From the Guidelines
The 1450 nm diode laser is the most effective laser treatment for acne, as it specifically targets sebaceous glands and reduces oil production while killing P. acnes bacteria. This is based on the most recent and highest quality study available, which was published in the Journal of the American Academy of Dermatology in 2019 1. The study found that the 1450 nm diode laser can improve acne and has been shown to cause sebaceous gland destruction in a rabbit ear model and in ex vivo human skin.
Some key points to consider when using the 1450 nm diode laser for acne treatment include:
- A typical treatment regimen involves 3-4 sessions spaced 3-4 weeks apart, with each session lasting about 30 minutes
- Patients usually see significant improvement after completing the full course, with studies showing 50-75% reduction in inflammatory acne lesions
- The 1450nm wavelength penetrates to the ideal depth for treating acne without damaging the skin surface
- Other effective options include pulsed-dye lasers (585-595nm) which target inflammation and redness, and intense pulsed light (IPL) therapy which can address both acne and post-inflammatory hyperpigmentation
It's worth noting that side effects are generally mild and temporary, including redness, swelling, and slight darkening of the skin that resolves within a few days 1. These treatments work best for moderate to severe inflammatory acne that hasn't responded well to topical or oral medications, though they may not be as effective for deep cystic acne or comedonal acne. Overall, the 1450 nm diode laser is a effective treatment option for acne, and its use should be considered in patients who have not responded to other treatments.
From the Research
Effective Laser Treatments for Acne
- The 595-nm pulsed dye laser (PDL) has been proven effective in the management of inflammatory acne 2, 3, 4, 5.
- The 1064-nm long-pulsed neodymium:yttrium-aluminum-garnet laser (Nd:YAG) has also been successful in treating inflammatory acne lesions 4.
- Combination therapy with low-dose isotretinoin and PDL has shown statistically significant greater improvement in acne treatment compared to standard higher-dose isotretinoin as monotherapy 2.
- Photodynamic therapy (PDT) with activation by long-pulsed PDL has been found to be a safe and effective treatment for recalcitrant acne of various types and levels of severity 6.
Comparison of Laser Treatments
- A comparative study found that 1064-nm Nd:YAG and 595-nm PDL treatments are equally effective in reducing inflammatory acne lesions and acne erythema in mild to moderate facial acne vulgaris 4.
- Another study found that the combination of 595-nm pulsed-dye laser and 1,450-nm diode laser is safe and effective for the treatment of inflammatory facial acne, acne scarring, and post-inflammatory erythema 5.
Treatment Outcomes
- Significant reductions in acne lesion counts, acne erythema grading, and erythema index have been demonstrated with 595-nm PDL and 1064-nm Nd:YAG treatments 4.
- Complete clearance of acne lesions has been achieved with PDT using long-pulsed PDL and topical 5-aminolevulinic acid (ALA) 6.
- Patients have reported moderate-to-marked improvement in acne, acne scarring, and post-inflammatory erythema with combination laser treatments 5.