Heat Therapy for Acne
There Is No Evidence that These Devices Fulfill Their Promises
The Essential Information
Heat therapy devices work by the notion that spot treating an acne lesion with heat can kill bacteria within the lesion, helping reduce inflammation and helping the lesion heal faster.
If they worked, they would be a great tool, but there is no compelling evidence to back them up.
Buyer Beware: These devices are money-makers for the companies that sell the devices and replacement "tips," but there is no reason to believe they are worth the expense.
In recent years, heat therapy devices like Zeno™, No! No! Skin™, and ThermaClear™ have hit the market, claiming to help heal acne lesions quickly by killing acne bacteria. The devices are marketed for mild, inflammatory acne (little red zits) only, and are designed to treat pimples that are already present. They do nothing for prevention, and tend to leave users chasing pimples around their face at up to 50 cents per "zap." Even so, if these devices worked, they would be great tools to have. Unfortunately, we're looking at a big "If." Science on these devices is incomplete at best, and based on our own admittedly unscientific trial here at Acne.org (several of us tried them for a few weeks and noticed no results), they simply do not work.
The medical concept behind all heat-producing acne treatment devices is that heat causes acne bacteria to activate heat-shock proteins, which then damages or kills some of the bacteria. Researchers theorize that acne bacteria plays a role in the process by which a clogged pore becomes inflamed, so damaging or eliminating some bacteria could theoretically help prevent a clogged pore from becoming a full-blown pimple. If this all sounds vague, that's because it is. The science behind these devices is scant at best.
Much of the science behind at-home devices comes from a single unpublished study which employs subjective analysis, and presents only two subject pictures.1Adding further questions to whether heat devices can do anything for acne, a more recent study showed that bacteria that were killed by heat were still able to produce an inflammatory response.2
What about Devices at the Cosmetic Dermatologist's Office?
Cosmetic dermatologists sometimes offer radiofrequency treatments that use heat in an attempt to plump the skin and provide anti-aging benefits in their offices. There is one very small, flawed and incomplete study showing some promise of these devices in treating acne as well.3
In addition, an even smaller preliminary study tested a novel acne treatment device that combines heat with light.4 While this device seems to show some promise for treating acne, it is impossible to determine whether the heat or the light is primarily responsible for the effect.
These treatments can be costly, and the jury is still out on whether these heat-producing radiofrequency devices can do anything for acne.
Expand to read details of studies
One small study published in 2003 in Dermatologic Surgery investigated the effectiveness of the ThermaCool™ device in 22 patients. The device works by generating electromagnetic energy, which heats a small area of the skin, while simultaneously spraying a cooling substance on the skin that prevents the heat from damaging the skin. "An excellent response (75% or better diminution in active acne lesion counts) was seen in 92% of the patients, a modest response (25% to 50% better on active acne lesion counts) in 9%, and no response (less than 25% in acne lesion counts) in 9%. Student's test showed a highly statistically significant difference in before versus after lesion counts. Acne was not made worse in any of these patients."3 Although this study suggests that radiofrequency therapy may be effective as a treatment for acne, it should be kept in mind that this study included a very small number of people and was funded by Thermage, Inc., the company that makes the device. In addition, the authors of the study did not describe how the response rate was measured and whether the person assessing the acne counts was blinded to the treatment. We therefore cannot draw any conclusions from this study.
Another, even smaller study published in Skin Research and Technology in 2012 tested a novel acne treatment device that combines heat and light therapy. The researchers tested the device on 13 volunteers with facial acne. They reported that treatment with the heat and light device decreased redness and inflammation in acne lesions in 11 of the volunteers. However, two of the volunteers experienced exactly the opposite effect - in other words, their acne lesions became redder and more inflamed.4
Again, 13 volunteers is a very small number, so we cannot draw any firm conclusions from this study. It is also important to note that the researchers did not test heat and light separately. Therefore, we have no idea how much of the effect, if any, was due to heat itself.
The Bottom Line
There is no science to support the use of at-home heat devices for treating acne. Since the beginning of civilization, salesmen have produced "miracle devices" which claim to heal just about every disease known to man. When something seems too good to be true, it usually is. When you consider the paucity of science behind these products, and also consider the cost of the devices combined with the cost of "replacement tips," a healthy dose of skepticism is in order.
Radiofrequency devices also do not have any rigorous or replicated data to back up their efficacy.
- Bruce, S. et al. Significant Efficacy and Safety of Low Level Intermittent Heat in Patients with Mild to Moderate Acne. Suzanne Bruce and Associates, Tyrell Inc., Synergos Inc. http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.587.9200&rep=rep1&type=pdf
- Lyte, P., Sur, R., Nigam, A. & Southall, M. D. Heat killed Propionibacterium acnes is capable of inducing inflammatory responses in skin. Exp. Dermatol. 18, 1070 - 1072 (2009). https://www.ncbi.nlm.nih.gov/pubmed/19624731
- Ruiz-Esparza, J. & Gomez, J. B. Nonablative radiofrequency for active acne vulgaris: the use of deep dermal heat in the treatment of moderate to severe active acne vulgaris (thermotherapy): a report of 22 patients. Dermatol. Surg. 29, 333 - 339; discussion 339 (2003). https://www.ncbi.nlm.nih.gov/pubmed/12656809
- Joo, Y., Kang, H., Choi, E. H., Nelson, J. S. & Jung, B. Characterization of a new acne vulgaris treatment device combining light and thermal treatment methods. Skin Res. Technol. 18, 15-21 (2012). https://www.ncbi.nlm.nih.gov/pubmed/21585558
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