Friday, January 28, 2022

Do They Work, Cost and More

  • Laser treatments can be used on their own but are usually one part of dual therapy 
  • They can effectively treat inflammatory acne symptoms as well as all types of acne scars
  • Cost is based on several factors including skin severity, the number of sessions required and provider’s fees
  • Potential side effects are rare and usually preventable

Acne is the most common skin disorder in the United States, affecting about 50 million annually. There are a great range of treatment options available including prescribed oral and topical medications, over-the-counter (OTC) products and professional treatments. While laser treatments for acne can be an effective standalone option, typically two modes of therapy are chosen to achieve greater results.

Do Laser Treatments Work for Acne?

Yes, laser treatments can effectively treat acne. There are several types in use, with some studies indicating results can last up to 1 year.  

Inflammatory acne typically forms when excess sebum, dead skin cells and debris accumulate within pores which encourages bacteria to flourish. This induces inflammation which presents as red, painful pus-filled pustules and papules.

Laser treatments can play an important role in treating and preventing inflammatory acne breakouts. In recent years, they have gained in popularity due to a high degree of efficacy, ease of use and low risk of side effects. 

Laser treatments have been demonstrated to effectively speed up healing of acne lesions and have few associated side effects. They can reduce sebum production by targeting sebaceous glands, and importantly, can destroy Cutibacterium acnes (formerly Propionibacterium acnes). 

As such, this type of therapy is an important tool in the acne arsenal, especially with the emergence of treatment-resistant antibiotics. However, laser treatments are not as effective for treating noninflammatory comedonal acne due to the absence of significant levels of bacteria. 

Laser treatments can effectively support other treatment modalities—such as oral and topical acne medications—to enhance results, and have therefore become an established option in fighting acne. They can also replace oral and topical acne treatments for those who cannot or do not want to go this route, as well as be a viable solution for those who fail to respond to more traditional forms of therapy.

Lastly, laser therapy can be introduced once a round of oral antibiotics have been completed to maintain results.   

Laser Treatments for Acne Scars

Some lasers treat acne scars by harnessing the power of heat and light to target the outer layers of the skin to break up scar tissue; others penetrate more deeply to encourage collagen production. 

Laser treatments are effective solutions for both atrophic (depressed) and hypertrophic (raised) acne scars by stimulating collagen production and breaking up scar tissue, respectively. While they can’t be completely eliminated, they do offer strong results.

Several lasers for acne scars have been used effectively for decades such as diode, pulsed dye and YAG lasers; more recently, ablative and nonablative lasers have been added to this treatment category as well as fractional versions for both.

Multiple studies indicate that laser treatments are effective and safe, and provide a high level of patient satisfaction. With the introduction of fractional ablative lasers, these newer lasers offer superior results with improved appearance, texture and pliability of scar tissue –  with less downtime.

While results can be seen after just one session, multiple sessions are required over the course of several months to achieve the best results.

Best Laser Treatments for Acne 

Lasers for acne employ various wavelengths, typically red and blue light and less often, green. Red light penetrates deeply to repair tissue, reduce inflammation and promote healing. Blue and green light work at the surface level to destroy acne-causing bacteria. 

In one study, red light was demonstrated to significantly reduce active acne lesions after 12 sessions. Another study examined the effects of blue light on inflammatory and noninflammatory acne lesions. Eight sessions effectively reduced the number of inflamed lesions in subjects; little effect was seen regarding comedones.

Diode laser

The 1450 nm diode laser can effectively suppress the activity of sebaceous glands to reduce the presence of oil on the skin. It has been proven to provide positive results by reducing inflammatory lesions after just one treatment, with results maintained over the long term.

Of note is that this laser can be effectively and safely used on darker skin tones which is notoriously challenging to treat due to increased risk of hyperpigmentation in this group.

ND:YAG laser

ND: YAG lasers direct micropulses of energy to destroy P. acnes and damage the sebaceous gland to limit sebum-producing activity.  

This laser is an effective and safe solution to treat mild-to-moderate inflammatory acne lesions. In one study, comparing this laser with pulsed dye lasers, both were found to significantly reduce lesion count and redness. Additionally, participants preferred the YAG laser as adverse effects were lower.   

Pulsed dye laser 

Nonablative pulsed dye lasers (PDLs) target blood vessels in the skin, and have been demonstrated to improve active acne after just one treatment. In one 12-week study, subjects reported reduced acne severity: total lesion count fell by 53% and inflammatory lesion count by 49%. The greatest improvements were recorded in the first 4 weeks, and the treatment was well tolerated.  

These lasers are increasingly being used to treat patients with postinflammatory erythema, (PIE) an acne-induced skin condition. This occurs when inflammation and blood vessel dilation leave behind red and pink discoloration This is a relatively new practice that has shown good to excellent results. 

One study of PIE and patients receiving 3–6 sessions resulted in 79% of patients showing more than 50% improvement in erythema scores. Another study showed excellent results with 90% or more clearance of inflammatory lesions.  

Are You a Candidate for Laser Acne Treatment?

Save for the 1450 nm diode laser, laser treatments are not recommended for darker skin tones as they can cause keloids, inflammation and hyperpigmentation. Good candidates are those that have mild to moderate inflammatory acne and in general good health.

It’s also important to notify your dermatologist if you’re prone to cold sores as laser procedures are known to trigger them. 

How Much Does a Laser Treatment for Acne Cost?

There are a number of factors that influence the price of laser treatments including the severity of acne, number of treatments required, geographic location and the experience level of your provider.

With that being said, the average cost of laser treatments for acne ranges from approximately $1,200 to $2,000. The type of laser used typically doesn’t affect the price of treatment. For example, treatments with the ND:YAG laser cost between $300–$600 per session, which is consistent with the cost of other lasers used for acne.

Takeaway

Laser treatments are considered a valuable component of acne therapy and are typically combined with an OTC or prescription topical or oral medications. They can also be used in place of traditional acne therapies and as maintenance therapy once a course of antibiotics is completed. 

These treatments effectively treat acne by destroying acne-causing bacteria and damaging sebaceous glands to reduce sebum production.  

Lasers have been proven effective against inflammatory acne symptoms, and are safe and well tolerated. Improvements can be seen in skin after just one treatment but typically, multiple treatments scheduled over several months will achieve optimal results.

Sources

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