Carbon Assisted Q-Switched Nd:YAG Laser Treatment with Two Different Sets of Pulse Width Parameters Offers a Useful Treatment Modality for Severe Inflammatory Acne: A Case Report

Abstract

The treatment of inflammatory and noninflammatory acne still presents problems to patients and dermatologists. A new technique using two different sets of 1064 nm Nd:YAG laser parameters has been developed in combination with a topical carbon lotion. A preliminary test of the efficacy of this new treatment technique is reported. A 14-y-old girl presented with moderate to severe pustular and cystic acne over the bilateral cheeks and chin. Following topical local anesthesia, a topical carbon lotion was applied to the face, and a Q-switched frequency-doubled Nd:YAG laser was used first in a quasi-long pulsed mode (a 300-μs pulse width at 1.1-1.5 J/cm(2)) followed immediately by a Q-switched mode (5-nsec pulse width, 1.5-2.0 J/cm(2)) using a 7-mm handpiece for both modes. Six treatments were given, 2 weeks apart. The procedure was well-tolerated. By the fourth treatment significant improvement was observed, and by the sixth treatment, better than 90% clearance of inflammatory lesions was achieved. At the 8-week follow-up after the last treatment, long-lasting improvements in the patient's acne were noted. Improvement was also noted in closed comedones and in the general skin condition, especially pores, sebum reduction, and the red spots seen after inflammatory acne. The patient was satisfied with the result. This new, minimally invasive technique as a stand-alone treatment gave very good clearance of inflammatory acne with minimal patient down time. Marked reduction in active acne was observed during treatments and at the 2-month follow-up visit. Further improvement could probably be achieved with other adjunctive therapeutic modalities.