Comparison of stacked pulses versus double-pass treatments of facial acne with a 1,450-nm laser.
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/cm(2) 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.
Uebelhoer
Nathan S
NS
SkinCare Physicians of Chestnut Hill, Chestnut Hill, MA, USA. nsuebelhoer@nmcsd.med.navy.mil
Bogle
Melissa A
MA
Dover
Jeffrey S
JS
Arndt
Kenneth A
KA
Rohrer
Thomas E
TE
D000152:Acne Vulgaris / Q000473:pathology / Q000532:radiotherapy*; D000328:Adult; D005148:Facial Dermatoses / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D028022:Low-Level Light Therapy / Q000379:methods*; D008297:Male; D012720:Severity of Illness Index; D016896:Treatment Outcome