LASER TREATMENT OF ACNE

Acne (Latin: Acne vulgaris) is a skin disease that begins at puberty, when hormonal changes result in excessive stimulation of the sebaceous glands. It is usually limited to the skin of the face, upper back and chest. Characteristic changes include blackheads, papules, pustules, pus cysts and scars, i.e. "blackheads" and "pimples". Acne usually affects adolescents. Genetic, hormonal and bacterial factors are responsible for the development of acne.

Acne vulgaris

Acne vulgaris occurs in over 80% of people aged 12 to 25 and is increasingly common in people aged 30 to 40. During puberty, changes occur in the sebaceous glands, which cause increased sebum secretion and its thickening (and, as a result, acne). The cells at the hair follicle opening become excessively multiplied, which leads to narrowing of the hair follicle. The exfoliated cells cannot get out, they stick to the sebum and clog the ducts. As the gland fills with sebum, a comedone is formed - a lump with a dark spot at the top. The closed gland does not receive oxygen and creates perfect conditions for the development of anaerobic bacteria, which multiply and cause inflammation, the result of which is acne. A blackhead may turn into a lump and then into a pustule with pus.

Rosacea

Rosacea occurs in women and men, most often after the age of 30. Changes appear on the face and neckline. If left untreated, it leads to the persistence of erythema, permanent dilation of blood vessels, and at a later stage to the formation of papules and pustules.

Laser treatment of rosacea

For effective treatment of acne, in our beauty salons we use Nd: YAG laser, neodymium-jag laser from Fotona Spectro SP with a wavelength 1064nm light. It is the deepest penetrating laser beam available on global markets, thanks to which it can destroy large diameter vessels deeply hidden under the skin. At the same time, thanks to homogeneous penetration, it has a very wide range of applications and minimizes the risk of tissue damage. Thanks to the highest power and advanced safety systems, the Fotona Spectro SP laser is the fastest and safest laser on the market. We can also use a laser with shallower penetration - i.e. a shorter wavelength - in this therapy. This device called IPL (Intense Pulsed Light) from Top Laser emits a light pulse of various wavelengths 530 - 1200nm through a crystal block transmitting the pulse to the skin. Using the phenomenon of similar absorption of waves by both hemoglobin and melanin contained in the epidermis, this laser is used to remove both superficial damage to blood vessels (erythema) and discolorations. A precisely selected beam of light penetrates deep into the skin and, acting on the sebaceous glands, limits the production of sebum and destroys the bacteria that cause acne. Tissues containing individual chromophores are damaged as a result of selective photothermolysis, i.e. without damaging adjacent tissues. Laser light also has disinfecting and pore shrinking properties. At the same time, IPL also increases the production of collagen, which increases skin elasticity and eliminates fine wrinkles.

Effects of the treatment:

Causes of acne

• Seborrhea - excess production of sebum (sebum)

In patients with acne, hormonal changes lead to excessive stimulation of the sebaceous glands, which causes overproduction of sebum and leads to hypertrophy of the sebaceous glands. This phenomenon is very common during adolescence, but it can last for quite a long time and occur in people aged 30-40.

• Excessive keratinization (hyperkeratosis)

In patients with acne, the cells at the mouth of the hair follicle undergo excessive multiplication (one of the reasons is the presence of sebum in the upper layers of the skin, at the mouth of the sebaceous gland, and the presence of bacteria). This phenomenon is called hyperkeratosis and leads to narrowing of the exiting canal and the formation of a plug that blocks the opening of the hair follicle, thus preventing sebum from escaping. Such retention of sebum contributes to the formation of acne lesions: initially microcomedones (white heads visible), and then open comedones (black heads - blackheads).

• Bacteria multiplication (P. acnes)

In patients with acne, there is an excessive multiplication of bacteria (Propionibacterium acnes - which plays the main role in the formation of acne) that normally occur on the surface of healthy skin. This bacterium secretes various types of irritating substances into the surrounding tissues, destroys the walls of the sebaceous glands, as a result, the contents of the comedones come out and trigger a foreign body reaction and intensify the inflammatory process. Red, painful skin lesions appear.

