***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: BACKGROUND Acne treatments using laser and light devices have been reported to have varying degrees of efficacy . However , there has been no study of treatment of acne using a dual mode ( quasi-long pulse and Q-switched mode ) 1064-nm Nd : YAG laser assisted with a topically applied carbon suspension . OBJECTIVE To evaluate the clinical efficacy , safety , and histological changes of new laser treatment method for acne vulgaris . METHODS Twenty-two patients received 3 sessions of quasi-long pulse and Q-switched Nd : YAG laser treatment assisted with a topically applied carbon suspension at 2-week intervals in a r and omized split face manner . RESULTS At the final visit , the inflammatory acne lesions were reduced on the laser-treated side by 58.6 % ( P < .001 ) , but increased on the untreated side by 5 % . The noninflammatory acne lesions were reduced on the laser-treated side by 52.4 % ( P < .001 ) . Sebum output reduction , inflammatory cell and cytokine reductions , a decrease of the thickness of a perifollicular stratum corneum and a full epithelium , and skin rejuvenation effect were found . The histopathologic examination of the acne lesions showed decreased inflammation and immunostaining intensity for interleukin 8 , matrix metalloproteinase-9 , toll-like receptor-2 , and nuclear factor kappa B , and tumor necrosis factor alpha was reduced significantly . No severe adverse reactions were reported . All patients reported mild transient erythema that disappeared in a few hours . LIMITATIONS The number of subjects studied was small . CONCLUSIONS This laser treatment was rapid and effective for treating not only the inflammatory but also the noninflammatory acne lesions when compared with the control side . The histopathologic findings correlated well with the clinical acne grade and treatment response . This novel laser treatment appears to be safe and effective for acne treatment Background / Purpose : Acne vulgaris is a very prevalent skin disorder and remains a main problem in practice . Recently , phototherapy with various light spectrums for acne has been used . There are some evidence s that low-level laser therapy ( LLLT ) has beneficial effect in the treatment of acne lesions . In this study , two different wavelengths of LLLT ( 630 and 890 nm ) were evaluated in treatment of acne vulgaris . Material s and Methods : This study was a single-blind r and omized clinical trial . Patients with mild to moderate acne vulgaris and age above 18 years and included were treated with red LLLT ( 630 nm ) and infrared LLLT ( 890 nm ) on the right and left sides of the face respectively , twice in a week for 12 sessions , and clinical ly assessed at baseline and weeks 2 , 4 , 6 , and 8 . Results : Twenty-eight patients were participated in this study . Ten weeks after treatment acne lesion were significantly decreased in the side treated by 630 nm LLLT ( 27.7±12.7 to 6.3±1.9 ) ( P<0.001 ) , but this decrease was not significant in the site treated by 890 nm LLLT ( 26.9±12.4 to 22.2±8.5 ) ( P>0.05 ) . Conclusion : Red wavelength is safe and effective to be used to treat acne vulgaris by LLLT compared to infrared wavelength BACKGROUND Acne patients who fail to respond to conventional treatments have been treated with isotretinoin , an effective treatment coming under strict regulation due to the risk of significant side effects . Photodynamic therapy ( PDT ) may be a viable alternative treatment for recalcitrant acne of various types and levels of severity . OBJECTIVE To determine the safety and efficacy of combination PDT with topical 5-aminolevulinic acid ( ALA ) and activation by long-pulsed , pulsed dye laser ( LP PDL , 595 nm ) energy with topical therapy in patients with mild to severe acne . METHODS A prospect i ve , controlled pilot , proof-of-principle study of 19 consecutive patients ( aged 16 - 47 years , Fitzpatrick skin types I-VI ) with mild to severe cystic , inflammatory , or comedonal acne of the face was conducted . All patients had failed conventional therapy , including oral antibiotics , topical treatments , hormonal therapy , laser procedures ( without ALA ) , and /or oral isotretinoin . Fifteen patients were treated with ALA PDT and 4 patients served as controls ; all were continued on topical medications . Patients undergoing PDT were initially r and omized to receive either blue light or laser energy . Because recrudescence occurred in 1 patient while undergoing multiple treatments with ALA and blue light , all subsequent patients were treated with ALA and laser energy . The total number of patients treated with LP PDL-mediated ALA PDT was 14 . ALA was applied for a short 45-minute incubation followed by 1 minimally overlapping pass with the LP PDL ( 595 nm , 7.0 - 7.5 J/cm2 fluence , 10-ms pulse duration , 10-mm spot size , and dynamic cooling spray of 30 ms with a 30-ms delay ) . Patients treated with conventional therapy ( oral