Types & Causes of Acne & Scar

Acne, commonly known as pimples, is a prevalent skin condition that primarily affects teenagers and young adults. There are many types of acne caused by different skin conditions.

The formation of acne is usually associated with the following factors:

· Excess Sebum: Overactive sebaceous glands producing too much sebum.
· Abnormal Follicular Keratinization: Excessive growth of skin cells within hair follicles leading to clogged pores.
· Bacterial Infection: Particularly Propionibacterium acnes proliferating in blocked pores, causing inflammation.
· Hormonal Changes: Such as those during puberty, can stimulate sebaceous glands.
· Lifestyle and Diet: Factors like stress, lack of sleep, and certain foods can exacerbate acne.

If acne is not treated or suppressed well in the early stage, the area of expansion will become larger and larger, and after reaching a certain degree, it will also rupture, making it highly susceptible to infection and leaving scars.

Common Treatment Devices & Principles

Acne treatment can utilize various medical aesthetic equipment, each with its unique treatment principles and indications. Here are some common equipment used for acne treatment:

· Intense Pulsed Light (IPL)

Principle: Emits a range of light wavelengths that can reduce skin oil secretion and eradicate acne-causing bacteria.
Application: Suitable for various types of acne, especially inflammatory acne.

· Laser Treatment Devices

Principle: Such as CO2 laser and Nd:YAG laser, can precisely target acne or acne scars, promoting skin regeneration.
Application: Suitable for treating acne scars and severe acne.

· Photodynamic Therapy Devices (PDT)

Principle: Uses specific wavelengths of light to activate photosensitizers in the skin, producing an oxidizing effect that kills acne bacteria and reduces inflammation.

Application: Mainly for moderate to severe acne.

· Radiofrequency (RF) Therapy Device

Principle: Uses radiofrequency energy to heat the deeper layers of the skin, promoting collagen reconstruction, which helps improve acne scars.

Application: Suitable for post-acne skin repair.

· Needle-Free Water Light Injection Device

Principle: Uses high pressure to directly inject active ingredients into the deeper layers of the skin, improving skin condition and aiding in acne treatment.
Application: Suitable for moisturizing and repairing acne-prone skin.

· Microneedling Device

Principle: Creates micro-injuries using microneedles, stimulating the skin's self-healing ability to improve acne scars.
Application: Suitable for acne scar treatment.

Principles & Advantage of Different Equipment

IPL / DPL

IPL (Intense Pulsed Light) describes the use of intense pulses of non-coherent light distributed over a range of wavelengths from 400nm to 1200nm. The technology utilizes specific wavelength ranges to target various chromophores in the skin. This enables effective treatment of a broad spectrum of conditions, including acne, vascular and pigmented lesions, skin photoaging treatments and hair removal.

DPL (Dynamic Pulsed Light) is considered an advancement over IPL. It combines both laser and light technology, leading to a more targeted approach. 
The main difference between IPL and DPL is that IPL utilizes a single light source, while DPL uses multiple pulsed lights at different wavelengths to provides outstanding results for safer, faster and more comfortable treatments. Additionally, IPL is typically used to target surface while DPL can be used to target deeper layers of skin. 

Endogenous porphyrins in Acne absorb the energy of pulsed light to produce photochemical reactions that release singlet oxygen to effectively kill propionibacterium in acne.
1. Propionibacterium Acnes (PAC) produces endogenous porphyrins during its normal metabolism.
2. The energy of specific bands is absorbed by porphyrin through the skin, and porphyrin is stimulated to release singlet oxygen ions.
3. Singlet oxygen ion can effectively kill propionibacterium acnes.

Advantages of IPL / DPL in Acne Treatment

· Multiple Wavelengths: IPL emits a range of wavelengths, allowing it to target various skin issues such as acne, pigmentation, and vascular lesions.
· Broad Application: Suitable for treating various types of acne, especially inflammatory acne.
· Non-Invasive: The treatment process is gentle with minimal damage to the skin.
· Skin Rejuvenation: Helps stimulate collagen production, improving skin texture and tone.

Q-Switched Nd:Yag

Nd:YAG (Neodymium-doped Yttrium Aluminum Garnet) is a crystal used as a laser medium. "Q-switched" refers to the technique of producing a high-intensity laser beam in very short pulses (nanoseconds). This allows the laser to emit powerful bursts of light energy in a controlled manner. The Q-switched Nd:YAG laser operates primarily at two wavelengths: 1064 nm and 532 nm. 

The 1064 nm wavelength is most commonly used for acne treatment. It targets the sebaceous glands and reduces their activity, thereby decreasing the production of sebum, which is a key factor in acne development. The laser energy also targets the P. acnes bacteria, which are responsible for acne inflammation. Additionally, it promotes collagen production, aiding in the healing of acne scars and improving skin texture.

Advantages of Q-switched Nd:YAG Laser in Acne Treatment

· Deep Penetration: Nd:YAG laser can penetrate deeper into the skin, reaching the deeper layers where acne forms, such as the sebaceous glands.
· Reduces Sebum Production: Specifically affects the sebaceous glands, effectively reducing oil production, thereby addressing a fundamental cause of acne.
· Targets Acne Bacteria: Specific wavelengths directly target acne bacteria, reducing inflammation and infection.
· Suitable for Various Skin Tones: More adaptable for different skin tones, particularly reducing the risk of pigmentation in darker skin types.
· Scar Treatment: Effective in treating acne scars, helping to improve skin texture and color.
· Rapid Recovery: Short recovery time post-treatment with minimal side effects.

Additionally, IPL/DPL and Q-switched Nd:Yag treatment stands out for providing the most convenient and comfortable option for patients. It typically requires less time per session compared to other treatments and involves minimal discomfort, making it an ideal choice for those seeking an effective, yet non-disruptive acne treatment.

Precautions During Treatments

· Avoid Sun Exposure: Prior to and post-treatment, to prevent skin sensitivity and pigmentation issues.
· Skin Care Regimen: Use gentle, non-comedogenic products.
· Follow-up: Adhere to the prescribed treatment schedule and follow-up appointments.
· Dietary Control: It is recommended to consume fresh and healthy foods during the treatment period, and to control the intake of oil, salt, sugar, spicy and other stimulating foods.
· Patient Selection: Not all populations are ideal candidates for IPL or Q-switched laser, such as those who have photosensitive signs or taken photosensitive drugs, have undergone some invasive skin treatment projects in the past week, or have used effective skincare products within three months and many other prohibited populations are not eligible for treatment. Therefore, a thorough skin assessment, multiple intensive treatments and professional doctor's consultation during treatment are crucial to reach the optimal results.