Acne is one of the most common and challenging skin diseases for patients and skincare specialists. Treatment typically requires a multi-modal approach involving the use of topical and oral medications to help reduce breakouts and prevent long-term scarring. As the healthcare industry as a whole works to expand antibiotic stewardship programs and isotretinoin—the most effective non-antibiotic oral medication for acne patients—remains heavily regulated, laser and light sources are again generating interest as alternative acne treatment tools.
The main impedance to incorporating laser and light treatments is that they are not reimbursable, which places a significant financial burden on patients. But for those who wish to stop oral medication and for those patients who are not experiencing significant results with current treatment modalities, laser procedures provide welcome relief.
In addition, newer, more affordable technologies that deliver effective wavelengths at shorter pulse durations allow practices to treat a wider range of skin types with little to no discomfort.
I have been treating my acne patients with the LightPod Neo (Aerolase), a 1064nm laser with a 650µs pulse duration. This wavelength allows us to treat all skin types. In the past, we had only long-pulsed (3ms to 15ms) 1064nm lasers, which were too painful for acne treatment. Thanks to the shorter pulse duration, we can deliver enough energy to make this work without the pain.
The interesting thing about the Neo is that it’s portable. The machine puts out a lot of power, is effective and versatile, and it’s the size of a suitcase. So it’s ideal for practices that are tight on space and physicians who travel between multiple practices—if you have an office in New Jersey, New York City and Long Island, you can just put it in the trunk and take it with you, and it calibrates itself when you turn it on.
The short-pulse 1064nm is not only effective for acne—you can also use it for skin rejuvenation, pigment correction and vessel removal, and it’s safe for darker skin types. It blends all the good things that I’m looking for when I’m looking to treat acne patients.
There are two types of acne patients for whom I recommend the LightPod Neo: those who have been on several different medications and are seeking technology as an alternative, and those who would like to increase the clearance of their acne by adding a technology component to their current medical regimens.
In dermatology, we are so programmed that we have to use a tetracycline antibiotic and a benzoyl peroxide topical or a retinoid. But the reality is those things take time. If we use the Neo and other types of lasers and light sources, we can dramatically speed up the treatment period, and make the skin look better, too.
Currently, I treat both children and adults with moderate to severe acne. With young patients, we can clear their acne faster. With adults, not only do we make their acne better, we improve the texture of their skin with the 1064nm laser.
This treatment is not for patients with mild acne, but it is an option for patients of any age and skin type with moderate to severe breakouts, and there is no downtime.
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The 1064nm wavelength is an effective option for acne because it targets both the P. acnes and the sebaceous glands. There is also a melanin component to acne that is addressed with this wavelength.
For the purposes of clinical study work, we performed the laser treatments alone, though realistically I always use some kind of medication in combination with laser treatment. I like to think that if a medicine takes 8 to 12 weeks to be effective, usually within two or three weeks I can improve acne patients’ skin using lasers or light sources.
The shortened 650µs pulse of the LightPod Neo allows us to deliver treatment without any pain or discomfort while affecting the sebaceous glands and bacteria in the glands, which has made it a major player in our laser acne treatment regimen.
To be clear, we’re not curing acne with this; we’re making treatment better and faster. The clinical work that was done on all these systems shows that the effect is quick and lasts two or three months, but that is also as far as patients were followed in clinical research. I’ve had patients in my practice who have stayed clear for years following laser treatment alone.
Following treatment, I do recommend a homecare regimen to help reduce inflammation and calm the skin. I have not seen any significant adverse events among patients treated with the LightPod Neo, and patients are very happy with the treatment.
Michael Gold, MD, is founder of the Gold Skin Care Center in Nashville.
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