How does acne occur?

The whole problem concerns the mouth of the sebaceous gland, which connects with the mouth of the hair follicle - follicular hair. This is where the increased and disturbed keratinization of the epithelial cells of the follicle opening and the increased production of sebum occur. Instead of flowing freely onto the skin, sebum is trapped below the plug, which leads to the enlargement of the follicle due to the accumulation of sebum, horn masses and bacteria. This is how a closed comedone (fine, white resulting from the proliferation of keratinocytes) or an open comedone (dark colored at the top, resulting from the oxidation of keratin and sebum) is formed and the so-called non-inflammatory period of acne begins. Blackhead - no red lump, no pus, nothing hurts yet. In such an environment, the activity of the saparophytic bacteria Propionibacterium acnes on the skin increases.

The number of Acnes bacteria, which we normally find on the skin even in healthy people, increases in the seborrheic environment and their activity intensifies. These bacteria begin to produce factors (bacterial lipases) that release a whole cascade of chemical and immunological reactions, causing more or less inflammation. At this point, a feature of genetic susceptibility to the inflammatory reaction caused by p. acnes bacteria is revealed. In some people this reaction will be very violent and long-lasting, in others it will be less intense and short.

Initially, the inflammation is limited to the follicle, but later the follicle ruptures and the inflammation spreads to the surrounding tissues. This is the papular or papulopustular period. Inflammations originating from one or several follicles may combine with each other and persist chronically, festering and causing the worst form of nodular-cystic acne.

Types of acne:

There are several clinical forms of acne:

• Comedoneal acne – it is dominated by non-inflammatory lesions – closed and open comedones. This type of acne is located mainly on the face.
• Papular acne – the most common form of the disease. It is characterized by pustules and papules, but also blackheads. This form of acne occurs on the face, neckline, arms and back.
• Pyogenic acne – a form with particularly severe inflammation. This case is characterized by deep, painful, acutely inflammatory tumors, pustules and purulent cysts (nodular cystic acne). These lesions often leave scars (keloid acne). This type of acne can be distinguished in several forms:
  • concentrated acne - a type with deep infiltrates and purulent cysts that heal leaving uneven, drawn scars, occurring mainly in men,
  • acne inversa, which may affect unusual areas - armpits, groin, buttocks.
• Severe fulminant acne with symptoms of disintegration and hemorrhagic eruptions, often accompanied by general symptoms - fever, joint pain. This variety is the result of the body's hyperreactivity to bacterial antigens.

Backgrounds of acne:

Hormonal background

Since acne does not occur in humans before the appearance of sex hormones in the body, we are sure that the cause of acne is hormonal.

It's not about the amount of hormones, but about how the hormones, which are quantitatively normal, act on the sebaceous gland. Therefore, when we talk about the hormonal basis of acne, we do not mean quantitative hormonal disorders, but the genetically determined amount of 5-alpha reductase and local hypersensitivity of follicles to the action of androgenic hormones DHT. The more 5-alpha reductase there is and the more active it is (and this is a genetic feature), the more DHT there is - hence the stronger effect on keratinization, sebum secretion and the formation of skin lesions.

However, hormonal tests in the treatment of acne are not standard.

In dermatological diagnostics, they are performed exceptionally if there are additional symptoms indicating hormonal problems, such as: menstrual disorders, excessive pubic or facial hair, hair loss or lack of progress in treatment.

Sebum secretion is inhibited by estrogens and estrogen-like compounds. This is why contraceptive treatment with a high dose of estrogen has a beneficial effect on the skin. Even local administration of estrogens reduces sebum secretion. Unfortunately, depending on the sensitivity of estrogen receptors in hair follicles, the administration of estrogens does not always have a positive effect on the course of acne - it depends on our individual genetic conditions.

Seborrheic background

Seborrhea plays an important role among the causes of acne. The reason is not only the amount of sebum, but also its composition. Sometimes acne affects a part of a person's skin that is naturally dry or very dry. As a result of abnormal keratinization of the epidermis, seborrhea may occur, trapped inside the clogged sebaceous glands, which again starts the entire cascade of changes.

