no statistically significant difference in the decrease in mean papule and pustule counts between the two groups . Both the groups tolerated the peels well . CONCLUSION Thus , 30 % SA peels were more effective than JS peels in treatment of noninflammatory lesions , that is , comedones and in overall improvement of mild-to-moderate facial acne vulgaris Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more BACKGROUND Acne is characterized by hyperseborrhea , follicular hyperkeratosis , and growth of propionibacteria . Alpha hydroxy acids depending on the pH of the finished product exhibit comedolytic as well as antimicrobial properties . OBJECTIVES The aim of this study was to investigate an oil-in-water emulsion-containing 10 % glycolic acid ( pH 4 ; Dr. August Wolff GmbH & Co. KG Arzneimittel , Bielefeld , Germany ) as monotherapy in mild acne regarding clinical efficacy and tolerability for 90 days . PATIENTS AND METHODS Patients ( n = 120 ; 73 f , 47 m ) suffering from mild acne ( Leeds score 0.25 - 1 ) aged ≥12 ( mean 21 ± 5.8 ) were included in this double-blind , placebo-controlled , r and omized , monocentric trial . The cream was applied once daily in the evening . No additional products were used . Cleansing was st and ardized by supplying the same product to all patients . RESULTS The number of patients ( n = 115 ) in the per- protocol and intention-to-treat analysis was the same . Acne improved significantly in the verum group up to day 90 . Already at day 45 , there was a statistical significant ( 5 % level ) difference against placebo . The subjective evaluation of the verum by physicians and patients regarding clinical efficacy and tolerability was favorable . Regarding reported adverse effects , there was no statistically significant difference ( 5 % level ) between verum and placebo . CONCLUSIONS The 10 % glycolic acid containing oil-in-water emulsion  improved mild acne applied as monotherapy in this study significantly , already after 45 days of treatment . Regarding tolerability , there was no objective or subjective difference between the 10 % glycolic acid containing oil-in-water emulsion and the corresponding placebo BACKGROUND The 1450-nm diode laser has been known to thermally alter sebaceous gl and s and has been found to be effective for the treatment of inflammatory facial acne . OBJECTIVE Our aim was to evaluate the dose response of a 1450-nm diode laser for treatment of facial acne , sebum production , and acne scarring utilizing two laser fluences and to determine long-term remission after laser treatment . METHODS Twenty patients ( Fitzpatrick skin phototypes II-VI ) received 3 treatments using the 1450 nm diode laser ( 3 - 4 week intervals ) . Split face comparisons were performed by r and omizing patients to one of two fluences ( 14 or 16 J/cm(2 ) ) on the right or left side of the face . Clinical photographs , lesion counts , and sebum measurements were obtained at baseline and after each treatment . Investigators ' and patients ' subjective evaluations of response to treatment were assessed . RESULTS Percentage reductions in mean acne lesion counts from baseline were 42.9 % ( 14 J/cm(2 ) ) and 33.9 % ( 16 J/cm(2 ) ) after one treatment and 75.1 % ( 14 J/cm(2 ) ) and 70.6 % ( 16 J/cm(2 ) ) after 3 treatments . There was persistent reduction of 76.1 % ( 14 J/cm(2 ) ) and 70.5 % ( 16 J/cm(2 ) ) at the 12-month follow-up ( P < .01 ) . Both objective and subjective improvements in acne scarring and sebum production were noted . Treatment-related pain was well tolerated , and adverse effects were limited to transient erythema and edema at treatment sites . LIMITATIONS This was a small study and comparison was limited to two laser fluences . CONCLUSION The 1450-nm diode laser reduced  inflammatory facial acne  lesions even in Fitzpatrick skin phototypes IV-VI with minimal side effects . Significant improvement in acne lesion counts were noted after the first treatment and was maintained 12 months after the third treatment , indicating significant long-term clinical remission after laser treatment BACKGROUND Glycolic acid ( GA ) peels are frequently performed as adjuvants to the treatment of  facial acne .  There have been few clinical trials reported of GA peels for acne in people with darker skin . OBJECTIVES To determine the safety and efficacy of GA peels in the treatment of moderate acne vulgaris in Asian skin . METHODS In this prospect i ve , r and omized , double‐blind , placebo‐controlled , split‐face clinical trial , 26 patients with moderate acne were treated with 40 % GA ( pH 2.0 ) on half of the face and placebo on the other half . The procedure was performed five times at 2‐week intervals . RESULTS The GA sides had statistically significant reductions in acne lesions at each time point from baseline values . There were statistically significant differences between the GA and placebo sides . The GA sides had better responses for noninflammatory lesions than for inflammatory lesions . In bioengineering measurements , sebum levels were statistically significantly reduced after the initiation of therapy on both sides at weeks 8 and 10 , but there were no statistically significant differences between the two sides . CONCLUSION Forty percent GA peels significantly improved moderate acne  in this study . It is effective and safe in Asians Fractional microneedling radiofrequency ( FMR ) is one of the promising methods in acne treatment . Moreover , bipolar radiofrequency ( BR ) generates heat thereby which induces neocollagenosis . FMR may have the potential to be a safe and effective treatment for the patients both with acne and acne scar . This study was performed to compare the efficacy and safety of FMR and BR in acne and acne scar treatment . Furthermore , mechanism of the FMR treatment was investigated through skin tissues obtained from subjects . Twenty subjects with mild-to-moderate acne and acne scars were treated in a split-face manner with FMR and BR . Two sessions of treatment was done 4 weeks apart in a total 12-week prospect i ve single-blind , r and omized clinical trial . Clinical assessment and sebum measurement were carried out for the evaluation of efficacy and safety . Skin tissues were acquired for investigation of molecular changes . FMR was more effective for acne scar especially in icepick and boxcar scar compared to BR . Both inflammatory and non-inflammatory acne lesions decreased by 80 and 65 % in the FMR-treated side at the final visit of 12 weeks , respectively . FMR treatment result ed in significant reduction of sebum excretion . Both treatments showed no severe adverse effects other than erythema . The FMR showed superior efficacy in acne and acne scar compared with BR . Increased expression of TGFβ and collagen I and decreased expression of NF-κB , IL-8 are suggested to involve in the improvement of acne scar and acne lesion by FMR CONTEXT The high prevalence of acne vulgaris and its significant morbidity underscore the need for convenient , low-risk , and efficacious therapy . Treatment with various lasers has been reported to improve acne . OBJECTIVE To evaluate the clinical efficacy of pulsed dye laser therapy in the treatment of acne . DESIGN , SETTING , AND PATIENTS R and omized , single-blind , controlled , split-face clinical trial of a volunteer sample of 40 patients aged 13 years or older with facial acne conducted at an academic referral center from August 2002 to September 2003 . INTERVENTION One or 2 nonpurpuric pulsed dye laser treatments to half of the face ( fluence of 3 J/cm2 ) , serial blinded clinical assess 
    Output:
    
The majority of the included studies demonstrated a significant reduction in acne lesions .
The most frequently reported side-effects for non-pharmacological therapies included erythema , tolerable pain , purpura , oedema and a few cases of hyperpigmentation , which were in most cases mild and transient .
Circumstantial evidence was found for non-pharmacological therapies in the treatment of acne vulgaris .
Nevertheless , our systematic review including a best- evidence synthesis did create order and structure in result ing outcomes in which a first step towards future research is generated