10.5826/dpc.1201a24
text/xml
2160-9381
1709
en
Marco Manfredini
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
active acne
Ablative Fractional Erbium:YAG Laser Resurfacing: A Treatment Option for Acne
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Research Letter
2022-02-02
2021-03-10
2022-02-02
2022-02-09
e2022024
Dermatol Pract Concept
Marco Manfredini
2022/02/02
10.5826/dpc.1201a24
e2022024
Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Science with Interest Transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
2160-9381
active acne
en
e2022024
Singh MZ, Singh SI, Basra PS. Erbium:YAG laser resurfacing in patients with inflamed cystic acne. J Cosmet Laser Ther. 2006;8(4):163-166. DOI: 10.1080/14764170601034711. PMID: 19839167.
Ablative Fractional Erbium:YAG Laser Resurfacing: A Treatment Option for Acne
https://dpcj.org/index.php/dpc/article/download/1709/1475
                    Dermatology Practical & Conceptual


  Ablative Fractional Erbium:YAG Laser Resurfacing:
             A Treatment Option for Acne
    Stefania Guida1, Nicola Lippolis1, Matteo Giovani1, Gioia Pedroni1, Giacomo Giovanni
             Urtis2, Giovanni Pellacani1,3, Francesca Farnetani1, Marco Manfredini1


1 Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Science with Interest Transplant, Oncological and
  Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
2 Cliniche Diventa, Milano-Roma-Como, Italy
3 Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome,
  Rome, Italy



Key words: acne, laser, erbium:YAG, active acne
Citation: Guida S, Lippolis N, Giovani M, et al. Ablative fractional erbium:yag laser resurfacing: a treatment option for acne.
Dermatol Pract Concept. 2022;12(1):e2022024. DOI: https://doi.org/10.5826/dpc.1201a24
Accepted: May 26, 2021; Published: January 2022
Copyright: ©2022 Guida et al. This is an open-access article distributed under the terms of the Creative Commons
Attribution-NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted
noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding author: Dr Nicola Lippolis, Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Science with
Interest Transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy.
E-mail: lippolisnicola@yahoo.it




Introduction                                                             patients gave informed consent to mild laser rejuvenation
                                                                         therapy with ablative fractionated erbium:YAG laser, (Xlase
Acne vulgaris is a disease of the pilosebaceous unit, charac-            plus; Biotec Italia srl, Dueville, VI).
terized by a hyper keratinization process, comedo formation,                  These patients were treated using the standard protocol
and inflammatory reactions [1]. The use of lasers for the                for mild resurfacing and rejuvenation. Employed parameters
treatment of acne has been described, but the role of resur-             were 1.5 ms, 3.5 mJ/cm2, 5 Hz on the cheeks and the chin,
facing lasers for active acne has not been clarified yet.                and the rest of the face was treated with 1.0 ms, 2.8 mJ/cm2,
                                                                         6 Hz. One laser session per month for 3 months was per-
                                                                         formed for each patient. Overlapping pulses were performed
Case Presentation
                                                                         over inflammatory lesions. After the laser sessions, the pa-
We present the cases of 3 women with noninflammatory                     tients were instructed to apply sunscreen SPF 50+ and a
and inflammatory acne lesions. They received laser therapy               hydrating cream for 30 days. All 3 patients tolerated the
because they refused prolonged topical treatments or other               treatment without any reported side effects. They showed a
systemic acne therapies. No treatment was given to the pa-               visible improvement of the skin texture and a reduction of
tients in the previous 6 months prior to laser treatment. The            active acne.




Research Letter | Dermatol Pract Concept. 2022;12(1):e2022024                                                                        1
    The average value for the Investigator Global Assessment               The short follow-up period of our patients represents
scale (IGA) was indicative of a mild-moderate acne at base-            a limitation of this case report. Further studies are needed
line (IGA 1-2) and decreased consistently to the almost-clear          to investigate the anti-acne effect of erbium: YAG laser and
stage (IGA 0-1) at the last follow-up visit 3 months after the         its mechanism of action with respect to comedogenesis and
last laser session (Figures 1 and 2).                                  inflammation.
    One paper describes the application of multiple sessions
of erbium:YAG laser treatment for active acne on 2 patients
                                                                       Conclusions
with inflamed cystic acne [2]. Singh et al hypothesized that
the mechanism of action of this laser source might be related          Acne is one of the most common skin diseases. Many ther-
to the photothermal effect acting on follicular hyperkeratosis         apeutic approaches are currently available for active acne,
and contributing to skin microbe modulation.                           including laser treatments. However, the role of resurfacing




    Figure 1. Clinical pictures of a 34-year-old woman. (A) Before the last erbium:YAG laser session. (B) 3 months after the last
    ­erbium:YAG laser session, showing the reduction of active acne lesions.




         Figure 2. Clinical pictures of a 25-year-old woman. (A) Before the last erbium:YAG laser session. (B) 3 months after the
         last erbium:YAG laser session, highlighting a consistent reduction of both inflammatory and noninflammatory acne skin
         lesions.



2                                                                          Research Letter | Dermatol Pract Concept. 2022;12(1):e2022024
with erbium:YAG laser has not been clarified yet. Results         References
from clinical practice, such as in the cases presented herein,
highlight the importance of further investigations in             1. Manfredini M, Greco M, Farnetani F, et al. In vivo monitoring
                                                                     of topical therapy for acne with reflectance confocal microscopy.
this field.
                                                                     Skin Res Technol. 2017;23:36–40. DOI: 10.1111/srt.12298.
Informed consent: Written informed consent for publication           PMID: 27273850.
                                                                  2. Singh MZ, Singh SI, Basra PS. Erbium:YAG laser resurfacing
of their clinical details and clinical images was obtained from
                                                                     in patients with inflamed cystic acne. J Cosmet Laser Ther.
all patients.
                                                                     2006;8(4):163-166. DOI: 10.1080/14764170601034711. PMID:
                                                                     19839167.




Research Letter | Dermatol Pract Concept. 2022;12(1):e2022024                                                                       3