Bacterial background

The population size of P. acnes is proportional to the amount of sebum produced.

Teenagers with acne show greater sebum production, which in turn means greater acnes colonization. These bacteria produce factors involved in the development of inflammation. The innate ability of the human body's immune response to these factors determines whether inflammation will occur and what its extent will be. Hereditary hypersensitivity of the immune system to acnes is responsible for the initiation and development of acne lesions, and not specifically the number of acnes. These bacteria also have a protective function - fatty acids produced by p. acnes inhibit the development of infection caused by group A streptococci.

Background of clogged pores

Cloged pores are blocked openings of the pilosebaceous gland. Excessive overgrowth of the epidermis at the opening of the follicle to the skin surface, usually associated with improper exfoliation of dead cells, is the primary point in the development of acne lesions, i.e. the so-called microcomedones. These changes are not visible to the naked eye, but they are crucial for further transformations. Therefore, treatment cannot be limited only to visible lesions, but should cover the entire skin where there is a tendency to change. The clogging of the sebaceous gland opening by horny masses limits the access of oxygen to the center of this microorgan, which creates an ideal environment for the development of acnes bacteria. The bacteria grow and cause a further inflammatory reaction.

Drug background

Some medications can trigger acne, but it is not common acne. For example, poisoning the body with halogenated compounds, in addition to severe organ damage, may lead to severe acne lesions. Corticosteroids, both administered orally and topically, may cause acne-like lesions. Similarly, consuming anabolic substances that cause the development of muscle mass may cause a sudden appearance of acne lesions.

Cosmetic background

Cosmetics, especially colored ones, may intensify keratinization in the sebaceous glands, so you should choose cosmetics or dermocosmetics that do not have comedogenic, i.e. comedogenic, effects.

What can worsen acne symptoms?

There are factors that may worsen acne symptoms. Belong to them:

• too much sweating,
• being in a too humid climate,
• menstruation in girls, especially the period of several days before bleeding occurs,
• pregnancy,
• contraceptive pills,
• medicines, e.g. corticosteroids, antiepileptic drugs (so-called drug-induced acne)

Drug treatment:

Acne treatment is a long-term process because the drugs used do not stop the disease process, but only alleviate the effects (except isotretinoin). The main goal of acne therapy is to reduce the number of deep, painful skin lesions, prevent the formation of unsightly scars and limit the duration of the disease, which is related to minimizing the stress and low self-esteem that accompany this disease. In most cases, in mild forms of acne, treatment with topical preparations is sufficient - retinoids, benzole peroxide, antibiotics, azelaic acid. However, more severe forms of acne are treated with generally used preparations such as:

• Antibiotics

  We use antibiotics in cases of severe acne or intolerance to topical medications. They should not be used for more than six months, but using the drug for too short a period is also not recommended - the minimum is sixteen weeks./doxycycline, limecycline, tetracycline/

• Hormonal drugs

  This treatment method applies only to women who have hormonal changes documented by appropriate tests. Contraceptive pills are also used in hormonal treatment. They do not cure acne, but when used they reduce its symptoms. The results of using hormonal drugs appear after 2-3 months, unfortunately not everyone is susceptible to this method of treatment.

• Oral isotretinoin

  It has been used in the treatment of acne since 1979, so we know its effects on the body perfectly. Isotretinoin acts on all etiopathogenetic factors: it significantly reduces the size of the sebaceous glands and the production of sebum, normalizes the keratinization of follicles, prevents the development of comedones and microcomedones, and, by exerting direct anti-inflammatory activity, inhibits the growth of bacteria.

• Currently, oral isotretinoin is the most effective treatment for acne, with a reported remission rate of over 80% of patients.

How to care for your skin?

