Acne remains a pervasive skin condition affecting individuals of all ages. Despite the range of available treatments, only 30% of acne sufferers rely on dermatologists, indicating a significant portion may not be fully satisfied or might not be accessing professional treatment options. Moreover, 38.1% of patients experience treatment failure, suggesting dissatisfaction among a substantial number of individuals who find their current acne treatments ineffective.1 This article explores two advanced laser technologies for acne treatment: the 1064nm and the 1726nm lasers, highlighting their efficacy, mechanisms, and clinical outcomes.
Wavelength and Technology
The 1064nm laser, exemplified by the Aerolase Neo Elite®, uses solid-state Nd:YAG technology. This laser operates with a pulse duration of 650 microseconds, delivering high power in short pulses. This specific wavelength penetrates deeper into the skin, targeting the root causes of acne without damaging the surface. The 1726nm laser, on the other hand, is a semiconductor diode with a pulse duration of up to 50 milliseconds. This wavelength is absorbed uniquely in sebum; however, the laser energy is not as focused, which can lead to different skin reactions and treatment outcomes. The deeper penetration of the 1064nm laser makes it more effective in treating acne at various depths, ensuring comprehensive treatment.
Pulse Energy and Skin Structures
The Aerolase Neo Elite® delivers a maximum energy of 255 J/cm2 per 650-microsecond pulse, the highest energy within this single pulse duration. The high energy level allows the Neo to heat the sebaceous glands effectively, reduce inflammation, and destroy acne bacteria. The short pulse duration enables greater patient comfort and the ability to treat all skin types safely. The 1726nm laser, with 70 J/cm2 on a 3mm spot, offers significant energy to heat or destroy the sebaceous glands.
FDA Clearance and Indications
The 1064nm laser has a range of FDA-cleared indications, reflecting its versatility and broad application for dermatology. These indications range from acne treatment to other skin conditions such as melasma, rosacea, and skin rejuvenation. The trust and authority that come with multiple FDA clearances make the 1064nm laser a reliable choice for dermatologists. In contrast, the 1726nm laser is only cleared for long-term treatment of mild to severe inflammatory acne vulgaris. While effective for its specific indication, it lacks the broad application of the 1064nm laser, limiting its utility in dermatological practices.
Mechanism of Action
The 1064nm laser reduces excess sebum production, reduces inflammation, and eliminates C. acnes bacteria. Its unique energy delivery also addresses the physical sequelae of acne, reducing or clearing post-inflammatory erythema, hyperpigmentation, and atrophic scars. Clinical data supports the Neo having the highest clearance rate compared to other acne lasers3,4, with an 84% reduction in acne at the end of treatment, 87% reduction at 90 days post-treatment, and 90-95% patient satisfaction during and after treatment.2 In contrast, the 1726nm laser works primarily by destroying sebaceous glands, which can be effective but may not address other acne-related factors.
Skin Reaction, Pain, and Equipment Maintenance
One of the significant advantages of the 1064nm laser is its minimal skin reaction. Patients typically experience no edema and only occasional transient erythema, making the treatment more comfortable and reducing downtime. Pain levels are reported to be minimal, crucial for patient satisfaction and compliance. The 1064nm laser does not require skin cooling, simplifying the treatment process and reducing the risk of complications. It is also a lightweight device at 25 lbs, and does not require repair-intensive fiberoptic and water cooling subsystems, further enhancing its practicality in a clinical setting.
In contrast, the 1726nm laser can cause prolonged edema and erythema, with higher pain levels, potentially leading to a less favorable patient experience. It often requires contact cooling and is significantly heavier at 175 lbs or greater lbs, posing operational challenges in a busy dermatology practice.
Conclusion
The 1064nm laser, such as the Aerolase Neo Elite®, offers numerous advantages over the 1726nm laser for acne treatment. Its higher energy concentration, minimal skin reaction, and comprehensive mechanism of action make it an excellent choice for dermatologists seeking effective and patient-friendly treatment options. With a broader range of FDA-cleared indications and lower maintenance requirements, the 1064nm laser stands out as a versatile and efficient tool in the fight against acne. As clinical data continues to support its efficacy and patient satisfaction, the 1064nm laser remains a top choice for modern dermatological practices.
1. LiVDerm. (n.d.). Acne awareness month: Common factors that exacerbate acne symptoms and minimize treatment efficacy. Retrieved from https://www.livderm.org/acne-awareness-month-common-factors-exacerbate-acne-symptoms-minimize-treatment-efficacy/
2. (2024), Abstracts. “Treatment of Mild to Severe Acne Vulgaris with a 650-Microsecond 1064-nm Nd:YAG Laser.” Surg Med, 56: S5-S185. https://doi.org/10.1002/lsm.23782.
3. U.S. Food and Drug Administration, Center for Drug Evaluation and Research. Cutera 510(K) K213461 letter, March 24, 2022, from https://www.accessdata.fda.gov/
cdrh_docs/pdf21/K213461.pdf
4. Data on file, Accure Acne, Inc. https://accureacne.com/the-accure-acne-laser-system/
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