Lasers and Light Therapies

An alternative for people whose acne hasn’t responded to traditional acne therapies is laser and light therapies. Lasers and light therapies show evidence of improving not only inflammatory acne, but can also lead to improvement in acne scars.

Laser can be tuned to target specific structures. When used to treat acne, the beams are adjusted to penetrate below the epidermis without causing any injury to it. They travel into the dermis where they can zero in on hair follicles, sebaceous glands, and the P. acnes bacteria. Certain lasers can also be used to destroy telangiectasias and by heating dermal collagen can help to “tighten” the dermis and result in less visible scarring.

There are two basic groups of acne-treating lights. One group of technologies inhibits the growth of the bacteria P. acnes and the other group of light sources aims to shrink the sebaceous oil glands that play a prime role in causing acne. One needs to keep in mind that laser and light therapy seem to be most helpful when used in combination with traditional acne medication treatment.

According to dermatologist, Dr. Herbert Goodheart, “the U.S. Food and Drug Administration has approved a non-laser, narrow-band, high-intensity visible blue-light therapy for treating inflammatory acne. It works by killing the acne-causing bacteria, P. acnes.”

The P. acnes that reside in sebaceous glands produce chemicals known as porphyrins as a by-product of their metabolism. The high intensity light source seeks out the porphyrins that are in the bacteria which kills the bacterial cells.

Photodynamic therapy (PDT) involves applying a painless solution to your skin called aminolevulinic acid (ALA) which is a photosensitizing agent that increases sensitivity to light. It’s left on your skin for 15 to 60 minutes and allowed to accumulate in the sebaceous glands. An intense, visible blue light source activates the ALA. Within about eight to ten minutes, the chemical reaction that occurs produces heat and the bacteria are destroyed. Many treatments may be necessary to achieve satisfactory results, for the destruction of P. acnes is only temporary because they revitalize rapidly.

Lasers that are used in acne scar treatment are the resurfacing lasers (ablative) and the non-ablative lasers.

Ablative lasers remove the outer layers of the skin by using high-energy light to burn away scar tissue, and stimulate the dermal collagen to tighten, reducing the amount of scar visibility. This procedure is used for deeper scars and carries the risk of further scarring. Much effort must be put into post-operative wound care and infection protection when the skin is injured and unprotected tissue is exposed. The skin may remain reddened for several months up to a year afterwards.

Non-ablative lasers have the ability to promote collagen growth beneath an acne scar without creating an external injury. The non-ablative lasers produce a controlled injury to certain target structures in the dermis, without injuring the epidermis. By heating dermal collagen, the laser helps to tighten the dermis and result in less visible scarring. These lasers can be effective for treating shallow boxcar scars, as well as for smoothing and tightening scars that have been treated previously.

Non-ablative lasers include:

InfraRed Lasers commonly used for thermally induced dermal remodeling and tightening.

N-Lite Laser is used to trigger collagen formation.

Sprinkling Laser beams (Fraxel laser) shoots out tiny clusters of beams that burn the skin in patterns of dots. It burns away old skin cells and spurs the growth of new cells and stimulates the production of collagen that, tends to fill the dots and smooth out the skin.

There are many types of lasers and there are a number of new procedures now available that complement or surpass previous scar revision techniques.