Acne Awareness: Discover Sciton’s Advanced Acne & Acne Scar Solutions

June 11, 2024—Acne is one of the most prevalent skin conditions, affecting up to 50 million Americans each year. While patients often worry about the immediate, visible signs of acne, scarring is one of the most challenging and enduring effects. Fortunately, research has identified various treatment options, including ablative lasers, non-ablative fractional lasers, and vascular lasers, as some of the most effective solutions for acne scarring.1
Read on to discover expert tips, tricks, and clinical pearls for achieving clear, healthy skin with Sciton’s award-winning technology for acne and acne scars.
ClearSilk® (1064 nm Nd:YAG) for acne and acne scars

“…We began doing the ClearSilk laser, and it has been a game-changer. Best of all, ClearSilk and BBL [BroadBand Light] in the same session. A series seems to give the best result we’ve gotten in the last decade working with cystic acne.” 2 Dr. Rebecca Gelber, MD

Dubbed the ‘lunchtime facial’ for its quick and comfortable application, ClearSilk is a non-ablative laser treatment ideal for first-time laser patients, younger patients with acne or acne scars, or those who want to maintain a youthful appearance without the recovery time of an ablative resurfacing treatment.

ClearSilk’s gentle yet powerful technology softens fine lines and wrinkles and reduces the appearance of uneven texture, pigmented lesions, acne, rosacea, blushing and flushing, redness, and acne scars, resulting in a smoother, more vibrant complexion. The treatment provides the appearance of tighter and plumper skin with buildable results over time.

ClearSilk’s 1064 nm wavelength is particularly effective for treating acne and acne scars in skin of color and sun-exposed skin due to its lower absorption of melanin. The treatment is safe and efficacious for all skin types year-round.

ClearSilk is the most popular treatment in my office, says Dr. Rebecca Gelber, MD, owner of Tahoe Aesthetic Medicine in Incline Village, NV. Recalling a patient with cystic acne, Dr. Gelber says, “ … after she had been on antibiotics, had been drained … in one week I did two ClearSilk treatments, and all of a sudden, she saw a huge improvement in acne.” 2

Hear more about Dr. Gelber’s experience using ClearSilk in this webinar.

 

 

Research backs 1064 nm Nd:YAG lasers for acne and acne scars

Numerous research studies validate the effectiveness of the 1064 nm Nd:YAG laser for treating acne and acne scars.

A National Library of Medicine study found that 1064 nm Nd:YAG lasers are safe and effective for improving facial acne scarring with minimal discomfort and no downtime.3

Another study suggests that 1064-nm Nd:YAG laser can be effectively and safely used to treat inflammatory lesions, particularly acne vulgaris, in Asian patients.4

Additionally, 1064 nm Nd:YAG laser treatments have been shown to improve atrophic scarring in darker skin types, with a reduced risk of pigment complications and patient discomfort.5

ClearSilk 1064 is proven to be an effective treatment for acne and acne scars.

 

BroadBand Light® (BBL®) for acne

“As a board-certified dermatologist who has treated acne for 40 years, I have never found a treatment that has worked faster or is more effective at clearing acne breakouts, red marks, and scars left from breakouts than BroadBand Light. Dr. Patrick Bitter, Jr., MD, FAAD

The Forever Clear mode of BBL HEROic addresses active acne breakouts in patients as young as teens—without the side effects of pharmaceuticals and with no downtime for the patient.

With the recent launch of BBL HEROic, the next evolution in Sciton’s best-selling BroadBand Light product line, providers can achieve superior clinical outcomes, including improved skin clarity. Discover HEROic‘s groundbreaking innovations in this blog post.

Forever Clear BBL® utilizes blue light to specifically target acne-causing bacteria and yellow light to reduce active inflammatory acne. The treatment helps prevent new breakouts and minimizes the appearance of scars, typically in four to six sessions, followed by maintenance visits.

“Acne can be one of the most difficult skin conditions to treat … For active acne, Forever Clear BBL is an extremely successful therapy to get the acne under control. Specific blue wavelengths of light are used to target and kill acne bacteria. Alternate wavelengths are used to target and treat redness associated with acne. Be aware that you need to be consistent and diligent with treatment; usually 3-4 or more treatments monthly,” says Kristin Jackson, MD, a practitioner in Maitland, Florida.” 6

In Sciton’s webinar, Treat Your Patients’ Acne With the Speed of Light, Dr. Patrick Bitter, Jr., MD, FAAD, a board-certified dermatologist and founder of Advanced Aesthetic Dermatology in Los Gatos, CA, discusses his three-step protocol for treating acne with Forever Clear BBL®.

