Acne is the most common skin condition both in the US and worldwide. In the US, up to 50 million people are affected each year and globally nearly 90% of all people will have been affected at some point in their lives1,2. For many it is a condition that significantly impacts their daily lives and in its more severe forms can be both physically and psychologically painful. Though topical and oral pharmaceutical treatments can significantly improve the condition, some patients may not experience adequate clearance or may not be amenable to traditional therapies for a variety of reasons. Retinoid based oral systemic therapy may not be the drug of choice for patients who are on anti-depressant medications. Topical retinoids can be drying and patient compliance as a result can be variable. Hormonal therapy can be difficult to tolerate for some patients. In other cases medication resistance, specifically antibiotic resistance, can develop. In all of these scenarios, energy based treatments can be useful as adjuncts to oral or topical therapies allowing treatment of patients who may not be able to tolerate the traditional treatment approach of retinoid and antibiotics or to shorten the treatment course for those patients on medications.

Cutibacterium acnes is the species of bacteria that affects the skin within the former classification of Propionibacterium acnes. It is found on healthy skin but found mainly in the sebaceous follicle. Acne lesions are formed when the sebaceous follicle becomes distended and then plugged with sebum and debris due to defective keratinisation of the lining of the duct. These inflammatory lesions, papules and pustules can be large and tender and when persistent over time can lead to scarring. 

Pulsed-dye laser (PDL) treatments at the 595 nm wavelength (Vbeam, Vbeam Prima) are indicated for the treatment of acne vulgaris and the mechanism of action is multi-fold. Erythematous papules and pustules have both a vascular component and an inflammatory component. The Vbeam PDL system has long been shown to treat the inflammatory component associated with these lesions via upregulation of TGF-beta, a potent immunosuppressive cytokine3. Redness caused by augmented microvasculature is reduced by coagulation of fine vessels. Additionally, reduction of bacteria by the 595 nm wavelength successfully targets porphyrins inducing thermal damage to the bacteria4. 

Our acne patient population can include both male and female patients over a range of ages from adolescence through to the peri-menopausal period. The Vbeam PDL is our first–line energy based treatment of choice in the treatment of inflammatory acne for its mechanisms of actions and safety profile used in both the Vbeam and Vbeam Prima platforms. The Dynamic Cooling Device™ (DCD) optimally protects the epidermis through its highly efficient cooling mechanism. The 595 nm wavelength does not have any depilatory effects and can also be used in males without concern for reduction of facial hair. Reduction in lesion size and inflammation are noted rapidly with significant reduction within the first 24 hours after therapy.