Discussion
sebaceous gland damage, tumor necrosis, shock, edema, erythema, acne scars, comedonal lesions, acne, comedonal acne lesion, AV lesions
ADVERSE EFFECTS, TUMOR NECROSIS, SHOCK, EDEMA, ERYTHEMA, ACNE, HEAT
Efficacy of Nd:YAG laser to treat acne has been established in multiple studies [The current study demonstrated improvement of AV lesions by both Nd:YAG laser and fractional COOn Nd:YAG side, inflammatory and comedonal acne lesion numbers decreased by 81.41% and 61.70%, respectively, from baseline to a month after the final session.Nd:YAG influences sebum output through sebaceous gland damage, normalizes follicular keratinization and corneocyte cohesion, upregulates TGF-β, and decreases the production of inflammatory cytokines, including interleukin-8, matrix metalloproteinase-9, nuclear factor kappa B, toll-like receptor (TLR)-2, and tumor necrosis factor-α [It is thoughted that, the damaging effect of 1064-nm Nd:YAG on the dilated superficial vessel of inflammatory acne and the changes of cytokine release, including the upregulation of TGF-β and the downregulation of IL-8 and TLR-2, were associated with the improvement of inflammatory acne lesions [The current results correlate with those of Chalermsuwiwattanakan et al. [Concerning the considerable improvement of the inflammatory lesions, these findings parallel our study findings with a substantial decline in noninflammatory lesions by 61.71%, which might be attributable to differences in patient demographics, number of sessions, and Nd:YAG parameters.Similar to the present results, long-pulsed Nd:YAG laser 1064 nm demonstrated improvement percentage of inflammatory acne lesions of 70.42% after the third session of a 1-month interval therapy and increased to 85.72% following a 3-month follow-up, while the improvement percentage of noninflammatory acne lesions was 41.8% after treatment sessions and increased to 49.05% after 3 months of follow-up [In addition, Monib et al. [It was evident that, similar to the present study, these trials demonstrated a more significant improvement in inflammatory lesions than in comedonal lesions. However, in the present study, the response rates were higher, which could be due to variations in participant features, device parameters and manufacturer, therapy session number, and time between sessions.On the fractional COThe high improvement percentage regarding noninflammatory and inflammatory lesions on the fractional COA few studies have considered fractional COPestoni Porvén et al. [In addition, Shin et al. [Adverse effects in this study such as erythema and edema were transient and progressively reduced immediately after treatment with the Nd:YAG laser and approximately 24 h following fractional COFractional COOur findings were marginally inferior to those of Eldeeb et al. [Nd:YAG laser treatment resulted in moderate to significant enhancement of wide pores in 19 cases (63.3%). This can be attributed to the thermal or mechanical impacts of 1064-nm laser on fibroblasts, resulting in the production of novel elastin and collagen as well as collagen remodeling [The present study involved six cases with acne scars in addition to active lesions; fractional COIt is recognized that Nd:YAG lasers generate heat shock protein 70 and procollagen I from dispersed dendritic cells in the papillary and upper reticular dermis, resulting in collagen deposition in the papillary dermis [In the present study, the percent of improvement of acne scars was 68.67% after fractional CO