This is a study I've had bookmarked. Thought others might like to
read it.

http://www.escribe.com/health/rosacea-support/m35828.html

Improves acne, rosacea
Intense Pulsed Light Eradicates Demodex Mites

Timothy F. Kirn
Sacramento Bureau


VAIL, COLO. — Intense pulsed light appears to kill Demodex mites
around hair follicles and sebaceous glands, which could make it
useful in treating acne, Dr. Neil Sadick said at a symposium
sponsored by the American Academy of Facial Plastic and
Reconstructive Surgery.

Dr. Sadick of Cornell University, New York, conducted an
investigation in which 24 patients with a mean age of 47 years and
Fitzpatrick skin types I-IV were treated with an intense pulsed
light
device (Quantum SR, ESC-Lumenis, Palo Alto, Calif.), which emits a
noncoherent, multiwavelength of light of 500-1,100 nm. All patients
were treated monthly, up to five times, using an average fluence of
25-45 J/cm2.

Patients were then evaluated using a number of techniques that
included observer rating of photographs, computer-based optical
profiling, histology, and the use of monoclonal antibodies to
measure
cytokine production.

Histology showed no evidence of appreciable new collagen formation,
either by ultrastructural observation or by monoclonal antibody–
binding concentration, even though there were indications of
increased fibroblast activity, he said at the symposium, also
sponsored by the American Society of Dermatologic Surgery.

"There is some attempt at `neocollagenesis' occurring, but, in my
opinion, there is not significant new collagen to the point where
you
can tell your patients that their wrinkling will be markedly
improved
because of new collagen formation," he said.

Likewise, there did not appear to be new elastin fiber formation.
But
there was "normalization" of the elastin fibers.

Histology also did not reveal any necrosis, or fibrin thrombi, and
only minimal new blood vessel formation.

On the other hand, since intense pulsed light wavelengths target
melanocytes, the investigation did find decreased melanin production
at the dermoepidermal junction and eradication of the Demodex mites
in the pilosebaceous units. Perhaps as a consequence, there was a
decrease in inflammatory infiltrate in the skin, both in rosacea but
also in photodamaged areas.

"If you treat patients with intense pulsed light, you can eradicate
almost all the organisms," he said.

The findings help explain the results already observed with intense
pulsed light, Dr. Sadick said. They also suggest that the patient
who
will benefit most is the person in his or her mid-40s who wants to
reverse early sun damage but does not need dramatic rhytid
improvement.

Killing of the Demodex organisms, and consequently toning down
inflammatory processes, probably explains why intense pulsed light
improves redness. Many patients believe that they have a decrease in
pore size, and this may be due to shrinkage of the sebaceous glands.
Normalization of the elastin fibers may improve elasticity and
account for some of the smoothing of texture that is seen. Decreased
melanin production accounts for the improvements in dyschromia.

The study did demonstrate fairly significant improvement, he said.
The independent observer assessment of the 17 patients who completed
five treatments found that 47% achieved more than a 50% improvement
in skin tone, texture, and color.

Based on the results, Dr. Sadick said he tells patients that they
can
expect a 25%-50% improvement in skin contour and redness.

Because of the eradication of Demodex, Dr. Sadick has begun to
investigate using intense pulsed light for acne. "In our experience,
we have found it is helpful in treating mild acne ... but not as
helpful in treating cystic acne."

SHARON WORCESTER, Tallahassee bureau, contributed to this story.