What is a Pulsed Dye Laser?
Pulsed dye lasers get their name from the fact that they use a specialized liquid dye suspension, instead of a crystal, as the lasing media. Pulsed dye lasers are designed to deliver short bursts of light that last only a fraction of a second. Many pulsed dye lasers can be adjusted (tuned) to work at several different wavelengths, although ~495 nm (yellow) is the most common. The most popular application for pulsed dye lasers is to remove birthmarks and other hyper-pigmented marks on the skin. Low power pulsed dye lasers are used to improve the appearance of wrinkles by stimulating regrowth of the tissue immediately underneath the skin. This application is also used to improve the appearance of acne scars. Pulsed dye lasers are also capable of targeting acne bacteria by activating porphyrins (as with blue light therapy) and have been used as part of a photodynamic therapy treatment plan. While pulsed dye laser systems are rarely used for treating active acne infections, there is some research indicating they may be effective at improving acne symptoms. That being said, the bulk of the scientific research indicates that there are more effective laser systems available for both the treatment of active acne infections and acne scarring.
How Does Pulsed Dye Laser Treatment Work?
Generally speaking, pulsed dye lasers are used for two different types of treatment, ablative and non-ablative. Ablative treatments (ablative means to be removed or vaporized at very high temperature) utilize longer laser pulses and/or high light intensity to thermally damage or destroy the target tissue. Because certain molecules, like oxyhemoglobin, preferentially absorb energy from pulsed dye lasers, they are used to target structures like spider veins that contain blood (and therefore also contain hemoglobin). Ablative laser treatment destroys the target tissue, which is then replaced by new, healthier tissue. Researchers are experimenting with using ablative laser treatment to target and destroy the sebaceous glands, whose hyperactivity contributes to acne. However, longer wavelength laser sources, like diode and CO2 lasers are generally preferred over pulsed dye lasers for this application. The more common application of pulsed dye lasers is for non-ablative treatments. These treatments are intended to stimulate tissue growth or to target specific molecules like porphyrins. Although most commonly used to improve skin tone and correct small wrinkles, pulsed dye lasers are also used to improve the appearance of acne scars.
Are Pulsed Dye Lasers an Effective Treatment for Acne and/or Acne Scars?
There are a few research studies whose results indicate that PDLs may be effective for treating active acne infections. There are also a few that suggest this type of treatment is not effective. The primary source of this disparity is likely due to the fact that the treatments being researched are fairly different, even though they use the same laser. Pulsed dye lasers can be used as part of photodynamic therapy to target the P. acnes bacteria. This works better with adjustable PDLs that are capable of producing a laser with a wavelength near 415 nm, instead of the more common 595 nm. Regardless, there are more accessible and less expensive light sources for photodynamic therapy. Another approach being studied is to use the PDLs to selectively damage the sebaceous gland, thereby inhibiting sebum production. While the research indicates that approach could work, there are alternative lasers with longer wavelengths that are better suited for this application. The most common application of PDLs is for the treatment of acne scars. Both ablative and non-ablative methods are used for treating acne scars. Improvements in acne scars are generally modest and superficial. Generally speaking, this laser platform is not well suited to correct severe acne scarring. On average, Pulsed Dye Laser treatment of acne and acne scars is reviewed as poor to moderate by patients after treatment. It is likely that PDLs are popular because they are a relatively inexpensive, versatile and common platform and not because they are highly efficacious for acne treatment.
How and Where is Pulsed Dye Laser Treatment Administered?
Pulsed dye laser treatment is usually administered at a dermatology or cosmetic surgery clinic. They can also be found at some spas specializing in light and laser therapy. As with almost all laser based treatments, there is the potential to cause permanent damage and PDL treatment should only be administered by a trained and certified professional.
How Much Does Pulsed Dye Laser Treatment Cost?
Pulsed Dye Laser treatments generally cost between $200 and $600 per session. In almost all cases, multiple sessions are required. In the research studying the efficacy of PDLs for acne treatment, they often found the best results required at least four treatments. In addition, the treatments for active acne infections usually only provide temporary relief, and acne symptoms eventually return. In summary, a complete pulsed dye laser treatment plan usually starts around a thousand dollars, and goes up from there. PDL treatments are comparable in cost to many other laser treatments, but their mediocre efficacy make them a relatively poor value.
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Before and After Pulsed Dye Laser Treatment Pictures of Acne Patients
A collection of before and after pictures from PDL patients can be found here.
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References and Sources
Laser Treatment of Acne Vulgaris.
Jih, et al. 2007. For article abstract, click here.
Investigation of the Mechanism of Action of Nonablative Pulsed Dye Laser Therapy in Photorejuvenation and Inflammatory Acne Vulgaris.
Seaton, et al. 2006. For article abstract, click here.
Treatment of Acne Vulgaris With a Pulsed Dye Laser: A Randomized Controlled Trial.
Orringer, et al. 2004. For article abstract, click here.
Improvement of Facial Acne Scars by the 585 nm Flashlamp-Pumped Pulsed Dye Laser.
Alster, et al. 1996. For article abstract, click here.
Comparison of a 585-nm pulsed dye laser and a 1064-nm Nd:YAG laser for the treatment of acne scars: A randomized split-face clinical study.
Lee, et al. 2008. For article abstract, click here.