Acne Laser Treatment — Candela SMOOTHBEAM

Acne laser treatment at Esthé Laser Clinic uses the Candela SMOOTHBEAM — a 1,450 nm diode laser specifically designed to target the sebaceous glands beneath active acne lesions without damaging the overlying skin. The 1,450 nm wavelength penetrates the dermis to a depth of 1.5–2 mm, reaching the sebaceous gland architecture responsible for excess sebum production. The DCD cooling system simultaneously cools the skin surface, making the treatment well tolerated. By thermally reducing sebaceous gland activity, SMOOTHBEAM addresses one of the root causes of inflammatory acne rather than merely treating surface symptoms. Clinical studies show significant reduction in acne lesion count after a course of 4–6 sessions. The treatment is appropriate for moderate-to-severe inflammatory acne that has not responded adequately to topical therapy.

Acne vulgaris is fundamentally a follicular disorder in which excess sebum production, abnormal follicular keratinisation, bacterial colonisation (Cutibacterium acnes), and follicular inflammation interact to produce the clinical spectrum of comedones, papules, pustules, and cysts. Topical and oral treatments address the bacterial and inflammatory components but have limited effect on sebaceous gland size and output — the core driver of recurrence in many patients with sebaceous-dominant acne. The Candela SMOOTHBEAM operates at 1,450 nm, a wavelength chosen because it is absorbed by water in the tissue rather than by melanin, making it safer across skin tones. At this wavelength and a typical fluence of 9–14 J/cm², the laser energy penetrates approximately 1.5–2 mm into the dermis — precisely the depth range where the sebaceous lobules connect to the hair follicle infundibulum. The thermal effect at this depth selectively damages the sebaceous gland architecture, causing thermal injury to the gland cells that produces long-term atrophy of sebaceous gland output. The sebaceous gland is not entirely destroyed (which would leave the skin excessively dry) but its secretory capacity is substantially reduced, lowering the sebum-to-follicle ratio that drives follicular plugging and the subsequent inflammatory cascade. The DCD (Dynamic Cooling Device) integrated into the SMOOTHBEAM handpiece delivers a cryogen spray to the epidermis immediately before each laser pulse. This epidermal cooling keeps the superficial skin at a safe temperature while the deeper dermal target receives the therapeutic heating — a key distinction from ablative laser systems that target the skin surface. Because the epidermis is protected, post-treatment there is typically no open wound and minimal downtime. At Esthé Laser Clinic, the SMOOTHBEAM treatment is administered by medical staff in individual sessions of 30–45 minutes for full-face coverage, with shorter sessions for localised areas. The treatment protocol typically calls for 4–6 sessions spaced 3–4 weeks apart, with clinical improvement becoming measurable after sessions 2–3. Published clinical data for the SMOOTHBEAM show 50–80% reductions in inflammatory lesion counts after a completed course in moderate-to-severe acne patients. A secondary benefit of the 1,450 nm wavelength is collagen remodelling in the dermis. The sub-ablative thermal effect stimulates a controlled healing response that produces new collagen fibres — an effect that can improve shallow acne scarring over the course of the treatment series. The extent of scar improvement depends on the scar depth and age, but many patients with post-inflammatory scarring observe improvement alongside the active acne control. The treatment is best suited to patients with moderate-to-severe inflammatory acne (Grades II–III on the Global Acne Assessment Scale) who have tried topical retinoids and benzoyl peroxide without achieving control, or who cannot tolerate systemic antibiotics. It is not indicated for purely comedonal (non-inflammatory) acne or for deep nodular/cystic acne (which typically requires oral isotretinoin first). Preparation: discontinue topical retinoids 7 days before the session. Avoid significant sun exposure and tanning 4 weeks prior. Arrive with clean skin, no foundation or SPF on the treatment area. Disclose any current acne medications to the treating physician — some interactions (photosensitising agents) require a medication pause. Contraindications: active oral isotretinoin use (treatment must wait 6 months after isotretinoin is discontinued due to altered wound healing), pregnancy, any photosensitising medication, active skin infection (such as impetigo) in the treatment area, Fitzpatrick VI skin type (very dark skin — higher risk of unintended epidermal heating).