Does anyone have experience (good,bad,or ineffective) with using a Nd:Yag for acne treatments? My candela yag has a recommended acne protocol which is almost similar to the skin tightening setting but I haven't had enough time to know if it'll be effective. The skin tightening I've been doing is going well and I'm hoping I can find another good use for the yag.

I have not seen any research to support the use of 1064 in acne. Many companies throw things like this in so they can add another service to their list and get unaware individuals to purchase the equipment. I have a 1064 made by another company that will tell you the 1064 is the best thing for rosacea well I can tell you from experience it does not work that well. There are much better choices.

I agree with LH.I have been using an Nd YAG 1064 by Sciton for 3,5 years and i haven't seen any improvement in acne.I have not seen also any research to support this.

1064 will not work well for acne. Try if you may. Medical treatment for acne is more cost effective for acne than any laser.

We get pretty good results actually with our 1064 on acne. We do a "mini-laser facial", settings are: 1064, 5mm spot, 18 fluence, 0.4 pulse-width, 5 Hz rep rate, pass over the face four or five times (total of about 800 pulses). Takes only a few minutes and really seems to calm down redness. Also, we have been utilizing azelaic acid lately with a lot of success. We do peels with it and prescribe it often to people with any sort of redness in the cheeks and nose area (including acne-rosacea). The Rx is Finacea 15% gel... definitely consider it..

tony PA,
those sound like cutera - genesis settings. i think it helps but the genesis is nothing really too exciting. probably comparable to LED therapy and would be less time consuming. not moving the hand around for flipping 45 minutes. for active acne IPL/levulan works well.

You have to ask the question is it the laser or is it the laser. I have never seen a report that supports the use of 1064 for acne treatment.

It's the Apogee Elite by Cynosure that we have, and although you can do the time-consuming, boring 45-minute facial, we're finding that you can achieve similarly noticeable results doing a 4x-pass, 800-pulse "mini"-laser facial, which only takes about 5 minutes... I agree, the results are not necessarily "amazing," but because the patient does see a result, it's a 5 minute procedure and it only costs them $250, they continue to come back for them...

The results I suspect may be from heat deposition / collagen remodelling which makes sense. .... hmmm....

I found this quote from Dr. Stephen Nightingale, M.D. on realself.com...

In our office, light treatment augments traditional treatment for acne. For mild comodomal/pustular acne, we still use traditional topical treatment. For more progressive inflammatory acne, we use topical and light therapy. Cystic acne is often treated with oral and topical medications along with light therapy. Light therapy typically comes in two types:

* 410nm blue light

* 1064nm red light

Blue light initiates a chemical reaction that causes the proliferation of endogenic porphrins (chemicals that you have within the skin), which attack and kill /p. acnes/, the bacteria that is responsible for acne. Since the reaction is not antibiotic-mediated, one never develops a resistance to blue light therapy.

_*Red light, however, works on the sebaceous glands rather than the bacteria that cause acne. The sebaceous glands produce sebum, which flows out of the follicle to protect the skin. Bacteria tend to live within the follicular-sebum mileu. 1064nm light can penetrate deeply into the skin and destroy the sebaceous glands, thus decreasing sebum production. The end result is less p. acnes and less acne. *_

IPL typically has wavelengths of 510-1200nm, thus theoretically covering both the effects of blue and red light. Unfortunately, the absorption spectrum of the porphyrins within the skin is pretty specific. Blue light concentrates all its energy at 410nm, the ideal wavelength, whereas IPL only has a small amount of energy within this range. The same applies in the red light spectra. A 1064nm laser emits concentrated energy in this spectra and has a better effect on destroying sebaceous glands than IPL, which again devotes less energy to this wavelength region.
In our office, we combine the use of blue light and 1064nm lasers to both kill /p. acnes/ and reduce sebum production. The result, I feel, is better than IPL or either device alone.

Based on what he is saying, there should be a way to use a 1064 Yag to improve acne.

