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Infrared Laser Treatment for Acne

Acne improved after nonmedical therapy with this device.

When developing the 1450-nm diode laser for improvement of facial skin texture, corporate scientists who were performing histologic studies noted damage to sebaceous glands. A controlled pilot study based on this serendipitous finding demonstrated that the 1450-nm diode laser effectively reduced the activity of inflammatory acne of the back. Now, researchers report the results of 1450-nm diode laser treatment of 19 patients with inflammatory facial acne.

Patients having at least five active facial lesions of inflammatory acne were enrolled and allowed to continue existing topical and oral therapy. Laser treatment occurred three times, at 4- to 6-week intervals. One hour before treatment, topical 5% lidocaine was applied under occlusion to the skin. The entire face was then treated with nonoverlapping, single pulses at fluences between 11 and 14 J per cm², with a 6-mm spot and 40 msec of cryogen spray cooling.

Acne improved in all patients. Lesion counts were decreased 37% after one treatment, 50% after two treatments, and 83% after three treatments. Patients tolerated the pain of the procedure well. Erythema and edema lasting up to 24 hours were common at treatment sites. No other side effects were noted.

Comment: Nonmedical therapeutic modalities are under increasing investigation for the treatment of acne. Two putative mechanisms of action might explain the effects of these treatments: They either reduce the numbers of Propionibacterium acnes or shrink the sebaceous glands by thermal damage. The 1450-nm diode laser apparently shrinks the sebaceous glands, as does isotretinoin (Accutane), which produces long-term improvement and many cures.

This study had several limitations: no control group, small numbers, and enrollment of patients with few lesions. What's more, inflammatory acne is known to intermittently clear even without treatment. Nevertheless, these results support the findings from the earlier controlled study of back lesions -- pulsed infrared lasers effectively improve inflammatory acne, at least temporarily. Larger, controlled studies with long-term follow-up will clarify the value of this treatment.

— Jeffrey S. Dover, MD, FRCPC

Published in Journal Watch Dermatology May 11, 2004

Citation(s):

Friedman PM et al. Treatment of inflammatory facial acne vulgaris with the 1450-nm diode laser: A pilot study. Dermatol Surg 2004 Feb; 30:147-51.

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