Treatment of Inflammatory Facial Acne with 1,450-nm Diode Laser in Type IV to V Asian Skin Using an Optimal Combination of Laser Parameters

BACKGROUND: The 1,450-nm diode laser is effective for the treatment of inflammatory acne, but there is a significant risk of postinflammatory hyperpigmentation (PIH) in Asian skin. OBJECTIVE: To determine whether lower fluence and shorter cooling duration of the 1,450-nm diode laser improve acne effectively with minimal PIH in darker skin. MATERIALS AND METHODS: Twenty-six subjects (skin phototypes IV-V) with inflammatory facial acne received four treatments using the 1,450-nm diode laser with 6-mm spot size 3 to 4 weeks apart. We used three passes with a fluence of 8 J/cm(2) with dynamic cooling of 25 ms to minimize PIH. Serial blinded assessment of acne lesion counts and sebum measurement were evaluated before and up to 6 months after treatment. RESULTS: Four weeks and 6 months after the last treatment, reduction of mean acne lesions was 29% (p<.01) and 40% (p<.03), respectively, from baseline in the group with moderate acne. Significant improvements of sebum production were noted. Four episodes of temporary PIH (3.8%) were observed out of all treatment sessions. CONCLUSION: Use of multiple passes of a 1,450-nm diode laser with lower fluence and shorter dynamic cooling device retains its therapeutic efficacy with substantial reduction of PIH for moderate acne.