Background: The 1450-nm diode laser has been known to thermally alter sebaceous glands and has been found to be effective for the treatment of inflammatory facial acne. Objective: Our aim was to evaluate the dose response of a 1450-nm diode laser for treatment of facial acne, sebum production, and acne scarring utilizing two laser fluences and to determine long-term remission after laser treatment. Methods: Twenty patients (Fitzpatrick skin phototypes II-VI) received 3 treatments using the 1450 nm diode laser (3-4 week intervals). Split face comparisons were performed by randomizing patients to one of two fluences (14 or 16 J/cm 2) on the right or left side of the face. Clinical photographs, lesion counts, and sebum measurements were obtained at baseline and after each treatment. Investigators' and patients' subjective evaluations of response to treatment were assessed. Results: Percentage reductions in mean acne lesion counts from baseline were 42.9% (14 J/cm 2) and 33.9% (16 J/cm 2) after one treatment and 75.1% (14 J/cm 2) and 70.6% (16 J/cm 2) after 3 treatments. There was persistent reduction of 76.1% (14 J/cm 2) and 70.5% (16 J/cm 2) at the 12-month follow-up (P < .01). Both objective and subjective improvements in acne scarring and sebum production were noted. Treatment-related pain was well tolerated, and adverse effects were limited to transient erythema and edema at treatment sites. Limitations: This was a small study and comparison was limited to two laser fluences. Conclusion: The 1450-nm diode laser reduced inflammatory facial acne lesions even in Fitzpatrick skin phototypes IV-VI with minimal side effects. Significant improvement in acne lesion counts were noted after the first treatment and was maintained 12 months after the third treatment, indicating significant long-term clinical remission after laser treatment.
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