When it comes to a no-nonsense approach to treating acne, Rochester, NY dermatologist Lesley Loss, MD relies on three letters: BBL.
“We have several patients who want a non-prescription solution for acne, so we use Forever Clear BBL by Sciton with great results,” she says. “Patients do need maintenance and/or we combine it with topicals to stay clear.”
While BBL—aka broadband light—isn’t necessarily new, New York dermatologist Jody A. Levine, MD says she’s noticed more and more doctors using it to treat acne and acne scarring of late.
“I have always been cosmetically oriented and have employed lasers in my practice to help with acne scarring—whether it be the BBL to improve red or brown pigmented scars, or the PicoSure to help with remodeling scar tissue, or the MicroLaser Peel and ProFractional to treat deep scars and remodel the skin,” she says. “I also have seen that delivering heat to the skin helps eradicate active acne as well and I have noticed that more and more doctors are employing lasers such as the BBL or Vbeam to treat the acne as well as the acne scarring.”
Pegging blue light by itself as “a long-standing acne treatment to kill the bacteria that contribute to acne,” Dr. Levine also sings the praises of lasers such as “Coolbeam and ThermaScan, to name a few, have been used to shrink sebaceous glands. Then, we started using photodynamic therapy (PDT), which was originally used to treat precancerous or superficially cancerous lesions, as an acne therapy as well.”
Similarly, Saddle Brook, NJ dermatologist Dr. Fredric Haberman relies on the “ABCs” of BBL, IPL and PDT for the treatment of acne, as well as the scars associated with it.
“Acne scarring is a common problem that BBL treatments can reduce or even eliminate—depending on the severity of the scarring. Treatment with a variety of narrowband light, IPL (intense pulsed light) and PDT (photodynamic therapy) may offer improvements in inflammatory acne and acne scarring, with more limited benefit for noninflammatory or comedonal acne.”
Dr. Haberman also praises the fact that “significant progress has been made so far in light-based treatment of acne” in recent years. “The strongest evidence for efficacy of light-based therapies for acne is for blue and blue-red light, with the greatest effect on mild to moderate inflammatory acne lesions. There is also evidence that PDT is effective in treating inflammatory acne lesions, although the adverse effects, mostly short-term and self-resolving, tend to be more severe than blue light. The most effective devices such as blue or visible light primarily reduce inflammatory lesions, more effective treatment of acne may be achieved if light therapy is combined with agents with anti-comedogenic and comedolytic properties such as topical retinoids. Also, a combination of Nd:YAG and Er:YAG laser is helpful to treat active acne and can produce excellent results in both inflammatory and non-inflammatory lesions and the redness.”
“Acne is a chronic condition that usually requires multiple medical visits and a wide spectrum of therapeutic modalities in combination in order to achieve management including stable results,” he adds. “Light devices can achieve control of acne flares when used as monotherapies or in combination with other modalities, which is what I prefer and have been doing for many years with excellent success.”
Like Dr. Haberman, all dermatologists we interviewed for this story pointed to a “multi-modality approach” when it comes to treating acne with lasers and light. Here are some of the formulas behind their favorite current combos
“The latest innovation is likely Sebacia. While the company went bankrupt, there is apparent new hope as the product has been bought and plans to reenter the market. Unfortunately, we didn’t get a lot of experience with it prior to it no longer being available, but are hopeful that this novel gold microparticle 1064 laser treatment is effective.” —Fort Lauderdale, FL dermatologist Dr. Matthew J. Elias
“I’ve been using my Fotona laser with excellent results for both active acne and the post acne erythema that often lingers.” —New York dermatologist Doris Day, MD
“I love combining Vbeam PDL with Picoway laser for treatment of acne and improvement of blemishes/scars—they are great for various skin types. Combo treatments are optimal.” —Davie, FL dermatologist Marianna Blyumin-Karasik, MD
“Radiofrequency lasers, such as Fractora and Morpheous, are also being use to shrink sebaceous glands and treat acne. Like many other things in dermatology, treating acne often requires a multimodal approach and we are learning each day how to make use of our many tools to compound results and get the best outcome possible.” —Dr. Levine
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