Comparison of Stacked Pulses versus Double-Pass Treatments of Facial Acne with a 1,450-nm Laser

Comparison of Stacked Pulses versus Double-Pass Treatments of Facial Acne with a 1,450-nm Laser
Published article online:
09 Mar 2007
Issue online:
19 Apr 2007
To cite this article: NATHAN S. UEBELHOER DO, MELISSA A. BOGLE MD, JEFFREY S. DOVER MD, KENNETH A. ARNDT MD, THOMAS E. ROHRER MD (2007)
Comparison of Stacked Pulses versus Double-Pass Treatments of Facial Acne with a 1,450-nm Laser
Dermatologic Surgery 33 (5), 552Ò559.
doi:10.1111/j.1524-4725.2007.33113.x
Blackwell Synergy

NATHAN S. UEBELHOER, DO*‹*SkinCare Physicians of Chestnut Hill, Chestnut Hill, Massachusetts; ‹Naval Medical Center San Diego, San Diego, California; , MELISSA A. BOGLE, MD*·*SkinCare Physicians of Chestnut Hill, Chestnut Hill, Massachusetts; ·Laser and Cosmetic Surgery Center of Houston and the Department of Dermatology, University of Texas, Houston, Houston, Texas; , JEFFREY S. DOVER, MD*?*SkinCare Physicians of Chestnut Hill, Chestnut Hill, Massachusetts; ?Section of Dermatologic Surgery and Cutaneous Oncology, Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut; Department of Medicine (Dermatology), Dartmouth Medical School, Hanover, New Hampshire; , KENNETH A. ARNDT, MD*??*SkinCare Physicians of Chestnut Hill, Chestnut Hill, Massachusetts; ?Section of Dermatologic Surgery and Cutaneous Oncology, Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut; Department of Medicine (Dermatology), Dartmouth Medical School, Hanover, New Hampshire; ?Harvard Medical School, Boston, Massachusetts; , AND THOMAS E. ROHRER, MD****SkinCare Physicians of Chestnut Hill, Chestnut Hill, Massachusetts; **Boston University Dermatology, Boston, Massachusetts

Address correspondence and reprint requests to: Nathan Uebelhoer, DO, Dermatology Department, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego CA, 92134, or e-mail: nsuebelhoer@nmcsd.med.navy.mil.

The laser used in this study was loaned by Candela Corp. Funding for the study was also provided by Candela.

Abstract
BACKGROUND Although effective as a monotherapy for the treatment of inflammatory acne, the 1,450-nm diode laser is associated with considerable pain at higher fluences.

MATERIALS AND METHODS Eleven subjects were treated with a 1,450-nm diode laser in a split-face bilateral paired acne study. One-half of the face received a single-pass consisting of stacked double pulses. The other side received a double-pass treatment of single pulses. Settings were 11 J/cm2 or lower as tolerated with appropriate dynamic cooling device (range 25Ò35).

RESULTS The mean pain rating was 5.33 on a 0 to 10 scale on the stackedÒpulse treatment side and 5.12 on the double-pass side. Blinded reduction in mean acne lesion counts were 57.6% and 49.8% reduction, respectively. An overall acne scar improvement was seen in 83% of subjects with acne scarring. Transient hyperpigmentation occurred in two patients on the stacked pulse side and completely resolved without sequelae.

CONCLUSIONS The pulsed 1,450-nm diode laser can be used at lower fluences that elicit less discomfort yet effectively improve inflammatory acne. Stacking pulses appears to render a slightly higher efficacy than the multipass technique. Single-pulse, multiple-pass treatments may have a lower risk of cryogen-induced transient hyperpigmentation compared to standard high fluence techniques.

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