Results with Dr. Bitter’s Forever Clear three-step protocol include a clearing of inflammatory acne, particularly cysts, improvement in erythematous and violaceous depressed and elevated scars, and reduced or no acne for up to 4-6 months.7

In a Journal of Drugs in Dermatology publication, Dr. Bitter’s three-step protocol was found safe and effective for patients with moderate to severe inflammatory acne. Dr. Bitter reports that approximately 80% of patients achieve at least a 75% improvement in their inflammatory acne, and many patients clear their acne completely. Improvements in acne begin to appear 2 to 3 days after a treatment session, and red, purple, raised, or depressed acne scars less than 1 to 2 years old begin to fade 1 to 3 weeks post-treatment.8

To learn more about Dr. Bitter’s detailed three-step protocol, watch the webinar here.

 

HALO® acne scar treatment

“HALO has really changed the game for certain types of acne scarring. While deeper scars may still require more aggressive or ablative treatment, many rolling types of scars are responding quite well to the HALO treatment. What makes HALO amazing is that it’s performed with a topical numbing agent (not injected numbing medicine), and there is no bleeding involved. Other than some redness and swelling, there isn’t much to it. The results I am seeing are quite impressive.” 9 Dr. Sherrif F. Ibrahim, MD, PhD

HALO is a hybrid fractional laser that combines a non-ablative 1470 nm and ablative 2940 nm wavelength to the same microscopic treatment zone to simultaneously target the appearance of fine lines, wrinkles, hyperpigmentation, acne scars, enlarged pores, skin dullness, pigmented lesions, and more.

Dr. Ibrahim, a board-certified dermatologist and owner of Rochester Dermatologic Surgery in Rochester, NY, says treating acne scars can be challenging but also highly rewarding when using the right technology, such as the HALO laser.

According to Dr. Ibrahim, HALO’s 1470/2940 nm wavelength is ideal for addressing both pigment and textural issues, including acne scars. This wavelength targets a depth range of 200-700 microns, where collagen and elastin are found, with 400 microns being the optimal zone. Dr. Ibrahim compares this with the 1927 nm wavelength used by Sciton’s MOXI™ laser, which effectively treats pigment in the epidermis at depths of 100-150 microns but is not sufficient for acne scars.10

Conversely, the 1550 nm wavelength, which penetrates up to 1300 microns, can be too deep, leading to unnecessary pain and prolonged downtime. Dr. Ibrahim emphasizes that the 1470 nm wavelength strikes the perfect balance for the most effective treatment of acne scars.10

 

 

HALO’s tunable acne scar settings

Scars like ice pick or boxcar scars are deep dermal processes. Effective treatment requires targeting the HALO laser deep into the dermis, where acne scars are located.

While pigment issues are found in the epidermis at depths of up to 100-200 microns, most textural damage occurs in the papillary dermis, which can reach up to 500 microns deep, says Dr. Ibrahim. He utilizes the HALO laser to its full potential, targeting the optimal depth of 200-700 microns, where most dermal pathologies, including acne scars, occur.10

Dr. Ibrahim’s HALO settings for acne scars include a small amount of ablation in the 20-30 micron range and maximum non-ablative settings at depths of 600-700 microns with 35-40% density. He advises staying above the jawline with these settings. The lower eyelid and upper lip can be more sensitive and may be skipped if focusing on acne treatment, says Dr. Ibrahim.10

Even when used at maximum settings, HALO’s recovery times are consistent, says Dr. Ibrahim.10 The healing diaries below demonstrate the uniform healing experience following HALO treatments. Whether delivering a 10% or 30% density treatment, the recovery process remains consistent, allowing providers to set realistic and reliable patient expectations.

Tune into our webinar, HALO: An Effective Option for the Treatment of Acne Scars, for an in-depth look into Dr. Ibrahim’s acne scars treatment protocol.

 

 

Resurfacing Perfected (Er:YAG) for acne and acne scars

“The Sciton platform (MicroLaserPeel and ProFractional) is most probably the best treatment for acne scars … I usually go quite deep in the dermis with my ProFractional (around 600 to 800 microns). As far as results are concerned, everyone has different skin, but usually, you should expect about 70% improvement.” Henri P. Gaboriau, MD, FACS 11

No other non-surgical technology can turn back time as effectively as a Resurfacing Perfected treatment. Sciton’s Resurfacing Perfected (Er:YAG 2940 nm) tunable technology provides everything from a light polish to a transformative result, allowing for independent adjustment of ablation and coagulation depth.

