Acne vulgaris is a prevalent skin condition categorized into two types: non-inflammatory
(comedones) and inflammatory (papules, pustules, and nodules). It primarily affects
adolescents and young adults, often leading to scarring and diminished self-esteem. Over
80% of teenagers experience acne, which can continue into adulthood. The psychological
impacts are significant, as many individuals experience reduced self-esteem and
heightened anxiety. Effective treatment and management are essential for enhancing the
quality of life for those affected.
The pathogenesis of acne is influenced by multiple factors, including excess sebum
production, follicular keratinization, Propionibacterium acnes colonization, and
inflammation. Acne treatments typically include topical and oral medications. Topical
options, such as retinoids and antibiotics, require frequent application, which can
affect patient compliance. Topical antibiotics often show poor efficacy and can lead to
recurrence. Additionally, topical retinoids may cause irritation, while oral medications
can have more severe side effects. Systemic isotretinoin is effective but associated with
high costs and significant side effects, including teratogenicity and dryness.
Laser treatment for acne, particularly the inflammatory type, has gained significant
popularity in recent years. This therapy effectively reduces acne lesions by inhibiting
overactive sebaceous glands and alleviating inflammation. The mechanism is believed to
involve the activation of porphyrins produced by Propionibacterium acnes, leading to the
destruction of their cell membranes. Lasers with a wavelength of 1064 nm have been
specifically studied for acne treatment. Various laser systems, such as near-infrared
lasers and radiofrequency devices, effectively destroy sebaceous glands. Additionally,
light sources like blue lights and intense pulsed light (IPL) are being increasingly
incorporated into standard medical treatments to improve therapeutic outcomes.
Several types of lasers have been used to treat acne vulgaris in recent years and have
shown great results. IPL and the 1,064-nm Nd:YAG laser are effective in treating
inflammatory facial acne vulgaris, with no significant difference in their effects on
facial acne lesions. Nd:YAG laser treatment also leads to a reduction in the total number
of comedones, similar to the improvement observed with inflammatory lesions.
Vascular lasers, particularly a 577-nm high-power optically pumped semiconductor laser,
are effective and safe for treating inflammatory lesions, decreasing Propionibacterium
acnes, and reducing the size and function of the pilosebaceous unit.
Effective management of acne comedones often requires consistent use of topical
treatments for several weeks to see significant improvement. If over-the-counter options
take a long time and require considerable effort, it may be beneficial to explore other
therapeutic avenues.