New Frontiers in Acne Therapy

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        5                                                                                                     Jason Lupton, M.D.

New Frontiers in Acne Therapy
Jason Lupton, M.D.
Laguna Hills, California   Introduction
                           Acne represents the most common cause                technique is used to cover the entire area.
                           for all dermatologist office visits, as it affects

                                                                                Patients are of Fitzpatrick skin types I, II, or
                           approximately 80 percent of the human                III, and the treatment parameters that we
                           population. Whether a patient is afflicted           use are as follows. When treating acne
                           physically in terms of pain or psychologically       on both the face and back, a 6 mm spot
                           in terms of self-image and confidence, there         size is used, with energy fluences of about
                           are many existing therapies that are effective       12–14 J/cm2, and the Dynamic Cooling
                           though not curative. The condition of acne           Device™ (DCD™) is set at 35–40 msec.
                           involves the increased production of sebum           When treating acne on thinner skin areas
                           by the sebaceous glands as a result of
                           increased hormonal activity. Treatments for
                                                                                such as the neck, the treatment parameters
                                                                                remain the same, but we use a lower energy
                           acne are either topical or systemic and may          fluence (about 11 J/cm2) and a DCD setting
                           consist of benzyl peroxide, retinoids, salicylic     of 30 msec. The cryogen is turned down
                           acid, antibiotics, hormone treatments, and           when treating darker skin types so as to
                           isotretinoin. Many of these treatment meth-          avoid hyperpigmentation that can potentially
                           ods have a temporary effect on the surface of        result from the cryogen burst. The optimal
                           the skin, but do not yield long-term clearance.      interval between treatments is two to four
                           Additionally, there are drawbacks to some            weeks, and approximately three to five
                           of these treatments, such as frustrating side        treatments are generally recommended
                           effects and a demanding treatment regimen,           for full clearance. Application of a topical
                           both of which frequently lead to lower               anesthetic prior to treatment is highly
                           compliance levels.                                   recommended. In our practice, we suggest

                                                                                that each patient apply Betacaine® or
                           A new treatment option is now available—
                                                                                Elamax® by rubbing it into the surface of
                           Smoothbeam™ laser treatment. A diode
                                                                                the skin 20–30 minutes before treatment.
                           laser with a 1450 nm wavelength, the
                                                                                Post-operative suggestions are simple; apply
                           Smoothbeam has the ability to target the
                                                                                ice as needed and use sunscreen immedi-
                           root cause of acne, and to cause a thermal
                                                                                ately following treatment.
                           injury to the sebaceous gland. The epider-
                           mis is cooled and protected at the time of           Most patients experience slight erythema

                           treatment using cryogen spray. Compliance            and transient, mild edema after the laser
                           issues are eliminated because there is no            treatment, which will subside within 30
                           need to rely on the patient to self-treat.           minutes. More aggressive treatments may
                           Few treatments are needed, and side                  result in some temporary pigment changes
                           effects are minimal.                                 in the skin. Subsequent treatments yield a
                                                                                more thorough and immediate clearing of

                           Method                                               these lesions, which is then followed by an
                                                                                overall reduction in the actual number of
                           Although most of our patients consist of             lesions. The consistent response to effective
                           women, we do treat some men, mostly for              Smoothbeam treatments enables us to
                           acne scarring as opposed to active acne.             maintain satisfied patients with expecta-
                           Areas of the body most commonly treated              tions that are being met and exceeded.
                           for acne are the face, neck, and upper back,         Accutane (isotretinoin) remains our prescrip-
                           and occasionally elsewhere. A single-pass            tion of choice when we are faced with


severe cases of acne. However, due to the                                    levels. Smoothbeam is a novel approach
side-effect profile of Accutane as well as any                               in that it represents a long-awaited alterna-
history of a contraindication to oral/systemic                               tive for acne patients who prefer to avoid
medications, many patients are now seeking                                   long-term antibiotic and drug therapies.
alternative treatment methods. We use                                        Smoothbeam has a very low side-effect
Smoothbeam to treat the residual acne                                        profile, and is viewed as a solution to the
                                                                             compliance issues that come with topical

scars commonly seen in patients with
severe acne.                                                                 and systemic treatments. More specifically,
                                                                             we have taken an active role in the periodic
Smoothbeam is a great asset to our practice                                  treatments, and we do not rely on patients       6 mm, 11 J/cm2, 250 ms, DCD: 40, 1tx
because it enables us to treat two patholo-                                  to self-treat or abide by a daily regimen.
gies at once. Patients prefer simultaneous                                   We have been pleased with the results that
treatments, as this is more affordable and                                   we have obtained with Smoothbeam, and
less time-consuming than treating each                                       look forward to continued success within
condition separately.

We have had very positive experiences
                                                                    ac       our practice.

with other methods of combination therapy                                    Conclusion
for acne, acne scarring, and general skin                                    Acne is a prominent issue for women in
rejuvenation. We regularly use the                                           their twenties and thirties, which can be
Smoothbeam in conjunction with chemical                                      exacerbated by stress and hormones as
peels, microdermabrasion, and Vbeam®                                         well as their menstrual cycle. This segment
pulsed dye laser. The technique that we                                      of women makes up the majority of the
have found to work best is to treat acne and                                 patients whom we treat with Smoothbeam
acne scars with Smoothbeam; then two                                         in our cosmetic practice. We have been           6 mm, 13 J/cm2, 250 ms, DCD: 40, 5tx
weeks later treat the same area with one                                     using Smoothbeam to treat active acne,
of the alternate methods mentioned above;                                    as well as acne scars, with great success
and then follow up with a Smoothbeam                                         for a year and a half, and we have been

treatment two weeks afterward, continuing                                    extremely pleased with the results. There
this pattern until the desired result is reached.                            are numerous advantages to using the
The chemical peels and microdermabrasion                                     Smoothbeam diode laser—one of the most
treatments are effective in making the                                       compelling characteristics of this new laser
pigmentation of the skin uniform, and the                                    treatment for acne is the low side-effect
intermittent Vbeam treatments serve as                                       profile. Our patients may experience a
a catalyst for collagen remodeling and                                       slight redness to the skin, which will subside

proactive reduction of erythema.                                             within a few hours—in addition to this, no
                                                                             downtime exists, and patients are able to
Results                                                                      return to normal activities immediately
                                                                             following treatment. Another reason that
The most unique advantage to having                                                                                                  Candela Corporation
                                                                             this treatment option is popular is that
Smoothbeam in our practice is the option                                                                                             530 Boston Post Road
                                                                             just three to five treatments are required,             Wayland, MA 01778 USA
it presents for treating both acne as well as                                                                                        Phone: (508) 358-7637

                                                                             and these treatments may be spread out
acne scars. The ability to simultaneously                                                                                            Fax: (508) 358-5569
                                                                             over time, with an interval of about four               Toll Free: (800) 821-2013
treat patients for multiple conditions is                                                                                  
                                                                             weeks in between each treatment.
directly correlated to our patient satisfaction

Smoothbeam is a trademark and Vbeam is a registered trademark of Candela Corporation. Elemax is a
registered trademark of Fermdale Laboratories. Betacaine is a registered trademark of Canderm Pharma, Inc.
Dynamic Cooling Device and DCD are trademarks. To find out more about Candela and its products, contact
your authorized Candela representative or call toll free worldwide (800) 821-2013. Dial USA country code
if calling internationally. Printed in the USA. 01/04 0920-23-0823 Rev. 02

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Description: Information on acne, acne treatment reviews, and treatment of scars. Includes a regimen to help clear your acne.
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