antibiotics , oral contraceptives , and topical medications ) or laser energy without ALA PDT served as control groups . Patients were followed monthly for up to 13 months . RESULTS Complete clearance was achieved in 100 % ( 14 out of 14 ) patients in the LP PDL PDT-treated group . A mean of 2.9 treatments ( range 1 - 6 ; 2.0 - 3.7 , 95 % CI ; n=14 ) was required to achieve complete clearance for a mean follow-up time of 6.4 months ( range 1 - 13 ; 3.8 - 8.9 95 % CI ; n=14 ) . The patient mean percent lesional clearance rate per treatment was 77 % ( 64%-90 % , 95 % CI ; n=14 ) . Improvement in acne lesions became apparent within 1 to 2 weeks after the first treatment . Clearance in the LP PDL PDT group was superior to control groups . In the LP PDL-only control group ( n=2 ) , the patient mean percent lesional clearance rate per treatment was 32 % without complete clearance after 3 to 4 treatments . In the oral antibiotics , oral contraceptives , and topicals control group ( n=2 ) , the clearance rate per treatment was 20 % , the mean clearance rate per month was 4 % , and complete clearance was not achieved after 6 to 10 months . In the LP PDL-mediated PDT group , treatments were well-tolerated with minimal erythema lasting 1 to 2 days . No cases of crusting , blistering , purpura , scarring , or dyspigmentation occurred . A reduction in the erythema in erythematous acne scars was observed . CONCLUSION For teenage to adult patients with recalcitrant comedonal , inflammatory , or cystic acne of various degrees of severity , ALA PDT with activation by LP PDL appears to be a safe and effective treatment with minimal side effects . LP PDL-mediated PDT may serve as an important alternative to isotretinoin . Cosmetically well-accepted , LP PDL PDT combined with topical therapy is the first PDT modality to achieve complete clearance with long-term follow-up as compared to controls BACKGROUND It has been suggested that cystic acne is rare in women 15 to 44 years of age and infrequent in men . OBJECTIVE To determine the prevalence of acne , we analyzed the primary data from the National Health and Nutrition Examination Survey ( NHANES ) that included a cutaneous examination of a stratified r and om sample of 20,749 noninstitutionalized U.S. residents . METHODS We calculated the prevalence of various disease states based on NHANES primary data and the NHANES population weights . Prevalence estimates and male/female ratios of these estimates were calculated . RESULTS From 1971 to 1974 , the projected prevalence of acne conglobata ( grade IV acne ) for women and men 15 to 44 years of age in the United States was 250,000 and 570,000 , respectively . At the time of examination , an additional 582,000 women and 749,000 men were projected to have moderate acne with cysts and scars . Therefore the prevalence of acne conglobata and acne of at least a moderate degree with cysts and scars was 832,000 for women and 1,319,000 for men 15 to 44 years of age . The male/female ratio for acne with cysts and scars is approximately 1.6:1 . CONCLUSION The NHANES examination data demonstrate that acne with cysts and scars is common in both men and women BACKGROUND Long-pulsed dye laser (LPDL)-assisted photodynamic therapy has been suggested to be superior to laser alone for acne vulgaris but no evidence is available . OBJECTIVE To evaluate the efficacy and safety of LPDL alone versus LPDL in photodynamic therapy with methylaminolevulinic acid ( MAL-LPDL ) for acne vulgaris . METHODS Fifteen patients received a series of 3 full-face LPDL treatments and half-face prelaser MAL treatments ; the latter being r and omly assigned to the left or right side . RESULTS Inflammatory lesions were reduced more on MAL-LPDL-treated than on LPDL-treated sides ( week 4 : 70 % vs 50 % , P = .003 ; week 12 : 80 % vs 67 % , P = .004 ) . Noninflammatory lesions reduced similarly . Patient satisfaction was slightly greater with MAL-LPDL versus LPDL treatments ( scale 0 - 10 : week 4 : 7 vs 6 , P = .034 ; week 12 : 8 vs 7.5 , P = .034 ) . Fluorescence measurements detected photobleaching with MAL-LPDL ( 35.3 % ) and LPDL ( 7.3 % ) treatments ( P < .001 ) . Erythema , edema , and pustular eruptions intensified from MAL incubation . No patients experienced pigment changes or scarring . LIMITATIONS The sample size was limited . The split-face design in this r and omized controlled trial does not allow us to draw conclusions about the efficacy of the LPDL , only about the efficacy of MAL-LPDL compared with LPDL alone . CONCLUSIONS MAL-LPDL is slightly superior to LPDL for the treatment of inflammatory acne 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 BACKGROUND The success rates of conventional treatments to acne vulgaris are limited because of intolerance and resistance . Photodynamic ther 
    Output:
    
There is low certainty of the usefulness of MAL-PDT ( red light ) or ALA-PDT ( blue light ) as st and ard therapies for people with moderate to severe acne .