Derm News: 2007.22(1)

Comparison of Stacked Pulses versus Double-Pass Treatments of Facial Acne with a 1,450-nm Laser

Dermatologic Surgery, 33(5):552-559
NATHAN S. UEBELHOER, MELISSA A. BOGLE, JEFFREY S. DOVER, KENNETH A. ARNDT, THOMAS E. ROHRER
ABSTRACT

Background

Although effective as a monotherapy for the treatment of inflammatory acne, the 1,450-nm diode laser is associated with considerable pain at higher fluences.

Methods

Eleven subjects were treated with a 1,450-nm diode laser in a split-face bilateral paired acne study. One-half of the face received a single-pass consisting of stacked double pulses. The other side received a double-pass treatment of single pulses. Settings were 11 J/cm2 or lower as tolerated with appropriate dynamic cooling device (range 25-35).

Results

The mean pain rating was 5.33 on a 0 to 10 scale on the stacked-pulse treatment side and 5.12 on the double-pass side. Blinded reduction in mean acne lesion counts were 57.6% and 49.8% reduction, respectively. An overall acne scar improvement was seen in 83% of subjects with acne scarring. Transient hyperpigmentation occurred in two patients on the stacked pulse side and completely resolved without sequelae.

Conclusions

The pulsed 1,450-nm diode laser can be used at lower fluences that elicit less discomfort yet effectively improve inflammatory acne. Stacking pulses appears to render a slightly higher efficacy than the multipass technique. Single-pulse, multiple-pass treatments may have a lower risk of cryogen-induced transient hyperpigmentation compared to standard high fluence techniques

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The Derm News service provided by the Editorial Consultants of Skin Therapy Letter^© and its founding editor Dr. Stuart Maddin.