|A Guide to Laser Treatment of Acne
There are several lasers now available and approved by the FDA for the treatment of acne. All of the lasers can be divided into two groups: 1) lasers that target sebaceous glands or 2) lasers that target bacteria.
Acne Lasers that target Sebaceous Glands
Smoothbeam for ACNE
The Smoothbeam is FDA-approved for the treatment of acne. It works by targeting your sebaceous (oil producing glands) and shrinking them. The Smoothbeam is typically done as a series of four treatments spaced two to four weeks apart. Results sometimes occur as early as the first treatment, but others must wait up to three months after the last treatment. Not everyone responds, but those who do get long lasting results (over one year for many of our patients).
Smoothbeam for acne SCARS
The Smoothbeam is also FDA-approved for the treatment of acne scars. I have found that it is not particularly effective for treating acne scars. The results are inconsistent and modest at best. If someone has only scars and no active acne, I do not recommend the Smoothbeam. Instead we use the Fraxel laser to treat acne scars. Click here to learn about acne scar treatment. Or here to read about the Fraxel laser.
Acne Lasers that target Bacteria
Different colors of light have different wavelengths. Blue light happens to be a wavelength of light that activates certain bacterial products in the skin. These activated bacterial products are toxic to the bacteria themselves. When the bacteria die, your acne improves. The Clear Light is probably the best known laser that uses blue light, but there are many others
Blue light treatments are typically less expensive than the Smoothbeam, but that is because you will require 4 to 8 treatments spaced one to two weeks apart. Blue light is not painful and does not require a numbing cream, but the results tend not to last as long (because bacteria can re-grow).
Acne Lasers that target both
Photodynamic Therapy ("Blue Light Plus ")
Photodynamic therapy (PDT) combines blue light with a chemical. Instead of just using blue light, first a chemical (called ALA or aminolevulinic acid) is applied to your acne. Next you wait for 30 to 45 minutes. During this time, the bacteria in your sebaceous glands convert the chemical to its active form. Finally, the blue light laser is used to activate the chemical in your skin, targeting the bacteria AND the sebaceous glands.
vs. Blue Light alone
PDT is a more aggressive treatment than blue light alone because the chemical tends to concentrate in the sebaceous glands and makes your acne more sensitive to the blue light. PDT requires fewer treatments (usually 2 or 3) than Blue Light alone, and is more effective, but also more expensive. The chemical used in PDT also makes you more sensitive to sunlight. You must be very careful to avoid even casual sun exposure for the next twenty four hours or you may get a pretty bad sun burn. For many patients this sun avoidance is not possible. Even with sun avoidance, you will get more red with PDT than with Blue Light alone. You may get some scabbing and crusting of the skin and sometimes even a temporary worsening of the acne before it improves.