Background: Isotretinoin is widely used in the treatment of moderate to severe acne all over the world. But most Doctors often delay of about 6 months, performing Fractional CO2 Laser while patient is on-going Isotretinoin treatment due to previous recommendations so as to prevent irritation and scarring. But delaying causes more psychosocial impact for most patients as they continue to suffer scars while prolonging patient’s agony.<br/><br/>Objective: The aim of this lecture is to show the effects and possible benefits of low dose Isotretinoin use in combination with Fractional CO2 Laser.<br/><br/>Method: We have reviewed the charts and responses of 32 patients (ages 18 to 45).<br/>Patients were treated with Low-dose Isotretinoin in combination with Fractional CO2 Laser with this regimen: <br/> 10 mgs/day for 1 to 2 months, then decreased dosage to every other day for another 1 to 2 months, then 1x to 2x a week for 1 month then discontinued.<br/>Patients were monitored for side effects, patient satisfaction, and their tolerance of both treatments. <br/>Patient healing and acne clearance was measured via Goodman Grading and noted in their charts and pictures. Fractional CO2 Laser settings were about 400 to 500 ms or 27 to 30 mJ. <br/>Previous studies on combination CO2 Laser and Isotretinoin were also reviewed. <br/><br/>Results: 50% of the patients did not experience any side effects.<br/>11 patients (33%) had mild dryness of the mouth, relieved by application of lip balm.<br/>3 patients (10%) had some dry skin including nails, relieved by application of lotion.<br/>2 patients (7%) had a mild increase of hair loss, relieved by decreasing the dose to 10 mgs every other day instead of 10 mgs daily. <br/>4 patients who had dry mouth had some purging in the first 2 weeks of treatment, relieved with application of clindamycin gel on the acne for 1 week and continued use of Isotretinoin to 10 mgs OD. <br/>90% of the patients said their skin has greatly improved, with remarkable acne clearance and very good scar resurfacing, especially after 3rd and 4th sessions of CO2 Laser.<br/>Under the Goodman Grading scale, all had excellent (>50%) improvement. And 97% of patients were very satisfied with the results of the CO2 Laser in combination with Isotretinoin.<br/>And for those who experienced some side effects, they were minimal and quite tolerable, and highly recommend this combination. Healing of the skin took 3 to 5 days, which was the same for those patients using the CO2 Laser alone. No PIH noted, no scarring or keloid noted.<br/><br/>Conclusion: Based on previous studies reviewed and observing the results in our patients, Isotretinoin low dose 10mgs is safe to use in Combination with Fractional CO2 Laser in the treatment of Acne and Acne Scars. Patients are very satisfied with the results and side effects are minimal and well tolerated .Healing time is unaffected in patients on isotretinoin. And in minimizing the dose and length of time of use of Isotretinoin you can maximize use of Fractional CO2 Laser for best results.

Objectives: The objectives of this presentation is to demonstrate the safety and efficacy of using EBDs to treat acne vulgaris.<br/>Introduction: Acne is the most common dermatologic disorder that dermatologists see on a regular basis in our offices. Dermatologists are fortunate to have some new topical and systemic therapies which work extremely well but some patients need more, and this is where EBD’s may play a significant role. These devices work mainly by targeting the P. acnes bacteria found in the pilosebaceous gland. <br/>Methods: Clinical studies showing the efficacy of several devices will be reviewed, including the short-pulsed 1064 nm laser, the combination 589-1319 nm laser, and the intense pulsed light sources.<br/>Results and Conclusions: This presentation will show how these devices can be incorporated into one’s clinical practice in a most successful manner.

In this session we will be discussing about the long-term treatment in acne management including the latest updates on new topical and oral agents. We will also be discussing about what’s new with isotretinoin and practical tips on how to use in our daily practice. Finally I’ll talk about the latest devices used for the treatment of acne.

Comming Soon

Currently in Japan, acne treatment is widely carried out in accordance with the guidelines created in 2008 and has been somewhat effective.<br/>The guidelines recommend topical and oral medications, but there is also high hope for combination treatment using devices, which is not covered by medical insurance.<br/>At my clinic, I have mainly focused on treatment by devices and would like to share my experience as well as the characteristics of IPL, Fractional RF, and Gold PTT for acne treatment.<br/>Although treatment by devices is not included in the current guidelines in Japan, it can provide quick and effective results preventing post-acne scarring. In my presentation, I would like to propose how treatment by device can be combined with treatments such as topical and oral medications in the future.