Evaluation of Clinical Improvement in Acne Scars and Active Acne in Patients Treated With the 1540-nm Non-Ablative Fractional Laser
August 2011 | Volume 10 | Issue 8 | Original Article | 907 | Copyright © August 2011
María José Isarría MD, Paloma Cornejo MD, Estefanía Muñoz BSc, Josefina Royo de la Torre MD, Javier Moreno Moraga MD
Instituto Médico Láser, Servicio de Dermatología, Madrid (Spain)
Abstract
Introduction. Acne is a characteristic condition of puberty; however, adults who continue to have acne outbreaks frequently attend dermatology clinics. Two conditions—active acne and residual scarring—often co-occur in these patients. The objective of the present study was to evaluate the improvement in scarring and active acne after treatment with a 1540-nm erbium: glass fractional laser.
Material and Methods. The authors treated 20 patients with acne and scarring. Each patient received panfacial treatment in four sessions with a 1-month interval between sessions. Patients, the treating physician and a blinded observer evaluated the results in four areas: improvement in scars, improvement in pores, improvement in acne, and improvement in sebum secretion. Improvements were graded using the Global Aesthetic Improvement Scale. The evaluation was made 12 weeks after treatment finished.
Results. Patients presented an improvement in both acne and scars. In 80 percent of cases, patients felt that the appearance of the scars had improved, and the improvement was classified as very much improved in 40 percent. In 85 percent of cases, patients felt that active acne had improved, and the improvement was classified as very much improved in 45 percent. Pore size was evaluated as improved by 75 percent of patients. Sebum secretion improved in 80 percent of cases.
Conclusion. A 1540-nm non-ablative fractional laser provides effective treatment of acne scars. Patient satisfaction is high and active acne lesions improve significantly. Treatment of this mixed condition (scarring and active acne) with a single device is reliable, with a favorable safety profile and a high degree of patient acceptance.
J Drugs Dermatol. 2011;10(8):916-921.
INTRODUCTION
Acne is one of the most common conditions seen in the dermatology clinic, and the highest incidence is recorded during puberty. However, adult cases are also common. Although not very severe, acne outbreaks can affect quality of life. Patients usually consult for two associated problems: residual scarring from previous outbreaks and active acne.
Acne is a multifactorial disease of the pilosebaceous follicle. Current medical approaches aim to treat the causes of acne by stemming growth of bacteria (Propionibacterium acnes), controlling sebum secretion, inducing anti-inflammatory effects, and regulating hyperkeratinization to avoid formation of comedones. Topical treatments (retinoids, antibiotics, bactericides) and oral treatments (antibiotics, isotretinoin) have proven effective and are the first option for many patients with active acne.
In some cases, and for different reasons, adult acne patients seek alternatives with lasers and light-based therapies, and several visible and infrared light systems are reliable for treatment of active acne.1-2
An associated problem in these patients is that acne scars are mostly atrophic and therefore require an independent therapeutic approach. Several options are available, ranging from surgery (subcision, punch elevation, extirpation) to mechanical treatment (dermabrasion), chemical peeling, and a wide range of treatment with lasers, light, and other forms of energy.
Several reports state that non-ablative lasers (585 nm, 1320 nm, 1064 nm, 1450 nm, 1550 nm) used to treat acne scars also provide an improvement in active acne, as a result of their collagen remodelling effect.3-5 At present, both ablative and
