Acne Treatment based on Selective Photothermolysis of Sebaceous Follicles with Topically Delivered Gold Plasmonic Particles

摘要

Acne is a common dermatologic disease with major psychosocial impact as well as potential for scarring. Acne lesions originate from active sebaceous follicles and glands. Selective photothermolysis of the follicles is a potential therapy for long term remission. Our hypothesis was that light-absorbing microparticles could be delivered into sebaceous follicles, enabling local photothermal injury by optical pulses. A suspension of gold coated silica microparticles exhibiting plasmon resonance with strong absorption at 800 nm was topically applied to human pre-auricular and swine skin in vivo, and mechanical vibration was used to assist movement into the follicles. After exposure to 10-50 J cm~(-2), 30 milliseconds, 800 nm diode laser pulses, microscopy revealed preferential thermal injury to sebaceous follicles and glands. Inflammation was mild; gold particles were not retained in swine skin 1 month after treatment, and uptake in other organs was negligible. An independent prospective randomized controlled clinical trials was performed for treatment of moderate to- severe facial acne. Clinically and statistically significant improvement of inflammatory acne was noted following three treatments given 1-2 weeks apart. Inflammatory lesions were significantly reduced at 12 weeks (p= 0.015) and 16 weeks (p =0.04) compared with sham treatments. This appears to be a well-tolerated, effective treatment for acne vulgaris.