ニードル状金微粒子と長パルス1064nm Nd:YAGレーザーを組み合わせた標的ニキビ治療：症例シリーズ

Acne vulgaris is a prevalent dermatological disorder associated with inflammation and sebaceous gland hyperactivity. Conventional therapies, including topical and systemic agents, are limited by side effects, antimicrobial resistance, and frequent relapse. Light-absorbing gold microparticles activated by long-pulsed 1064 nm Nd:YAG laser therapy represent a novel, non-invasive approach targeting sebaceous glands. However, clinical data remain limited, particularly regarding optimal dosing. We report a series of four patients aged 19-31 years with moderate to severe acne vulgaris. Two patients received a low dose (1-2 cc), and two received a standard dose (2.5-3.5 cc) of gold microparticle suspension applied with sonophoresis, followed by 1500 shots of long-pulsed 1064 nm Nd:YAG laser. Each underwent three treatment sessions at two-week intervals. Clinical outcomes were assessed using standardized photography, Janus skin analyzer evaluation, and patient-reported satisfaction two weeks after the final session. Patients treated with the standard dose demonstrated marked reductions in inflammatory lesions, post-acne erythema, and skin oiliness, with high satisfaction and no recurrence during follow-up. In contrast, patients receiving the low dose showed only moderate improvement, with partial reduction in lesion counts and erythema. No adverse effects or complications were observed across all cases. This case series suggests that higher doses of gold microparticles combined with long-pulsed 1064 nm Nd:YAG laser therapy may provide superior clinical outcomes compared to lower doses in the management of moderate to severe acne vulgaris. Nonetheless, treatment with either dose was safe, well-tolerated, and associated with moderate-to-high patient satisfaction. Although encouraging, these findings are limited by a small sample size, and larger controlled studies with extended follow-up are needed to confirm efficacy and optimize treatment protocols.