February 2006
Dear Paula,
I’ve been reading about a new device approved by the FDA in June 2005 called Zeno (www.myzeno.com). It claims to get rid of 90% of pimples within 24 hours of treatment! The device is about the size of a cellphone and apparently uses heat to destroy the bacteria in the clogged pore. It costs $225, which is a lot, but if it actually works I’d gladly pay that much to be rid of my lifelong acne problem! Do you have any additional information or evidence on whether this product works as well as it claims?

Ella, via email

Dear Ella,

After looking at www.myzeno.com I can see why you would be tempted to spend $225. The claims and promises about eliminating 90% of breakouts are remarkable. However, I admire your skepticism, because something that sounds too good to be true often is. I emailed Dr. Jonette Keri, Assistant Professor of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, who is known for her expertise in the treatment of acne. Her information was enlightening and might save you money and time. What follows includes her responses to my questions.

“Indeed this device was approved for the treatment of acne by the FDA in June 2005 after completion of a double-blinded study with 51 patients where improvement of their acne was found to be statistically significant. The Zeno treated lesions improved faster and more often in this small study. After five days 100% of the Zeno lesions had improved versus 76.5% of the placebo group.”

Before you get overly excited about a 100% improvement, keep in mind that the placebo group also had an impressive amount of improvement—a 76.5% change for the better is impressive too. Also, the study compared Zeno only to using nothing on the breakouts, so you have to ask, what if you used benzoyl peroxide or salicylic acid on the placebo side? What would those results have been? Getting approval from the FDA does not mean Zeno is a slam-dunk. I’m sure you have tried lots of other acne treatments approved by the FDA, but as you note, they haven’t eliminated the problem.

How does Zeno work? The premise is that the bacteria responsible for blemishes, Propionibacterium acnes, can’t survive a temperature of 119°F. Zeno delivers 121°F of heat to the skin. Heat serves as a form of stress to the bacteria, which then produce “heat-shock proteins” that trigger death of the bacteria. P. acnes does contain heat-shock proteins (Source: FEMS Microbiology Letter, October 2000, pages 183–186), so theoretically they may be involved in the death of the bacteria and dissolution of the pimple.

Even if you are still curious to give this a try, it is important to realize that using Zeno can be incredibly time consuming, depending on the extent of your breakouts. The directions explain that you should hold the device on “the pimple” for 2½ minutes. Each individual pimple must be treated in this manner. You can treat the same pimple up to three times a day, at intervals separated by four hours, but not everyone will be able to tolerate that much heat on their face. (Think about getting into a hot tub at 104°F! And this device generates 17 degrees more heat.) No information is provided about burns or other possible heat damage, but Zeno has only been for sale for a short three months, so it’s hard to know what problems could occur.

It is best to remember that acne is a multifaceted disease. While Zeno may help after a pimple develops (though it’s not necessarily better than benzoyl peroxide or salicylic acid because that wasn’t part of their study), it does not reduce the occurrence of breakouts. Zeno was approved as an after-the-fact treatment, which may serve a purpose for some people.

Suffering from any amount of breakouts is emotionally difficult and Zeno may be worth the cost to see if it works for you, but the $225 cost doesn’t include the need for the replacement tips after 90 treatments, for an additional $35 each.