• Make-up removal (miceral fluid should be used)
• Washing the skin with a cleansing gel adapted to the degree of lubrication and dryness of the skin, its sensitivity and vascularity
• 1x a week use of exfoliating peels (fine-grained or enzymatic)
• Use of moisturizing preparations to prevent excessive drying of the skin by medicinal preparations
• Do not use cosmetics containing alcohol (e.g. aftershave)
• Do not squeeze out blackheads yourself. Improper removal may cause skin damage and scarring, so cleansing procedures should be performed after medical consultation in beauty salons
• It is not necessary to avoid the sun, but the improvement of the skin after sun exposure is short-lived. Later, acne symptoms worsen. Some cosmetics and medications for acne-prone skin do not tolerate the sun at all.
• When using a towel, dry the infected areas, do not rub them with a towel and always use a separate towel for the infected skin

There are no contraindications to applying makeup and using corrective sticks. In addition, modern dermocosmetic foundations, powders and sticks have a sebum-reducing effect and give the skin a matte appearance. They have astringent, healing and soothing properties, and often inhibit the development of additional bacterial flora.

Very important are treatments in a beauty salon that empty the contents of the horn plug, thus limiting inflammation, reducing sebum secretion, limiting the development of p. acnes, eliminating discoloration, scars and other complications. The most frequently used and recommended treatments for acne are chemical or medical peels combined with mechanical removal of comedones. These treatments involve the use of various chemicals to prevent the formation of a horn plug. They have sebostatic, antiseptic and brightening properties, cause exfoliation and then regeneration of the epidermis, thus limiting complications. The only condition is to prepare the skin in advance with local or oral medications.

Recommendations for patients with acne problems:

Acne is a condition that is not the most pleasant. Usually, people are ashamed of their appearance and try many techniques to get rid of or, ultimately, cover up the problem. Unfortunately, most of us try to fight the effects rather than prevent them. All we need is a little good will to avoid the specter of acne:

• Eat a balanced diet with vitamins, microelements, vegetables and fruit every day
• Avoid spicy, fatty and sweet foods
• Avoid fried foods (oxidized fats)
• Limit salt intake
• Incorrect proportions of fat in the diet - it should be about 30%
• Drink about 2-3 liters of water a day

Laser therapy in the treatment of acne:

Laser treatments allow you to quickly and safely correct skin imperfections. This is a non-invasive method, individual lengths of light rays affect specific skin problems, acting only on the selected lesion. This allows you to achieve spectacular effects with a minimally short recovery period. Taking into account laser removal of wrinkles or improvement of skin firmness, the advantage of the laser is its method of operation based on the stimulation of the skin's natural reconstruction, as opposed to surgical lifting procedures, which is appreciated by an increasing number of patients. Laser scar removal is also based on our skin's natural tendency to regenerate. The phenomenal possibilities when it comes to laser acne removal are based on the bactericidal and sebostatic effect of the laser head, which, by heating the skin, simultaneously treats acne and firms it. More importantly, it does not involve drug treatment that is often long and unhealthy for the body. To sum up, laser therapy, contrary to appearances, is closer to natural regeneration methods, without the unpleasant side effects that surgical or pharmacological intervention often exposes us to. To sum up, laser therapy in the treatment of acne has anti-inflammatory and antibacterial properties, shrinks acne lumps and prevents the recurrence of new lesions. After just one treatment, significant improvement is visible.

After the treatment, the skin is slightly red and there may be slight swelling lasting up to 48 hours.

The treatment does not cause any aesthetic indisposition.

Possible repetition of the procedure individually after medical consultation.

Contraindications to laser therapy:

• Pregnancy
• Diabetes
• Pacemaker
• Bloathing disorders
• Epilepsy
• Tan (too much accumulated melanin absorbs a large dose of energy, which may cause skin discoloration). You should not sunbathe (sun, solarium) for 4 weeks before and 4 weeks after the procedure
• Tendency to discoloration
• Active viral or bacterial lesions on the skin
• Use of certain medications:
  
  
  • Medicines that reduce blood clotting; anticoagulants, e.g. aspirin
  • Steroids
  • Photosensitizing drugs: some antibiotics, e.g. tetracycline, doxycycline, vitamin A derivatives, some cardiological drugs and others, e.g. furagine
  • Use of some herbs: marigold, St. John's wort
  • Using creams with retinol

