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Objectives: 1: Diagnosis of various types of acne
2: Understand pharmacological and non-pharmacological treatments for acne
3: Understand Photothermal therapy (PTT) and Photodynamic therapy (PDT) for Acne

Introduction: Acne vulgaris is a disorder of the pilosebaceous unit that can cause severe cosmetic and psychological problems, particularly in adolescents. Pharmacological therapy is not always desirable because of the development of antibiotic resistance or the potential risk of adverse effects. Non-pharmacological therapies can be viable alternatives for conventional therapies. Photothermal therapy (PTT) and photodynamic therapy (PDT) are non-pharmacological therapies that have recently been spotlighted for acne.

Materials / method: For PTT, after cleansing the skin, light-absorbing gold microparticles were sonophoresis for 10 minutes. The remaining light-absorbing gold microparticles on the skin surface were then wiped off with gauze. We treated acne using a 1064 nm long pulse Nd:YAG laser with 30-33 J/cm2, 30 msec duration.
PDT was performed on 19 inflammatory acne patients. After applying 5-ALA to the treated area twice, occlusion therapy was performed for 60 minutes to help the drug penetrate. After that, IPL was irradiated and the use of sunscreen and excessive sun exposure were avoided for 48 hours after treatment.

Results: After PTT and PDT, acne lesions and sebum secretion decreased.

Conclusion: PTT with light-absorbing gold microparticles and PDT with 5-ALA are effective in treating acne. The advantage of PTT with light-absorbing gold microparticles is non-pharmacological therapy, does not require sun protection for 48 hours after treatment, the main target of treatment is sebaceous gland, so the duration of remission is long.

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Objectives: I’ll be presenting about the long-term treatment in acne management especially the latest updates on new topical and oral agents. I’ll also talk about what’s new with isotretinoin.

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Objectives: treating inflammaotry acne with lasers

Introduction: Standard treatments for moderate-to-severe acne routinely require oral medications and produce short-lived results or side-effects. Lasers facilitate a rapid onset of improvements while simultaneously preventing and treating acne scars, with minimal side-effects.

Materials / method: Forty individuals with moderate-to-severe acne were treated with a dual wavelength laser (1319-nm and 589-nm laser )applied sequentially for a total of 5 treatments. Treatments were conducted at 2-3 weekly intervals. Patients were digitally photographed at baseline, before each treatment, and at one month after the final treatment. 15 patients were seen at 3 months after the last laser
Patients were assessed on improvements in acne severity, erythema and for pain, level of seborrhea, overall aesthetic improvement and patients satisfaction

Results: All patients showed improvements one month after the last treatment. 72.5% of patients had more than 75% improvement, 37.5% improving to mild acne and 62.5% improving to almost no acne lesions. Fifteen patients with an additional visit at 3 months after the last treatment also showed sustained acne improvements at 3 months. Erythema and skin pigmentation associated with acne also improved. The treatment was well-tolerated

Conclusion: The dual-wavelength laser is effective and safe for treating moderate-to-severe inflammatory acne, and leads to high patient satisfaction. It is recommended for patients unwilling or unable to take oral medications, or those with acne-associated pigmentation, erythema and seborrhea.

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Objectives: The aim was to review experience using combined approach in the treatment of post inflammatory hyperpigmentation in acne patients with 1,064-nm Q-switched NDYG laser assisted with topically applied carbon suspension and superficial chemical peels.

Introduction: Acne is one of the most common inflammatory skin disorders. Patients with skin of color often worry more about post inflammatory hyperpigmentation and scarring than acne itself. Acne-PIH has negative impact on patients’ quality of life. Early intervention and aggressive acne treatment are important in patients with dark skin to treat as well as prevent acne-related PIH. Dermal hyperpigmentation can take years to fade to normal, while the epidermal variant can take up to 6-9 months. Very few therapeutic modalities have proved to be really efficacious in this condition.

Materials / method: Patients were treated with 1,064-nm QSNY laser and superficial chemical peel in the same session. Carbon suspension has been used which is an oil base carbon and the device used is Spectra from Lutronic. Total of 3 passes has been delivered, we start with Quasi-long pulse mode (300 micro sec) known as spectra mode to heat the carbon and then use the 5ns Q-switched mode (1064nm) to blast of the carbon, followed by chemical peel [ mandelic, glyco k, or retinol peel ] in the same session. Photographs were reviewed to determine the efficacy. Adverse effects were noted.

Results: The dual mode of the quasi-long pulse and Q-switched Nd:YAG laser treatment assisted with a topically applied carbon suspension acted quickly, and was effective for treating post inflammatory hyperpigmentation in acne lesions.1064nm being longer wavelength penetrates deeper, thus leading to less paradoxical PIH. Chemical peels when combined with lasers optimize outcomes and enhanced patient satisfaction. The sessions were well tolerated and no serious side effects were observed. Patients noticed significant reduction in pigmentation was faster with fewer sessions.

Conclusion: Management of long-lasting PIH due to acne is a psychological and cosmetic morbidity and it remains a challenge, especially in dark-skinned individuals. Although many treatment options are available for PIH, it takes months to resolve, even with an adequate therapy. The advantages of combining the dual mode of the quasi-long pulse and Q-switched Nd:YAG laser treatment assisted with a topically applied carbon suspension and chemical peel may provide a novel approach that is safe and effective for acne PIH.

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