PracticalDermatology

Close to 50 million Americans have acne, a condition that can result in significant physical and psychological problems, according to the American Academy of Dermatology (AAD). There are a multitude of acne treatment options available today including topical therapy, antibiotics, isotretinoin, oral contraceptives and/or laser and light-based devices. New AAD guidelines for the management of acne vulgaris suggest that combining therapies provides the best chance for clearance.

Lasers represent an extremely attractive option for acne patients who have not responded to traditional therapies and for those who either cannot take or who do not want to take oral medications including antibiotics or isotretinoin.

At first, much hope was pinned on blue light for acne and while this can be effective, some inherent drawbacks exist. For starters, blue light acne therapies are best suited for mild-to-moderate acne cases. Patients who have severe acne likely won’t benefit from blue light. This modality is usually only effective in killing the most common types of acne bacteria, not some of the outliers that we know can cause or worsen acne. Intense heat from the earlier generation of lasers caused pain, burns, and/or other adverse affects. Other light-based devices, including intense pulsed light (IPL) and diode lasers do not possess such deep heating power. Instead, many apply “sucking mechanisms” to the skin to bring the targeted sebaceous glands closer to the skin surface. This can make the procedure less hygienic and can increase risk of spreading the P. acnes bacteria to unaffected skin sites.

For these reasons, there has been tremendous enthusiasm about Aerolase’s LightPod Neo for the treatment of acne vulgaris. This 650-microsecond laser effectively and safely treats both pediatric and adult acne patients, regardless of skin type. It penetrates deeper than any other laser/light modality, allowing energy to reach sebaceous glands where it will achieve bacterial destruction. The Neo selectively targets water, melanin, and hemoglobin—all three of which comprise the main components of the sebaceous gland. It’s a short-pulsed laser and because of this, it really targets the vascular components of acne, coagulating blood capillaries to cool inflammation and redness. It also reduces hair growth to prevent the formation of new blockages in the sebaceous glands.

Aerolase’s LightPod Neo in Practice

Most of my acne patients are already using something to treat their acne. When they come to see me, we may adjust their medication, but we also introduce the concept of lights and lasers and how we can use technology to better treat acne. Many patients will opt to be treated that day; others may wait, but most sign up once my staff and I delineate the benefits. Laser and light treatments for acne are typically adjuncts to topical or oral medication. Aerolases’s LightPod Neo air is safe for use with these medications excluding isotretinoin. I typically recommend six to 12 sessions, but this varies depending on the severity of the acne. The parameters are based on the patient’s skin type and what they can tolerate. Most everyone starts at 6.0 out of 8.0 joules; patients with darker or more inflamed skin should begin treatment at 2-4 joules.

If we treat the acne a couple times a month, we get remarkable clearance. This even holds in severe acne patients who failed isotretinoin.

Patient satisfaction is high, and downtime is minimal. The laser pulses through the epidermis in a fraction of the time compared to traditional long-pulsed 1064nm lasers, resulting in significantly less pain.

I charge $150 to $200 per treatment which, while low, adds up quickly when we do five to 10 time treatments a day for five days. Treatment takes five to 10 minutes, and is performed by a laser technician. The device is also portable which makes it ideal for dermatologists practicing in multiple offices. I will also recommend adjunctive home devices to some LightPod Neo patients. I don’t use Aerolase’s LightPod Neo as a scar treatment, but we do get some collagen formation with it. Instead, I say, “Let’s get the acne cleared and then I have a ton of devices to help with whatever scarring is left.”

LightPod Neo makes acne better, pigment better, and vascular lesions better. It has become a workhorse for my practice. It is my go-to device for acne. n

Based on a presentation given at Cosmetic Surgery Forum 2015. Cosmetic Surgery Forum will be held November 30-December 3 in Las Vegas. To register: CosmeticSurgeryForum.com.

Michael H. Gold, MD is a consultant, investigator and speaker for Aerolase.

Dr. Gold is founder of Gold Skin Care Center, Advanced Aesthetics Medical Spa, The Laser & Rejuvenation Center, and Tennessee Clinical Research Center in Nashville. Dr. Gold is also Clinical Assistant Professor at Vanderbilt University School of Medicine and School of Nursing and Adjunct Assistant Professor at Meharry Medical College, School of Medicine in Nashville.