You’ve seen the signs billing lasers at the new millennium cure for acne. But can a laser displace traditional acne treatments like oral contraceptives, antibiotics and even isotretinoin?
Laser fanatics tout these medical devices as obliterators of “acne causing bacteria” and excess oil.
But at recent gathering of the American Academy of Dermatology Edward Seaton, MD, of the Hammersmith Hospital in London, proposed that nonablative laser acne treatments do not kill Propionibacterium acnes (bacteria largely blamed for causing acne) or decrease sebum production.
Rather, the lasers cause a rapid and dramatic increase in transforming growth factor beta.
Dr. Seaton explains that transforming growth factor beta, “is very important anti-inflammatory cytokine that plays a pivotal role in decreasing inflammation…” Inflammation always accompanies an acne lesion.
To better understand the exact effect of nonablative lasers on acne, Dr. Seaton used nonablative laser therapy on the foreheads of 19 subjects with mild to moderate acne who had received no previous acne treatments.
He took before and after measurements of P. acnes colony count, sebum production, and several cytokines and receptors including transforming growth factor beta.
Each participant received one session of nonablative laser therapy. Dr. Seaton measured cytokine levels via punch biopsies from the buttocks before the laser treatments and at hour three and 24 hours after the treatment.
After 24 hours, Dr. Seaton noted no decrease in the number of P. acnes colonies on the treated area, moreover there was a non-statistically significant increase in the number of colonies. There was no significant decrease in the oil excretion rate at 2, 4, 8, or 24 weeks post treatment.
Yet, after 24 hours, there was a fivefold increase in transforming growth factor beta, but no significant changes in any other cytokine or receptor levels.
The transforming growth factor beta levels had increased slightly, but not significantly three hours after the nonablative acne treatment.
According to Dr. Seaton this, “is the first time a biologic explanation of lasers” as an acne treatment has been clinically explained.
Back in the United States, Dr. Mitchel P. Goldman remains so convinced of the potency of lasers and the futility of conventional acne treatments that he doesn’t accept insurance, just cash for a laser zap.
Dr. Goldman uses a customized set of preparations for his laser acne treatment that includes pretreatment with salicylic acid, microdermabrasion, an acetone scrub, an hour with agent 5-aminolevulinic acid (ALA) followed by exposure to a brief 10-15 minutes with the blue-light laser.
In ritzy La Jolla, California, Dr. Goldman’s clients hand over $500-$600 for just one laser acne treatment session. While Dr. Goldman revealed his ties to maker of the BLU-U light laser device, he admits, “Have I done controlled studies? No,” but his justification for lasers as the definitive acne treatment is, “It definitely lasts a long time.”
Dr. Goldman reported at least a 30% improvement in inflammatory acne after each laser acne treatment- typically spaced about 4 weeks apart. Strikingly, Dr. Goldman remarked that he has never done more than three treatments on a patient and he has never seen a patient’s acne return, even years after a final treatment.
While Dr. Goldman and Dr. Seaton’s in-house laser acne treatments prove remarkable, the price of laser surgery remains out of reach for many acne sufferers.
Considering a price tag of roughly $1500 in a three-month span, most acne relief seekers will reach for a $5 tube of benzoyl peroxide before opting for the potentially effectively but monetarily inaccessible laser acne treatments.