Introduction. Severe acne vulgaris is a chronic inflammatory dermatological disease associated with persistent lesions, a high risk of scarring, and significant psychosocial burden. Its management is often limited by the adverse effects and poor tolerability of systemic therapies. Although oral isotretinoin remains the standard treatment for severe acne, growing concerns regarding systemic side effects have increased interest in non-pharmacological treatment modalities, including long-pulsed Nd:YAG laser therapy.
Aim. The aim of this study was to compare the clinical efficacy of long-pulsed Nd:YAG laser therapy with oral isotretinoin in adult patients with severe acne vulgaris.
Materials and Methods. A randomized clinical trial was conducted in adult patients diagnosed with severe acne vulgaris. Participants were randomly allocated into two treatment groups. One group received standard systemic therapy with oral isotretinoin, while the second group underwent a structured course of long-pulsed Nd:YAG laser therapy. Clinical response was assessed using a validated acne severity grading scale at baseline and during scheduled follow-up visits. Treatment outcomes were evaluated based on changes in acne severity and overall clinical improvement.
Results. Both treatment modalities resulted in significant clinical improvement over the course of therapy. However, patients treated with long-pulsed Nd:YAG laser therapy demonstrated a more pronounced reduction in acne severity compared with those receiving oral isotretinoin. Clinical improvement in the laser-treated group was observed earlier and was characterized by a marked reduction in inflammatory lesions and overall disease activity.
Conclusion. Long-pulsed Nd:YAG laser therapy demonstrated superior clinical efficacy compared with oral isotretinoin in the treatment of severe acne vulgaris. These findings support the role of Nd:YAG laser therapy as an effective and promising non-pharmacological alternative, particularly for patients in whom systemic therapy is contraindicated or poorly tolerated.
References
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