Resurfacing Perfected treatments address superficial to deep wrinkles on all skin types, including hard-to-treat lines around the lips and eyes, acne scars, post-traumatic and surgical scars, pigmented lesions, and poor skin tone and texture. Treatments can be tailored to each patient’s desired outcome and tolerance for downtime. The recovery time for a Resurfacing Perfected treatment varies depending on the treatment intensity and the skin conditions being addressed.

Clients who opt for the lightest treatment may have as little as a few hours of downtime, while those who choose deep resurfacing may need 10 days or more of recovery.

 

NanoLaserPeel® addresses the appearance of pores, dull skin, and fine lines for a brighter, more even complexion anywhere on the body, including the face, neck, chest, and hands. Treatments typically take between 8-15 minutes and can be repeated every 2-3 weeks to refresh the skin.

MicroLaserPeel™ minimizes imperfections on the skin’s surface, including the appearance of rough texture, large pores, acne, and dark spots, leading to healthier, more youthful-looking skin. The treatment is suitable for all skin types and can be customized to meet each patient’s needs.

 

ProFractional™, Sciton’s fractionated erbium laser, is one of the most effective treatment options for all types of atrophic scars. The treatment’s tunable technology offers superficial to deep polishing for all skin types. ProFractional treats a portion of the skin at a time, resulting in a shorter recovery time and a dramatic reduction in the appearance of texture, fine lines, deep wrinkles, scars, and pigmented lesions, such as sunspots, freckles, and actinic keratosis. The untreated areas aid in rapid re-epithelization of the skin, reducing the chances of prolonged and serious adverse effects.

One study found that 97% of participants reported an improvement in acne scars with the Er:YAG laser, with minimal adverse effects and reduced healing time. The study concluded that the Er:YAG laser is a safe and effective modality for treating acne scars.12

Other research indicates that CO2 fractional laser treatments tend to result in higher pain intensity and may carry a higher risk of post-treatment pigmentation compared to Er:YAG fractional laser procedures.13

 

Expert weigh-in: Acne scar treatment tips

Step 1: Patient assessment and consultation

It’s important to thoroughly understand your patient’s needs and expectations before beginning treatment. During the consultation, conduct a detailed assessment of the patient’s skin, focusing on the severity and type of acne, as well as the extent and characteristics of acne scarring. Discuss their specific concerns and desired outcomes to create a tailored treatment plan.

Ask patients specific questions: Erin Blackwell, LE, CLT, owner of EnlightenU and licensed esthetician and laser practitioner at Aya Medical Spa in Atlanta, GA, asks her patients the following questions before beginning treatment:10

  • Acne history: Can you pinpoint when your acne started?
  • Diet: What is your diet like? (Dairy and sugar can significantly impact acne.)
  • Breakout duration: How long have you had this breakout?
  • Previous treatments: What treatments have you tried, and did any provide results?
  • Current skincare: What skincare products are you currently using?
  • Medications: What medications are you on now, and what have you taken before for acne?
  • Stress factors: Have you had any major life events causing stress?
  • Breakout patterns: Are the breakouts monthly or constant?

Answer these key questions: Understanding these factors ensures a personalized and effective treatment plan tailored to each patient’s needs and expectations.

  • What goals does the patient have?
  • What goals are realistic?
  • How much downtime can the patient afford?
  • How much money does the patient want to spend?
  • How much can this patient tolerate?
  • What risks do you foresee with this patient?

Step 2: Identify the type of acne scars and appropriate treatment

Here are the types of acne scars and the Sciton modalities that can help treat them:

  • Rolling scars: This type of acne scar is characterized by sloping edges and uneven appearance.
  • Boxcar scars: Boxcar scars are the most common type of acne scar. They have sharp vertical edges and a wider appearance than ice pick scars. HALO can effectively treat boxcar scars, often in combination with ProFractional for severe cases. Adding filler six weeks after HALO and ProFractional can enhance the smoothness of the skin, writes Erin Blackwell in this research paper.14
  • Ice pick scars: Ice pick scars are the most challenging to treat due to their deep, narrow depressions. HALO can significantly improve their appearance by heating tissue where collagen resides, which helps plump and reduce the punctured look of the scars.14
  • Superficial vascular scars: Resembling shallow boxcar scars with erythema, vascular scars are often the easiest to treat with the HALO laser. HALO helps remove, heal, and prevent deeper scars, effectively addressing any vascular scars on the skin’s surface.14

Step 3: Develop a treatment plan 

Every provider has a unique approach to treating acne and acne scars. Erin shares her treatment plan for acne and acne scars here:10

  • Prior to treatment: A chemical peel for active acne
  • 3 weeks post peel: HALO or a BBL/HALO ScitonStaX™ combination treatment
  • 3 weeks post HALO: BBL treatment to address redness or erythema
  • Maintenance: BBL 1x/quarter and HALO 1x/year
  • Skincare to maintain results includes: Starting tretinoin from day 5 onwards, using a simple cleanser, a hydrator, and SPF

To hear more treatment pearls from Erin and Dr. Ibrahim, catch a replay of the webinar.

