Energy-based therapies serve as a bridge between topical regimens and systemic drugs for patients with treatment-resistant inflammatory acne.1 In her San Francisco Dermatological Society lecture, Dr. Ekama Carlson explained how a structured broadband-light sequence accelerates clearance, controls redness, and begins scar remodeling before oral medications reach full effect. The approach is especially helpful when pregnancy, iPLEDGE requirements, adverse reactions, or personal choice make systemic therapy difficult.2,3

The treatment protocol spans six to eight office visits, scheduled one to two weeks apart. Each session combines three sequential wavelength ranges.4

Step 1: Low-fluence blue light (420–480 nm) photoactivates porphyrins within Cutibacterium

acnes, inducing bacterial destruction.5

Step 2: Two to three passes of yellow or red light (560–755 nm) target inflamed vasculature and

attenuate local cytokine activity.6

Step 3: Continuous near-infrared energy (755–1200 nm) is swept across breakout-prone areas to gently warm the upper dermis, stimulate collagen remodeling, and soften early scars.4 For Fitzpatrick types IV-VI, the fluence is lowered in the first pass, yellow light is avoided in the second pass and instead replaced with an 800nm filter, and a non-ablative fractional laser may be added once a month for established scars.

Dr. Carlson reported that approximately 75% of patients achieve near-complete clearance following a single treatment series.4 Clinical improvements often begin within weeks. Downtime is minimal, and benefits persist for four to six months, with single-session maintenance treatments recommended every one to three months. The protocol integrates well with topical agents such as retinoids and benzoyl peroxide, and in patients concurrently taking isotretinoin, it may reduce background erythema.6

Ideal candidates include pregnant individuals, adolescents with adherence challenges, adults seeking to avoid antibiotics or spironolactone, and patients interested in holistic or technology-forward approaches to early scar prevention.1 Limitations include device discomfort, potential for post-inflammatory hyperpigmentation (especially in darker skin types if parameters are not adjusted),7 limited insurance coverage, and the absence of standardized treatment protocols across platforms.

Despite these limitations, a well-executed broadband-light series offers a versatile, fast-acting adjunctive option that addresses multiple acne pathophysiology domains, such as bacterial load, inflammation, erythema, and scarring, within a single coordinated treatment plan.8

Bottom line

Structured multi-wavelength broadband light is a safe, adaptable adjunct that provides a valuable alternative for patients who are unwilling or unable to pursue systemic acne treatments.