title: Comparison of stacked pulses versus double-pass treatments of facial acne with a 1,450-nm laser.
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/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.
authors: SkinCare Physicians of Chestnut Hill, Chestnut Hill, MA, USA. nsuebelhoer@nmcsd.med.navy.mil
authors: Nathan S
authors: NS
authors: Uebelhoer
authors: Melissa A
authors: MA
authors: Bogle
authors: Jeffrey S
authors: JS
authors: Dover
authors: Kenneth A
authors: KA
authors: Arndt
authors: Thomas E
authors: TE
authors: Rohrer
mesh_terms: 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