Bonus tip: Bundle stacked treatments during the consultation

As a Sciton owner who offers the best, let your patients know you’re combining several award-winning Sciton treatments for the most efficacious and thorough results.

For example, BBL may be used post-HALO for removing residual erythema, clearing acne lesions, removing hyperpigmentation, and reducing inflammation. For significant ice pick and boxcar scars, a focused ProFractional pass may be conducted prior to HALO. This combination is particularly effective for active acne, post-inflammatory hyperpigmentation (PIH), and hypopigmentation due to acne scarring and sun damage.14

To avoid overwhelming or intimidating prospective patients, some providers prefer to market their ScitonStaX combination treatments or serial treatments (ex, more than 1 HALO) as one “Sciton treatment” delivered over two sessions. Dr. Ibrahim offers patients a HALO treatment delivered over 2 sessions and spaced 4-6 weeks apart for optimal results.10

Successfully manage patients’ acne and acne scars

Sciton’s award-winning energy-based devices offer powerful, minimal-downtime solutions for managing acne and acne scars. Reach out to a Sciton expert today to learn more about our comprehensive skin revitalization platforms.

 

References:

1Salameh F, Shumaker PR, Goodman GJ, Spring LK, Seago M, Alam M, Al-Niaimi F, Cassuto D, Chan HH, Dierickx C, Donelan M, Gauglitz GG, Haedersdal M, Krakowski AC, Manuskiatti W, Norbury WB, Ogawa R, Ozog DM, Paasch U, Victor Ross E, Clementoni MT, Waibel J, Bayat A, Goo BL, Artzi O. Energy-based devices for the treatment of Acne Scars: 2022 International consensus recommendations. Lasers Surg Med. 2022 Jan;54(1):10-26. doi: 10.1002/lsm.23484. Epub 2021 Oct 31. PMID: 34719045.

2ClearSilk: The Most Versatile Tool in Your Toolbox – Part 1 and ClearSilk: The Most Versatile Tool in Your Toolbox – Part 2

3Lipper GM, Perez M. Nonablative acne scar reduction after a series of treatments with a short-pulsed 1,064-nm neodymium:YAG laser. Dermatol Surg. 2006 Aug;32(8):998-1006. doi: 10.1111/j.1524-4725.2006.32222.x. PMID: 16918561.

4Lee H, Kim YJ, Lee SJ, Lee CH, Choi EH, Lee SH, Kim YK.  Acne Vulgaris Successfully Treated with Long-Pulsed 1,064-nm Neodymium:Yttrium-Aluminum-Garnet Laser. Medical Lasers 2018;7:91-93.

5Badawi, A., Tome, M. A., Atteya, A., Sami, N., & Morsy, A. L. (2011). Retrospective analysis of non-ablative scar treatment in dark skin types using the sub-millisecond Nd:YAG 1,064 nm Laser. Lasers in Surgery and Medicine, 43(2), 130-136.

6Realself.com: Can Forever Clear BBL help with cystic hormonal acne?

7Sciton Webinar: Treat your patients’ acne with the speed of light!

8Acne Treatment With 3-Step Broadband Light Protocol. November 2016 | Volume 15 | Issue 11 | Original Article | 1382 | Copyright © November 2016

9Realself.com: Can the Halo laser be used for acne scars?

10Sciton Webinar: HALO: An Effective Option for the Treatment of Acne Scars

11Realself.com: Is ProFractional laser the best treatment for these acne scars?

12Efficacy and safety of CO2 fractional laser versus Er:YAG fractional laser in the treatment of atrophic acne scar: A meta-analysis and systematic review

13Chathra N, Mysore V. Resurfacing of Facial Acne Scars With a New Variable-Pulsed Er:YAG Laser in Fitzpatrick Skin Types IV and V. J Cutan Aesthet Surg. 2018 Jan-Mar;11(1):20-25. doi: 10.4103/JCAS.JCAS_4_18. PMID: 29731588; PMCID: PMC5921445.

14HALO®: An Effective Treatment for Acne Scars, Tips to Achieve Radiant Results by Erin Blackwell, Licensed Esthetician & Licensed Laser Practitioner