Utility of lasers in acne treatment

The popularity of laser and light devices has recently grown among acne patients, not only due to their efficacy but also because treatments are quick and clean, says Michael H. Gold, M.D., director, Gold Skin Care Center, Tennessee Clinical Research Center and The Laser and Rejuvenation Center, and Clinical Assistant Professor of Dermatology at Vanderbilt University School of Medicine and School of Nursing, Nashville, Tenn.

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“I think the interest in laser and light modalities has gotten much greater over recent years as we learn more about how these devices work and how they can fit in our treatment protocols, particularly with all the current concerns over antibiotic resistance, patient compliance with medicines, medicines that can take too long to work and are perhaps too expensive or not covered by insurances,” he says. Dr. Gold shared insights with colleagues during the 18th Annual South Beach Symposium, Miami, Fla.

There are several different laser and light devices that are currently used and work very well in acne treatment. Among them, blue light remains one of the oldest modalities that, historically, has achieved excellent reproducible outcomes. The modality has approval from the U.S. Food and Drug Administration (FDA) to treat up to severe cases of acne and, according to Dr. Gold, physicians should not discard blue light as ‘old technology,’ but, instead, recall its significant utility in quelling symptoms.

Intense pulsed light (IPL) systems also work very well, and some are now equipped with filters in the 400-nm range, which allow the use of blue light type settings that lead to improvements in acne symptoms. Among the different devices currently available on the market, the Lumenis M22, Sciton Joule and Rohrer Spectrum remain the IPL devices of choice in Dr. Gold’s clinic for patients with mild-to-severe acne.

Using a combination of 589-nm and 1319-nm wavelengths and patented PulSync technology, the ADVATx (Advalight Corp.) laser has been found to be very useful in treating any area or lesion that has a vascular component or requires collagen remodeling. Relatively new to the market, Dr. Gold says the unique solid-state yellow and infrared diode laser may be the ideal treatment choice for those patients with some in ammatory acne and potential acne scarring.

Another laser device that has proven its utility in patients with moderate-to-severe acne is the Neo Elite system from Aerolase. The shortpulsed 1064-nm laser is virtually painless, significantly enhancing treatment tolerability and patient compliance. According to Dr. Gold, a series of treatments with the device performed in two-week intervals can signi cantly improve acne symptoms very quickly.

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“Everybody wants a quick fix in terms of fast results, and these laser and light systems can provide that. I don’t disagree with this trend, but it is an important consideration that we all have to keep in the back of our minds because that’s what our patients want,” Dr. Gold says. “Nevertheless, I often prefer a combination approach, treating pharmacologically and following-up with laser and light therapy to help quell in ammation and address any potential scarring.”