The Food and Drug Administration has approved several lasers for treating acne scars. While these lasers come from various manufacturers, the lasers generally receive FDA approval because the functions and safety levels of one laser are almost identical to previously approved lasers.
For instance, enhanced lasers like the CoolTouch CO2 (carbon dioxide) laser and recently approved Fraxel IV laser earned FDA approval because the devices have the same or similar wavelength and operating principles as previously approved devices.
Since a substantial portion of laser devices attain FDA approval based on the effectiveness of previously approved devices, how is the consumer to discern which laser is best for removing acne scarring?
Before we address that issue, another item makes reviewing medial studies of laser treatments for acne scars even more puzzling.
Thomas Rohrer, a dermatologic surgeon in private practice in Chestnut Hill, Massachusetts, elucidated this point in a Skin and Allergy News editorial. Dr. Rohrer used an example of how evaluators of patient improvement levels after laser treatments could not independently or unbiasedly concur on the level of improvement in the patient's skin.
For example, in four separate studies, the same physician performed laser treatments on different groups of patients using the same type of laser. Yet, when study evaluators examined before and after images of the study participants, their opinions on the cosmetic improvements in the patient's skin varied enormously.
The laser treatment conundrum Dr. Rohrer's exposes is, "How could such varying results come from using the same device with the same technique, especially considering that the four studies were all performed by the same investigator?"
Dr. Rohrer proposes this inconsistency arises from the three categories of laser study evaluators. The the laser "enthusiasts" give the procedure the best scores. The "ambivalent" evaluators give scores in the middle range. And finally, the laser doubters give the lowest scores.
Regardless of the grave variables tainting laser studies, the number of treatments needed and the overall acne scarring improvement level do allow a means to rank cosmetic lasers. Here's how four competing lasers to treat acne scars compare.
#4 1,064-nm Nd:YAG Pulsed Light System
Treatments: 8 Improvement rating: 29.36%
Marketed names include PhotoSilk Laser
Last year, a study in Dermatologic Surgery tested the efficacy of the 1,064-nm Nd:YAG laser at removing acne scars. Nine patients received eight treatments for moderate to severe acne scarring. Three independent physicians rated the overall improvement level of acne scarring severity for the group at 29.36%.
# 3 1,320-nm Nd:YAG
Treatments: 5 Improvement rating: 40-60%
Marketed names include CoolTouch Laser
An investigation from the same journal featured eight patients with facial acne scars. The group received eight treatments with the 1,320-nm Nd:YAG laser. After five treatments, independent observes assessed the overall acne scarring improvement rate between 40-60 %.
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