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Objectives: Modern acne therapy should always combine several treatment pillars. Since highly inflammatory acne carries a high risk of permanent scars, we recommend intensifying the therapy at an early stage, also with low-dose isotretinoin. Laser and light-based procedures are nowadays an integral part of the therapy of acne patients of all ages, as they are very potent and have few side-effects. PDL laser treatments result in the reduction of inflammatory triggers as well as sebum production. We recommended an intensified combination therapy consisting of PDL laser treatment vs low dose isotretinoin Introduction: Laser and light-based technologies have expanded the therapeutic arsenal for acne, and can improve the skin appearance of inflammatory acne and scarring in a short time, which increases patient compliance and satisfaction. Depending on the severity of acne , it is treated topically or in combination with systemic medication. As a result, the inflammation and the severity of the acne, improves quickly and significantly. This is most likely due to reduced sebum production, which rebalances the skin microbiome. PDL also leads to a histologically confirmed reduction of inflammatory cells. Materials / method: We presented 4 case reports of patients ( 25-36 years old). All patients have severe acne and a long history of non-effective treatment. Our goal was a combination of energy-based devices (PDL/IPL therapy) with isotretinoine (low doses ( 8-16 max mg ,during the long time for cumulative effect). All patients have a perfect retrospective result ( after 6,9 months) All treatment protocols, patients satisfaction levels and blood analysis we present during 3,6,9 months and 12 months after treatment Results: After a total of three sessions done in a period of three weeks (one session per week), there was almost a total disappearance of the acne and facial postinflammatory hyperpigmentation. The patients and the operator were satisfied with the results obtained after each application, and finally, at the third session, a decision was made to end the treatment because of the satisfactory results obtained. Moreover, this protocol did not show any side effects, pain, or discomfort during and/or after treatment and within three months of follow-up. Conclusion: We recommended an intensified combination therapy consisting of PDL laser treatment , isotretinoin and topical skin treatment with acne-specific wash lotions, as well as an antibacterial and cornification dissolving peeling gel. In addition, we recommended combined laser treatments to the patient to improve inflammation and skin texture. Laser and light-based technologies have expanded the therapeutic arsenal for acne, and can improve the skin appearance of inflammatory acne and scarring in a short time, which increases patient compliance and satisfaction.