Treatment of inflammatory facial acne with 1,450-nm diode laser in type IV to v Asian skin using an optimal combination of laser parameters

Abstract

Background The 1,450-nm diode laser is effective for the treatment of inflammatory acne, but there is a significant risk of postinflammatory hyperpigmentation (PIH) in Asian skin. Objective To determine whether lower fluence and shorter cooling duration of the 1,450-nm diode laser improve acne effectively with minimal PIH in darker skin. Materials and Methods Twenty-six subjects (skin phototypes IV-V) with inflammatory facial acne received four treatments using the 1,450-nm diode laser with 6-mm spot size 3 to 4 weeks apart. We used three passes with a fluence of 8 J/cm2 with dynamic cooling of 25 ms to minimize PIH. Serial blinded assessment of acne lesion counts and sebum measurement were evaluated before and up to 6 months after treatment. Results Four weeks and 6 months after the last treatment, reduction of mean acne lesions was 29% (p<.01) and 40% (p<.03), respectively, from baseline in the group with moderate acne. Significant improvements of sebum production were noted. Four episodes of temporary PIH (3.8%) were observed out of all treatment sessions. Conclusion Use of multiple passes of a 1,450-nm diode laser with lower fluence and shorter dynamic cooling device retains its therapeutic efficacy with substantial reduction of PIH for moderate acne. The nonablative 1,450-nm diode laser was loaned for this study by Candela, Corp., Wayland, Massachusetts. © 2009 by the American Society for Dermatologic Surgery, Inc.