Efficacy of Fire Needling Combined with 420 nm Intense Pulsed Light in the Treatment of Acne Vulgaris

Abstract

Background

Conventional acne treatments face limitations. This study evaluated the synergistic effects of combining fire needling with 420 nm intense pulsed light (IPL), a promising physical therapy combination for which there is limited real-world evidence regarding its impact on quality of life and scarring.

Objective

To assess the efficacy and safety of fire needling plus 420 nm IPL for moderate-to-severe acne, focusing on inflammation control, quality of life, and scar prevention.

Methods

A retrospective, propensity score-matched cohort study included patients treated between January 2023 and June 2025. Patients were allocated to a combination group (fire needling + IPL, n = 40) or a control group (IPL alone, n = 40). Primary outcomes were clinical efficacy rate and inflammatory lesion count. Secondary outcomes included global acne grading system (GAGS), traditional Chinese medicine syndrome (TCMS), pain visual analog scale (VAS), dermatology life quality index (DLQI), ECCA scar scale scores, and adverse events.

Results

After 8 weeks, the combination group showed superior clinical efficacy and greater improvement in inflammatory lesions, GAGS, and TCMS scores. It also demonstrated better outcomes in pain VAS, DLQI, and ECCA scar scores. Adverse events were similar between groups.

Conclusion

Combining fire needling with 420 nm IPL is effective and safe for moderate-to-severe acne. This regimen offers superior inflammation control, symptom and quality of life improvement, and potential benefits in preventing atrophic scarring.