%0 Journal Article
%A Lee, Kar Wai Alvin Lee
%A Chan, Kwin Wah Lisa Chan
%A Lee, Cheuk Hung Lee
%A Wong, Tin Hau Sky Wong
%D 2026
%J Journal of Cosmetic and Regenerative Medicine

%@ 3107-2933

%V 1
%N 2
%P 18

%T Clinical Application of Laser for Acne Vulgaris: An Update and Critical Review
%M doi:10.65381/jcrm.2026.01010018
%U https://jcrm.jams.pub/article/1/2/28
%X Background: Acne vulgaris is a common chronic inflammatory disorder driven by sebaceous hyperactivity, follicular hyperkeratinization, Cutibacterium acnes proliferation, and inflammation. Although topical and systemic agents remain standard therapy, their use is often limited by irritation, antimicrobial resistance, teratogenicity, systemic adverse effects, and poor adherence. These limitations have increased interest in laser and light-based therapies as targeted, nonpharmacologic alternatives or adjuncts capable of addressing multiple pathogenic pathways. Methods: This update and critical review used structured evidence mapping of peer-reviewed publications indexed in MEDLINE, PubMed, and Ovid from 2024 to 2026. Eligible studies included randomized controlled trials, split-face trials, cohort studies, case series, systematic reviews, meta-analyses, and expert reviews evaluating lasers, light-based devices, and photodynamic therapy for active acne. Forty-two publications were included and appraised according to Oxford Centre for Evidence-Based Medicine levels to assess efficacy, safety, tolerability, and emerging treatment paradigms. Results: Recent evidence shows a transition from broad phototherapy toward mechanism-based energy devices. Sebum-selective 1726 nm lasers demonstrated promising efficacy, acceptable safety across diverse skin phototypes, and potential durability through selective sebaceous gland photothermolysis. Vascular lasers, including 577–589 nm and 585 nm systems, consistently improved inflammatory lesions and post-inflammatory erythema. Various 1064 nm Nd:YAG platforms showed benefit for inflammatory acne, deeper lesions, and early scar prevention. Solid-state dual-wavelength lasers and optimized photodynamic therapy protocols further enhanced lesion reduction, while newer cooling systems and software-assisted temperature monitoring improved procedural precision and reduced pain or pigmentary risk. Evidence from meta-analyses also supported selected combination use with isotretinoin, challenging older safety concerns. Conclusions: Laser and light-based therapies are evolving into important adjunctive and, in selected patients, alternative treatments for acne vulgaris. The strongest advances involve sebaceous targeting, vascular modulation, and safer treatment delivery across skin types. However, heterogeneity in parameters, cost, and limited long-term relapse data still restrict universal standardization. Future multicenter trials should define optimal protocols, clarify durability, and refine combination strategies to maximize efficacy, safety, and accessibility for broader adoption across routine dermatologic practice in coming years.