Michael Sinclair, MD
http://www.epilution.com

First of all 1064 is not red light. It's IR. I agree with his theory but I'm not sure 1064 is the best wavelength to heat up the sebaceous gland. If he was using 1320 or 1540 I could buy the story because it has a much higher absorption in water than 1064. Maybe 1064 bulk heats the dermis enough although I would say there are better wavelengths for this. The idea of treating both the sebaceous gland and the P. acne is solid though.

dexter or anyone else:

Would electrolysis help shrink the sebaceous glands?

Guys,

They are working on the best way to treat sebaceous glands. They have apparently just figured out what appears to be the best wavelength and the winner is 1210nm.

Dave,

I have never seen research to support the use of electrolysis for sebaceous glands.

1450 nm the best

Personnaly I use 1450 nm, 4 mm spot, Fluence 13 J/CM2, only one pass. If dark or fragile skin, I lower the fluence to 11 J/cm2. If there is a touch of inflammatory acné before treatment, I use cyclin 15 days before treatment or macrolid; 4 sessions at one month interval. Workd better and the 1064 I also used.

Michael Sinclair:

I just have a comment on the quote your have by Dr. Stephen Nightingale where he says that "1064nm light can penetrate deeply into the skin and destroy the sebaceous glands, thus decreasing sebum production."

Now is that a true statement? Are there studies which actually show that a 1064nm laser (such as Laser Genesis by Cutera) can actually shrink the sebacous glands? The reason I ask is because I e-mailed Cutera about their 1064nm Laser Genesis machine. The Clincial Support Specialist replied saying that:

"Laser Genesis does not shrink anything. The mechanism of action makes is appear that the pores are "shrinking". In reality, the pores are being "filled in" with new collagen generation. As we age, the collagen and elastin in our skin breaks down creating fine lines, wrinkles and the appearance of larger pores. Actually, what has happened is the "framework" of our skin breaks down, much like if the framework of a building was weak and began to deteriorate then the structure will start to "sag" so to speak. We do not have large pores when we are young because the structure of our skin is strong. Laser Genesis creates a thermal wound in the dermis that stimulates them immune system to create more collagen in the dermis. This new collagen generation actually "fills in" the pores and fine lines. The ideal settings are determined by patient tolerance and epidermal response. The idea is to create bulk heating of the dermis in order to stimulate the wound healing/immune response that creates the new collagen."

Therefore, I'm not sure how Dr. Stephen Nightingale can make a statement saying that a 1064nm laser can destroy sebaceous glands. If it were true, I'm pretty sure Cutera and other companies, would be using it as a marketing tool.

Thanks dave...

You have mentioned very different aspect of acne that is very advantageous mainly to those who are very keen to have different types of information on their favorite subject. As it is mentioned by someone that “I have not seen any research about it” it is really true. Finally I would say that it is good effort, good acne tips.

http://www.treatmentsforacne.net/

I'm using a 1450nm smoothbeam to treat acne and acne scars. For acne, I've been using 6mm, 8 J/cm2, and DCD 28 which has been working great at reducing oiliness and controlling csytic acne when used in combo with appropriate topicals & sometimes antibiotics as well. The setting is very tolerable.

For acne scars, I have it set to 14J, DCD 40, 6 mm. Because this setting is uncomfortable, I've been using a zimmer cooler which makes it very comfortable for the patient. However, I'm wondering if this will lessen the results by not allowing the dermis to heat up properly or if the zimmer is only cooling the surface but the laser is still able to heat the dermis appropriately. Does anyone have an opinion?

Use the Sciton 1319, it works well.

I have been using an Aesthera PPx for acne. OK, the company is sub-optimal and it's a cheap box; does not work that well for hair removal (I only do underarms and bikinis now) and kinda' OK for pigment if I combine with microdermabrasion, skin care prods.and medical grade peels.
70% of my practice is now acne oriented. I rarely see results after one tx but after tx #2 and #3....damn good. I think it has to do with the suction. Plus, I steam the face first. Not many boxes within a few zip codes so I'm thinking making it a stand alone biz.

Taking care of your skin is a lifetime goal. Good skin represents good health.