Double-Pass, Low-Fluence Laser Treatment Using a Large Spot-Size 1,450 nm Laser Improves Acne

Background: Laser treatment using a 1,450 nm diode laser has been shown to improve acne and acne scarring. Its widespread adoption in younger populations has been significantly limited by discomfort. A new double-pass protocol reduced pain, but doubled treatment time. A new laser with a fourfold larger area treatment beam was developed to decrease treatment time and improve efficacy. Materials and Methods: Thirteen subjects with active papular acne were enrolled in the study. Subjects were treated 4 times at monthly intervals using an average fluence of 7.8 J/cm(2), a 12 mm spot and an average dynamic cooling device setting of 42.2, treating the entire face with 2 laser passes. Acne counts, Allen-Smith acne grades and standardized digital photography were performed 2 months following the final treatment, and compared to pre-treatment counts and photographs. Results: Improvement in 11 subjects completing treatment evaluated by physician observers comparing pre- and post-treatment photographs was rated as none to mild improvement in three subjects, moderate improvement in six subjects, and marked improvement in two subjects. Allen Smith acne scores decreased from 2.7 pre-treatment to 2.0 post-treatment, and lesion counts decreased from an average of 34.4 pre-treatment to 16.1, 2 months posttreatment. Pain ratings on a 1 (min) to 10 (max) scale averaged 4.9 (range 1-10). All subjects rated their skin as less oily at the follow-up period. Conclusions: Low-energy, double pass 1,450 nm laser treatment with a larger 12 mm-diameter spot size effectively reduces acne counts 2 months post-treatment. Lasers Surg. Med. 41:116-121, 2009. (C) 2009 Wiley-Liss, Inc.