Acne is one of the most common skin conditions aesthetic practitioners and dermatologists will face in their clinics. It affects 742 million patients globally, and 95% of 11-30-year-olds in the UK suffer from the condition to some degree.1,2 There are a number of aesthetic treatments available to treat mild-to-moderate acne either temporarily or semi-permanently, but AviClear from Cutera is the first US FDA-cleared aesthetic device to treat mild-to-severe acne, with permanent results.3 According to Cutera, AviClear will offer patients an alternative to prescription medications which can trigger side effects, requiring just three 30-minute sessions to provide a long-term solution to active acne.
The technology
One of the leading causes of acne is the sebaceous glands becoming blocked with the oily substance sebum.4 Many energy-based devices can be used to treat mild-to-moderate acne, such as radiofrequency or infrared light lasers which target and down-regulate sebaceous glands but can consequently cause pain and skin damage.5 Cutera’s goal was to build on the efficacy of these options while negating possible side effects.
AviClear uses a 1726 nm wavelength that selectively targets and down-regulates the sebaceous glands rather than targeting melanin or water, thus causing minimal damage to the surrounding tissue, according to Cutera.6 Research suggests that with this wavelength, sebum absorbs two times more energy than water.7 AviClear can achieve this with a non-ablative, 100-watt laser, complete with AviCool sapphire cooling to reduce downtime and discomfort without the need for topical anaesthetic.6 The nature of the technology also means it is safe to use for all Fitzpatrick skin types.8
Results
A full AviClear treatment protocol comprises of three 30-minute sessions performed three weeks apart. To test the efficacy of this, a non-randomised, open-label study was conducted with 104 participants, with the primary endpoint being the percentage of patients who achieved a 50% reduction in lesion count by three months after the final treatment.3 Three months post-final treatment, 80% of patients had a 50% reduction in inflammatory lesion count (ILC).3 No pain mitigation was used, and no patients dropped out due to pain.3
Another study examined 17 patients aged 18-36 who received three treatments.9 The safety assessment showed only mild and transient device-related adverse events.9 In a follow-up four to 12 weeks after the final treatment, a statistically significant reduction in ILC of 52-56% was observed.9 After 24 months, an ILC reduction of 97% was seen.9
In a patient satisfaction study, 87% of patients were ‘satisfied’ or ‘very satisfied’ with their results, and 75% were ‘likely’ or ‘very likely’ to have the treatment again.10 The contraindications for AviClear are pregnant patients and those undergoing treatment for skin cancer.8 Treatment should not coincide with use of topical anaesthetic, and it should not be used over or near tattoos, permanent makeup or dysplastic nevi/questionable pigmented lesions.8 Caution should be exercised for patients with darker skin types and tanned skin – lower fluence and lower cooling are recommended for those with melanin-rich skin to avoid side effects.8
Practitioner perspective
US-board certified dermatologist Dr Mira Kaga, who has been using the device in her clinic in New Jersey for more than a year, commented, “As the aesthetics industry continues to thrive, we see a drive for clear skin as the basis for all other results. AviClear definitely helps with this. The fact that my patients are seeing immediate results, combined with the continued improvement in their active acne and acne scarring, means I’m seeing much happier patients. We’ve found that we haven’t even had to advertise the treatment much, because our patients’ skin is speaking for us.”
A long-term solution
AviClear is designed to treat mild-to-severe acne and acne scars, avoiding the potential negative side effects which can arise from traditional acne treatments including prescription medications and other energy-based devices. Such a treatment could have a significant positive impact on patients’ self-esteem and quality of life if it proves effective.
AviClear is not yet available to UK practitioners, but visit Cutera at CCR 2023 to find out more.
