Laser and Light Therapies for Teenage and Adult Acne and Acne Scars

Acne affects nearly all teenagers worldwide, and many adults — especially women — continue to break out for decades. Whether it’s mild acne that just won’t go away or severe, inflammatory acne that causes scarring, sometimes even prescription oral antibiotics do not help, or other medications, like isotretinoin (Accutane), have poorly tolerated side effects or cannot be taken for medical reasons.

Photodynamic therapy (PDT) is an excellent alternative to traditional acne treatments for moderate to severe inflammatory acne and can produce long term remissions. PDT works by addressing the multiple causes of acne, which include an inherited tendency towards clogged hair follicles, overactive sebaceous (oil) glands and the growth of P. acnes bacteria that cause the inflammation. PDT kills the P. acnes bacteria, damages the sebaceous glands to reduce oil (sebum) production, and unclogs the hair follicles by causing the skin to shed or exfoliate following treatment. The treatment involves the application of a medication called Metvixia to the affected skin for 2 to 3 hours, followed by a 10 to 15 minute red laser or light treatment.

Patients develop some redness and swelling for 2 to 3 days after treatment, and a second treatment may be required 4 to 6 weeks later. PDT is a safe, non-invasive procedure that usually produces long term remissions from acne flares and also has the advantage of improving scarring that is already present. For adults with persistent mild acne or periodic flares, a combination treatment using the VBeam pulsed dye and SmoothBeam diode lasers is recommended. The skin is treated after the application of a topical anesthetic (numbing) cream, and patients can apply make-up and return to work immediately. Like PDT, this combination laser treatment will also improve the appearance of the skin by reducing scarring and smoothing irregular skin texture. Laser Treatments Reduce Acne Scars

In clinical studies performed by Dr. Kauvar, the combination of non-invasive fractional laser treatment and scar subdermal incision (subcision) produced excellent improvement in all types of acne scars. Fractional technology, including the Palomar Lux 1540 laser and the eMatrix, plumps up depressed acne scars by causing the skin to produce new collagen in areas thinned out by scarring.

These non-invasive devices use heat to create wounds in microscopic bits of tissue from the surface of the skin down to the deeper layers of the acne scars without creating open sores. The skin responds with its natural, self-healing abilities to repair the wound and build up new collagen. In more severe cases, the skin is often tightly bound to the underlying tissue but can be released using the subcision technique. After administering a local anesthetic, a needle is inserted into the scar tissue to create tiny tunnels through the scar which enables those areas to expand with new collagen, thereby resulting in a plumper, smoother appearance.

Recovery from these procedures is limited to 3 days of redness and swelling. The fractional procedure is usually repeated for 4 to 5 monthly sessions for optimal results.