What is Laser Treatment in Acne?
New Generation Approaches and Clinical Activities


Acne vulgaris is one of the most common reasons for admission to dermatology clinics today. It accounts for more than 30% of all dermatological cases. Many factors such as genetic predisposition, hormonal changes, follicular obstruction, sebum increase and Propionibacterium acnes (P. acnes) colonization play a role in the formation of the disease.

Although traditional treatments include topical and systemic drugs, in recent years laser and light-based treatments have become an effective alternative, especially in drug-resistant cases. These lasers are generally divided into two groups: those targeting the sebaceous glands and those targeting P. acnes.

KTP Laser (532 nm)
The potassium titanyl phosphate (KTP) laser has previously been used in conditions such as rosacea and telangiectasia due to its collagen stimulation and vascular effects. Studies have shown that it is also effective in acne treatment. It provides a photodynamic effect by affecting P. acnes and sebaceous glands with its 532 nm wavelength. In clinical studies, a significant decrease in acne severity was achieved after 4 sessions. No side effects were reported.

Pulsed Dye Laser (PDL) (585–595 nm)
PDL targets oxyhemoglobin by emitting yellow light. It has effects such as reducing inflammation, shrinking vessels and increasing collagen production in acne lesions. Studies have reported a reduction in inflammatory lesions of up to 49%. However, it should be used with caution in dark-skinned individuals due to the risk of hyperpigmentation.

Nd:YAG Laser (1064–1320 nm)
Nd:YAG lasers penetrate deep tissue and affect the pilosebaceous unit. Studies have observed a reduction of up to 58% in inflammatory lesions and a decrease of up to 30% in sebum production. It is considered a painless, safe and effective method.

Diode Laser (1450 nm)
The FDA-approved diode laser works by targeting the skin's water molecules and heating the sebaceous glands. It is used in both acne and wrinkle treatment by also triggering collagen production. Clinical studies have reported a lesion reduction of up to 83%. The most common side effects are temporary erythema, edema, and hyperpigmentation in dark-skinned individuals.

Erbium Glass Laser (1540–1550 nm)
The Er:Glass laser is particularly effective in inflammatory lesions by targeting intracellular water. It can reach a depth of 0.4–2 mm. Studies have reported up to 78% improvement in acne lesions. Although no change was observed in the amount of sebum, histopathologically, a shrinkage in the sebaceous glands was observed.

Radiofrequency (RF) Treatments
Radiofrequency, which has a different mechanism compared to lasers, provides heating in the dermis with electrical energy. It reduces the activity of the sebaceous glands and regulates skin structure. Fractional microneedle RF provides successful results especially in inflammatory lesions. Side effects after treatment may include mild pain, erythema and temporary bleeding.

Conclusion
Laser treatments have become alternative or complementary options to drugs in acne treatment by providing fast and effective results. Each type of laser has different wavelengths and mechanisms of action. Factors such as appropriate patient selection, number of sessions and skin type directly affect the success of the treatment.

It is stated in the literature that lasers are safe and effective in acne treatment. However, more scientific studies supported by large patient groups and long-term follow-up are needed.