Results from a systematic review and meta-analysis published in the Annals of Family Medicine indicate conflicting evidence for the efficacy of blue-light therapy for acne vulgaris.
Investigators conducted a search of PubMed, Cochrane, Embase, and the Web of Science from inception through March 5, 2018, for randomized clinical trials that assessed the safety and efficacy of blue-light therapy for acne vulgaris. Nonrandomized studies and studies without a control group were excluded. Literature screening and data extraction were performed independently by 2 reviewers. Risk for bias was assessed using the Cochrane Collaboration’s Risk of Bias tool. The primary outcome of interest was investigator-assessed change in acne symptoms. Patient-assessed change and adverse events were extracted as secondary outcomes. When sufficiently powered, meta-analysis was conducted on pooled study estimates.
A total of 18 references describing 14 studies were included in analyses. The overall risk for bias was high, with risk for performance bias, detection bias, and reporting bias each observed in >25% of trials. The pooled study cohort comprised 698 patients. Between-study heterogeneity prevented meta-analysis of investigator- and patient-assessed acne improvements.
Overall, 5 of 14 trials reported investigator-assessed improvement quantitatively, of which 3 reported greater improvement with blue-light compared with no treatment or placebo. Two of the 14 trials described acne symptoms narratively: one reported that blue-light performed similarly to clindamycin, while the other suggested that patients treated with blue-light showed “moderate to marked improvement.” Four of 14 trials reported patient-assessed improvements; all 4 of these trials indicated at least some improvement with blue-light therapy. Data were pooled for noninflammatory and inflammatory lesion counts; no significant differences were observed between patients treated with blue light and patients treated with a comparator. Adverse events were generally mild, with some trials reporting dryness, itching, or irritation with blue-light therapy. In some cases, the side effect profile of blue-light therapy was favored over that of benzoyl peroxide.
Limited data are available on the use of blue-light therapy for acne vulgaris treatment. In existing studies, heterogeneity and risk for bias were high, limiting the capacity for meta-analysis. “Clinicians and patients should therefore consider the balance between…[the] benefits and adverse events [of blue-light therapy], as well as costs,” investigators wrote.
Scott AM, Stehlik P, Clark J, et al. Blue-light therapy for acne vulgaris: a systematic review and meta-analysis. Ann Fam Med. 2019;17(6):545-553.