A pilot investigation comparing low‐energy, double pass 1,450 nm laser treatment of acne to conventional single‐pass, high‐energy treatment

Abstract

Background and Objectives: Laser treatment using a 1,450 nm diode laser has been shown to improve acne and acne scarring. Its widespread adoption in younger populations has been significantly limited by discomfort. Study Design/Materials and Methods: Six subjects with active papular acne were treated in a pilot study to determine parameters for a split-face, double-pass, lowenergy protocol of 1,450 nm laser treatment. Sides of the face were randomized to receive single-pass, high-energy treatment (13-14 J/cm 2 ), or double-pass, low energy treatment (8-11 J/cm 2 ), for a total of four treatments delivered at monthly intervals. Acne counts and standardized, digital photograph were performed 2 months following the final treatment, and compared to pre-treatment counts and photographs. Results: Improvement was evaluated comparing pre-and post-treatment photos and averaged 2.5 for the highenergy, single-pass side and 2.3 for the low-energy, double-pass side, using a 0 (worse) to 4 (max improvement) scale. Acne counts were reduced 78% on the high-energy, single-pass side and 67% on the low-energy, double-pass side. Pain ratings on a 1 (min) to 10 (max) scale averaged 5.6 (range 1-9) for the high-energy, single-pass side and 1.3 (range 1-2) for the low-energy, double-pass side. Conclusions: Low-energy, double-pass 1,450 nm laser treatment effectively reduces acne counts 2 months posttreatment, and dramatically reduces the pain associated with treatment. The treatment parameters used in this study have eliminated the need for anesthetic cream in daily practice.

Clinical effect of low‐energy double‐pass 1450 nm laser treatment for acne in Asians

“…In a previous study, PIH was observed in 39% of Asian patients with Fitzpatrick skin types IV–V; this study used a DCD spray for a duration of 50 ms with single‐pass treatment, at fluencies ranging from 11 to 12 J/cm 2 for facial atrophic acne scars (13). It has been suggested that using lower energies delivered in two passes may prove to be considerably useful in darker skin types and tanned patients (10). However, another study concerning PIH suggested that the duration of cryogen spray while using dynamic cooling during the laser treatment played an important role in causing hyperpigmentation (14).…”

The Asian Dermatologic Patient

“…[72] Significant adverse effects such as transient hyperpigmentation, exfoliation, and crusting were observed. Bernstein [74] recently published a pilot study demonstrating superiority of low-fluence (8-11 J cm 2 ), doublepass 1450-nm diode laser treatment over conventional treatment. [14] Infra-red lasers are increasingly being used in the treatment of acne and acne scarring.…”

Low-cost/high-efficiency lasers for medical applications in the 14XX-nm regime

“…The laser is capable of outputting in excess of 2W with a maximum electro-optical efficiency of 25%. With the adjustment of pulse duration and frequency, the deliverable energy from the unit is comparable to that used to treat acne [2], [3], [9], [10] and wrinkles [4], [11], [12]. High power laser diodes require drive currents up to 10A.…”