[Lecture of the month] HELIOS II In Acne Cocktail Management II

Lecturer/Dr. Dhananjay Chavan

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After that I performed resurfacing procedures. After applying carbon, I used 900~1300mJ for long mode and without carbon, I used 1500~2000mJ. I used 1800~2000mJ in pigmented acne scar or erythema without carbon. I used the collimated handpiece for carbon peel and the fractional handpiece at 420~900mJ for pigment treatment. I use the Zoom handpiece at 300~800mJ. This can be changed depending on the skin type. For example, the fractional handpiece is more effective in the nose area.

<Image1> shows parameters I normally use and <Image2> shows grade II acne. I performed salicylic acid 30% + gycolic acid 70% peel at the initial visit and used Helios II and carbon at the second visit. To prevent PIH, I used the fractional handpiece. At the 3rd and 4th visit, I combined glycolic acid peel and laser. As a result, acne was markedly improved. However, the patient was not satisfied with scars, erythema around 2.5 months after treatment I additionally performed long pulsed Nd:YAG laser for scar and redness reduction. Combination therapy carried out over 4-5 months brought drastic improvement.

I rarely use long pulse in Grade I acne. I use carbon but not in all cases of acne. Several treatments of peel and laser can improve the skin tone and texture. I saw that Grade II and III active acne improved greatly with long pulsed Nd:YAG laser. Here, the important thing is that glycolic peel and salicylic acid were combined. The long pulsed Nd:YAG laser therapy was clearly effective and can even prevent post-acne scar or sequelae. Long-term treatment using the fractional handpiece after applying carbon can improve the skin tone.

As acne has psychological impact, the treatment should be rapid. Helios II had excellent efficacy in perioral acne and PIH was drastically improved. As you all know, the Q-switched Nd:YAG laser was particularly effective in pigmented lesions. I switched to the fractional handpiece only when the lesion was not active acne.

Image 3 shows prevention of acne scar. I used the Nd:YAG laser for 4 months. After 1.5 years, the condition improved to what is shown in <Image 4>. Grade III, IV acne can also benefit from early treatment and restoration (Image 4, 5).

Helios II was effective in combination wih injection as well. I irradiated the long pulsed laser once over the entire face area and a couple times more only on the acne lesions. Side effects occur occasionally, however, most cases are hypopigmentation and diligent use of a sunblock can prevent this.

The cocktail therapy combining isotretinoin, glycolic peel, salicylic acid, and Helios II, etc. brings high satisfaction of patients when used according to the patient’s skin condition and the severity of acne.