A research team from Henry Ford Hospital recently suggested in a medical research paper that treating hidradenitis suppurativa more effectively could involve not one medication, but rather a multimodal approach including not only topical and systemic therapies, but also laser and light-based treatments.
A Review of Laser and Light-based Treatment Modalities
The researchers reviewed laser and light-based treatment modalities for Hidradenitis Suppurativa to address the symptoms which are well known to cause severe discomfort and pain. It is suggested that laser and light-based treatment options could show promise—for example, Nd: YAG evidence promise one clinical trial evidenced positive outcome in the Hidradenitis Suppurativa patient population. According to the authors, it appears to effectively and selectively impact “hair shafts and follicles via absorption by the melanin and water chromophore,”. This particular treatment could be used alone or together with CO2 lasers with unmanageable cases.
Nd-YAG laser is a crystal laser with water and hemoglobin as the absorbing chromophore; a wavelength of 1064nm, and a penetration depth of 10mm. CO2 lasers according to the research, produces minimal removal of unaffected tissue; however, it may advance wound healing and conditions.
Diode lasers use the principle of selective photothermolysis to target specific chromophores in the skin, usually melanin or blood. By generating multiple wavelengths, it is purported that they could offer improvement as compared to traditional crystals and dies utilized by other lasers. In one study out of Thailand, the researchers from the Ministry of Public Health investigated the safety of an 810-and 940-mm diode laser for treating skin laxity. They enrolled 30 patients in this study with facial skin laxity grading scale II to IV. The patients underwent four treatment sessions over three-week intervals. This research team, led by Nataya Voravutinon, MD, found that this approach led to significant improvement in laxity of facial skin.
Alexandrite lasers are reported to show some efficacy in damage the bulge stem cell and dermal papilla of hair follicles when targeting melanin. It uses an alexandrite crystal as the laser source of medium. It is considered a red light laser. It is available in “Q-switched mode,” which is a technique to make the laser produce a high-intensity beam in very short pulses. This laser can cause very precise tissue destruction of the lesion and leave the tissue in the surrounding area undamaged.
According to the Henry Ford Hospital Team, intense pulsated light lasers studied in at least one randomized trial and several case series that evidence some benefit, but more research is needed.
However, according to researchers from Ulster Hospital, Belfast Northern Ireland and Bedford Hospital Laser Center, of the approaches discussed thus far, Nd: YAG laser evidence some benefit to be effective for the treatment of Hidradenitis Suppurativa, as is intense pulsed light therapy (IPL). However, there is weak evidence to recommend the use of carbon dioxide, diode, or alexandrite lasers—there must be larger randomized controlled trials for these lasers so that medical researchers have a greater understanding of how effective and safe they are.
Finally, Henry Ford Hospital-based team suggested photodynamic therapy, a treatment that uses a drug called a photosensitizer, or photosensitizing agent along with a type of light, requires more research for safety and efficacy for treatment of Hidradenitis Suppurativa.
The Henry Ford Hospital research team suggests that Hidradenitis Suppurativa necessitates an “individualized patient-centered multimodal approach using a combination of topical, medical, systemic, laser, light-based and surgical options for the management of HS” and of course there is some evidence, for at least some people, certain lifestyle changes may have some positive effect (e.g., what we eat, smoking, etc.). Moreover, a number of new therapies are in the clinical trials pipeline.
TrialSite News has been contacted by many people struggling with Hidradenitis Suppurativa, as a lack of medical research investment has created a void where one or two therapies dominate the market. Yet, in many cases, they don’t lead to good outcomes for the patients. Hence as research centering on Hidradenitis Suppurativa surfaces, TrialSite News will bring it to the attention of this very important patient community worldwide.
About Henry Ford Dermatology Research
Henry Ford Health System Dermatology Research has impressed TrialSite News as they have evidenced a commitment to the Hidradenitis Suppurativa patient community with an investment in physicians and staff, infrastructure, and ongoing research in addition to ongoing care. They conduct ongoing laboratory and clinical research to advance the treatment of skin diseases. Their department epitomizes a power clinical research as a care model where they are the well-known primary care providers in the Detroit metropolitan area, as well as in other Michigan locations. At the same time, they also offer patients continuing access to the most advanced therapies through clinical trials. Investigative therapies are available in all areas of dermatology, and current clinical trials can be reviewed.
Alexis B. Lyons, MD
· Steven M. Townsend
· Dilara Turk
· Shanthi Narla
· Natasha Baah
· Iltefat H. Hamzav