Topical Brimonidine Tartrate 0.33% Gel versus 577-nm Pro-yellow Laser for the Treatment of Post-acne Erythema: A Comparative Study.

Background: Post acne erythema (PAE) is a common sequela of inflammatory acne vulgaris resulting from the dilatation of microcapillaries within the papillary dermis, thinning of the epidermis, and release of inflammatory cytokines. OBJECTIVE: The authors sought to compare the safety and efficacy of topical Brimonidine tartrate 0.33% gel versus A 577-nm pro-yellow laser for treatment of post acne erythema.

Methods: This was a comparative study, randomized clinical trials conducted on 60 adult patients with PAE. Patients were assigned into two groups: Group I included 30 patients who received brimonidine tartrate 0.33% gel once daily for three months, and Group II included 30 patients who received Pro-yellow laser with 577-nm therapy, for four sessions at three weeks intervals. Evaluation of erythema was done by Clinician's Erythema Assessment (CEA) and Patient's Self-Assessment (PSA) scales at baseline and at the end of the therapy. The dermoscopic images were analyzed for percent area of erythema and the optical density (OD) using ImageJ® freeware.

Results: Twenty-two patients (73.3%) were females and eight patients (26.7%) were males in Group I. In Group II, 20 patients (66.7%) were females and 10 patients (33.3%) were males. The mean±SD age of the studied groups was 22.07 years ±2.64 ranging from 20 to 24 years in Group I versus 20.93 years ±2.88 ranging from 19 to 23 years in Group II. Clinical improvement is distributed as follows among Group I; 56.7 percent are excellent, 56.7 percent good, 26.7 percent poor, and 10 percent fair for Group II; 33.3 percent good, 6.7 percent poor, and 60 percent excellent. There was no statistically significant difference between studied groups as regard Clinician's Erythema Assessment (CEA), Patient's Self-Assessment (PSA) mean area percentage and the optical density (OD) before treatment, while a statistically significant difference between studied groups after treatment was observed (p<0.001).

Conclusion: Topical brimonidine tartrate 0.33% gel and 577-nm pro yellow laser were effective and well tolerated therapeutic options for treatment of Post acne erythema (PAE), however the 577-nm Pro yellow laser was superior to brimonidine tartrate 0.33% gel.