Clear skin... forever? What you need to know about the latest in laser tech

Pizza face, crater face, volcano face. Kids can be cruel. Then again, so can adults. Acne is one of the most common skin conditions in the United States, but it is also the skin condition that can cause the most physical and emotional pain for sufferers. The American Academy of Dermatology Association estimates that acne affects up to 50 million Americans and that at least 85 percent of people between the ages of 12 and 24 experience some form of it.

What if "just wait until you grow out of it" isn't enough? What if, like many Americans, you never grow out of it and continue to suffer from adult acne? When cleansers, antibiotics and topical and oral medication are not enough or don't give you long-lasting results, you have little choice but to accept the pimples or continue fighting the good fight and never get off the endless wheel of breakout, treatment, healing, breakout. Clear skin forever can sound like a pipedream.

What if the latest laser technology holds the key to a clearer, more radiant and acne-free complexion? Banishing acne with lasers is not just a flash in the pan. It may be the next wave of pimple popping.

What is acne?

Throw out everything you think you know about acne and get back to basics. Acne is an inflammatory skin condition that occurs when hair follicles under the skin become clogged. In healthy skin, sebaceous glands that connect to the hair follicle produce oil that helps keep the skin from drying out. Sebum, or oil, flows to the skin's surface through the pores and moisturizes the skin.

Unfortunately, sebum, dead skin cells, dirt and other materials can get stuck or clump together, clogging the pore. This mixture can foster the growth of bacteria that live on the skin, causing inflammation and pimples or blemishes. Bacteria growth, dead skin buildup and excess oil production contribute to the development of acne.

Put aside the common misconceptions that diet, greasy foods, stress and scrubbing your skin too hard cause pimples. These things can potentially make acne worse, but at its core, acne is an inflammatory response caused by clogged pores. Hormones, certain medications and family history can increase a person's risk of developing acne.

There are several categories of acne, including:

• Whiteheads
• Blackheads
• Papules
• Pustules
• Nodules
• Cystic acne

The type and cause of acne breakouts can help a doctor determine the best treatment options. Mild cases of acne can benefit from over-the-counter products containing salicylic acid, which helps exfoliate the skin and prevent clogged pores. More severe cases of acne may require prescription medications and antibiotics or topical creams.

For decades, Accutane, an aggressive retinoid medication, has been the gold standard for treating severe acne. It significantly reduces the production of sebum, helping to prevent clogged pores. It also shrinks oil glands. However, taking this oral medication has its own set of risks. It can cause extreme birth defects if taken when pregnant. It is also highly drying, often leading to cracked and peeling skin, and tends to make acne worse in a purge before the skin clears.

New laser technology is changing the way doctors fight acne

New developments in laser technology may be the breakthrough acne sufferers have been waiting for to treat and prevent their breakouts. Yet, you may need to adjust how you view laser treatments and their effects on the skin.

Troy Pittman, MD, FACS, utilizes the AviClear laser treatment for acne in his practice. This system was the first FDA-approved laser to treat acne by homing in on specialized cells that produce sebum.

"When we're targeting acne, the key to a really good effective acne treatment is to target where acne starts," said Dr. Pittman. "And so, where acne starts is in the sebaceous gland."

How does this laser target acne? Dr. Pittman explained that every laser is designed to reach a certain level of skin based on its chromophore. Chromophores are molecules that absorb light at a specific wavelength.

"The chromophore for AviClear is the actual sebocyte," said Dr. Pittman. "So, what it does is literally targets and kills the cell that is producing sebum, which is the root of acne."

Have you ever been to a fair or arcade? Then you know tackling acne can be like playing a never-ending carnival game.

"With patients who get AviClear, you know, our skin is constantly regenerating, and it is like whack-a-mole," said Dr. Pittman. "So, you want to kill the sebocytes, but they keep kind of coming back. So, we do three AviClear treatments. In the studies, three treatments seem to resolve or permanently reduce acne in all age groups and all skin types."

You read that right, but it's okay to read it again. Studies suggest this laser treatment can reduce the number and severity of acne breakouts in patients of all ages and with all skin and acne types. In addition to reducing acne and improving skin texture, it delivers long-lasting results by killing sebocytes.

The downside is that practitioners cannot use numbing cream during treatment. During treatment, expect some discomfort, mostly a prickling feeling on the skin. Most adults tolerate the treatment well, but it may be uncomfortable for younger patients, like teenagers. As for recovery, after each treatment session, you'll have some side effects.

"You look like you have a sunburn for 48 hours," said Dr. Pittman.

Since AviClear hit the market, other companies have been looking to enter the clear skin game. Forever Clear BBL is a new FDA-approved laser technology from Sciton.

"The use of light technology has been around for decades and is the basis for IPL (intense pulsed light) lasers," said Sara Dickie, MD. "BroadBand Light, or BBL, is a little newer and has a greater ability to isolate different light wavelengths to specifically target various skin problems like brown spots, sun damage, redness and unwanted hair."

Forever Clear BBL starts treating acne by targeting inflammatory compounds called porphyrins, produced by acne-causing bacteria like Propionibacterium acnes, or P. acnes, with short wavelengths of blue light.

"The blue light wavelength excites the porphyrin molecules and effectively kills the bacteria," said Dr. Dickie. "This is using light as an anti-bacterial treatment like topical benzoyl peroxide or oral doxycycline."

Other wavelengths are also used for this treatment.

"The proprietary branding of Forever Clear BBL utilizes two other wavelengths as well," said Dr. Dickie. "The yellow light spectrum is used to reduce inflammation caused by P. acnes, which results in redness and pustules that are familiar to acne sufferers. Finally, the infrared light spectrum is used to promote skin healing."

The laser treatment takes a three-pronged approach to tackling acne breakouts and clearing the skin. Be aware people with deep cystic acne may not respond as well to the treatment because it doesn't penetrate as deep into the skin.

Dr. Dickie recommended that patients need the treatment done every two weeks for a total course of six to eight treatments to see maximum results.

"Typically, patients will have zero downtime and can continue their other acne treatments when they are having the laser light series done," said Dr. Dickie. "I think the Forever Clear BBL is a wonderful adjunct to help reduce the redness and inflammation of the acne cycle."

Just don't forget that acne is multimodal. A combination of treatments is often necessary to get on top of it. She also notes that if a patient is on an intense anti-acne regime, like Accutane, it is best to consult a dermatologist before progressing with other treatments.

"If they are on Accutane, I will typically consult with their prescribing dermatologist before initiating treatment," said Dr. Dickie. "Often, they will recommend waiting until the Accutane treatment is completed."

Acne doesn't have to leave you feeling embarrassed or self-conscious. Emerging laser technology may be one of the most exciting innovations in skincare, whether you are 16 or 60. If you think one of these new laser treatments might be right for you, talk to a board-certified plastic surgeon who is an ASPS member about your options. These treatments may be available at a local med spa, but always look for a med spa whose medical director is a board-certified plastic surgeon local to your area.

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.