Recommendations for the patient before laser acne treatment:

• Do not sunbathe (sun, solarium) for 4 weeks before the procedure
• Do not use exfoliating treatments (peeling) for a week before the treatment
• If you use drugs: anticoagulants, steroids, photosensitizing drugs, they should be discontinued (if possible) 7 days before the procedure, and then they can be used again 14 days after the procedure
• Do not drink alcohol on the day of the procedure
• The treatment is performed on clean skin (cosmetics should be washed off before the treatment)

Recommendations for the patient after laser acne treatment:

• It is not recommended to use a hot bath or sauna 14 days after the treatment
• It is not recommended to sunbathe (sun, solarium) for 4 weeks after the treatment
• For facial treatments, use creams with a filter of at least SPF 30 for 4 weeks after the treatment
• Cosmetics can be used only 24 hours after the treatment, alcohol-based preparations should be avoided and skin moisturizing preparations should be used
• You should come for a follow-up visit after the procedure

Why do we treat acne with Nd:YAG and Er:YAG FOTONA SPECTRO SP lasers?

Fotona neodymium-jag Nd:YAG and Er:YAG lasers - are modern devices enabling a number of procedures in the field of surgery, dermatology and aesthetic medicine. The spectrum of applications is very wide, ranging from laser epilation, through acne treatment, photorejuvenation, to the treatment of skin cancer, removal of varicose veins and laser lipolysis procedures. The Spectro SP laser achieves maximum effects with a minimum depth of laser beam penetration. This laser is the ideal tool for fast, cold ablation.

The average power in quasi-continuous pulse mode is 30 WAT. The competition doesn't even come close to this result. Thanks to this, treatments are performed much faster and more effective. In the hands of a doctor, this laser is an almost perfect tool.

Effective treatment of acne for all skin types:

Nd:YAG Laser Photons with long pulses is characterized by homogeneous penetration and low absorption by tissue chromophores. These two advantages allow the Nd:YAG laser to reach deeper structures without damaging the epidermis, regardless of skin type.

Innovation of the Nd:YAG and Er:YAG lasers Fotona Spectro SP:

This laser is equipped with a number of innovative solutions such as EFC (impulse feedback control) - a system that provides a previously unavailable degree of control over the energy of the laser beam pulse. Thanks to each calibration of the device, the laser always provides a beam with precisely defined parameters, which increases the safety and effectiveness of the treatment. Another innovation in Fotona Spectro SP lasers is the VSP system (variable square pulse - a patented solution) that allows the generation of a pulse with given parameters with a negligible rise and fall time of the pulse energy. This increases the efficiency of the laser beam and simultaneously improves the effectiveness and speed of treatment compared to other devices.

The Fotona Spectro SP laser, thanks to the highest power and advanced safety system, is the fastest and safest laser on the market.

The security of the Fotona Spectro SP system is:

• EFC (impulse feedback control)

  Thanks to this system, we avoid a decrease in laser power during the treatment, which could lead to weaker or incomplete results. We also do not have to worry about energy surges that may cause tissue damage.

• VSP (variable square pulse)

  Unlike other systems, where there is a sudden jump in energy and then a slow decrease, in the Fotona Spectro SP system the pulse energy distribution is even. This protects us against overheating and tissue burns. At the same time, the effectiveness and safety of treatments are radically improved.

The effectiveness of the Fotona Spectro SP system is:

The neodymium-Jag laser with a wavelength of 1064 nm is the deepest penetrating laser beam available on the market, thanks to which it can destroy large-diameter vessels hidden deep under the skin. At the same time, thanks to homogeneous penetration, it has a very wide range of applications and minimizes the risk of tissue damage. High power in quasi-continuous pulse mode is 30 Watts. The competition doesn't even come close to Siudo's result. Thanks to this, treatments performed with the Fotona Spectro SP system are much faster and more effective. With this laser system, all patient needs can be met, achieving excellent clinical results and unprecedented gentleness.

Laser therapy can also be invaluable in the care of seborrheic skin and in the prevention of acne.