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Presentation

Combined Ablative and Non-Ablative Laser Treatment for Acne Scars, PIH, and Skin Rejuvenation in Skin Types IV-VI

Description

The speaker presented experience treating acne scars, post-inflammatory hyperpigmentation, and skin rejuvenation in skin types IV–VI using a layered approach that combines non-ablative and ablative lasers in the same session. The protocol starts with deeper non-ablative devices and moves upward through the skin, using technologies such as 1340, 1064, Pico, diode laser, and IPL plus radiofrequency, then finishes with ablative lasers like CO2 and Erbium/air. He emphasized the importance of understanding laser depth and treating from the bottom to the top of the skin to reduce complications and improve outcomes. To help prevent PIH and speed healing, he sometimes performs a Jessner peel before ablative treatment and may use drug delivery through laser-created microchannels with ingredients like tranexamic acid, vitamin C, or alpha arbutin. He showed three cases, including patients with acne scars and PIH, all of whom improved after one session or within a week, even in darker skin types, with good tolerance and visible cosmetic and psychosocial benefits.

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Conclusions

A layered approach that sequences non-ablative treatments from deeper to more superficial skin, followed by ablative lasers, can improve acne scars and post-inflammatory hyperpigmentation in ethnic skin.
Using multiple laser modalities in a single session appeared effective and well tolerated across Fitzpatrick skin types IV to VI in the presented cases.
Pre-treatment with a skin peel such as Jessner’s may accelerate healing and help prepare the skin before ablative laser resurfacing.
Careful selection of wavelengths and devices based on skin depth and target can reduce risk while addressing both scarring and pigmentation.
Combining laser resurfacing with drug delivery through microchannels may further support recovery and treatment outcomes.
The presenter suggests that skin of color is not a contraindication to laser treatment when protocols are used cautiously and tailored appropriately.
Successful treatment of visible acne scars may have meaningful psychosocial benefits, including improved confidence and relationships.