{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T23:05:23Z","timestamp":1790809523720,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T00:00:00Z","timestamp":1736294400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Lasers Surg Med"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This work highlights the methods used to develop a multi\u2010pulse 1726\u2009nm laser system combined with bulk air\u2010cooling for selective sebaceous gland (SG) photothermolysis using thermal imaging and software algorithms. This approach enables treating to a desired tissue temperature and depth to provide a safe, effective, reproducible, and durable treatment of acne.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We designed and built a 1726\u2009nm laser system with a 40\u2009W maximum power output, a highly controlled air\u2010cooling device, and a thermal camera in the handpiece, which permits real\u2010time temperature monitoring of the epidermis. IRB\u2010approved safety and efficacy trials demonstrated SG damage at depth, resulting in safe, efficacious, and durable clinical outcomes. Bioheat transfer and light transport modeling confirmed that the pulsing protocols could produce therapeutic temperatures at various SG depths, while protecting the epidermis and dermis with bulk air\u2010cooling. Similarly, we employed clinical observations and photothermal modeling to identify pain mitigation opportunities while maintaining therapeutic efficacy. Biopsies were subsequently taken for histological evaluation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Clinical and histological data, confirmed with modeling, demonstrated that multi\u2010pulse laser delivery with bulk air\u2010cooling selectively increased SG temperature compared to surrounding dermis and at depths unachievable by a single pulse. Subjects showed an average 71% ILC reduction at 3 months posttreatment. We identified two different pulsing protocols with similar selective photothermolysis (SP) of the SG with very different pain responses. Thus, changing the pulsing protocols allowed for pain mitigation and eliminated the need for injectable anesthetic. Histology confirmed the selective damaging of the SG at depth and the preservation of the surrounding dermis and the epidermis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The multi\u2010pulse 1726\u2009nm laser with bulk air\u2010cooling, thermal monitoring, treat\u2010to\u2010temperature (and depth) control, and a unique pulsing protocol, is capable of selectively damaging SGs at depth without damage to the surrounding dermis or the epidermis. The system offers two different protocols that were developed with different levels of discomfort allowing for two different methods for pain mitigation (injectable vs. topical anesthesia).<\/jats:p><\/jats:sec>","DOI":"10.1002\/lsm.23872","type":"journal-article","created":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T05:30:17Z","timestamp":1736400617000},"page":"236-251","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Treatment of Acne With a 1726\u2009nm Laser, Air Cooling, and Real\u2010Time Temperature Monitoring, Software\u2010Assisted Power Adjustment to Achieve a Temperature Endpoint With Selective Sebaceous Gland Photothermolysis"],"prefix":"10.1002","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1115-3219","authenticated-orcid":false,"given":"Emil A.","family":"Tanghetti","sequence":"first","affiliation":[{"name":"Center for Dermatology and Laser Surgery Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Sierra","sequence":"additional","affiliation":[{"name":"Accure Acne Inc. Boulder Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Estes","sequence":"additional","affiliation":[{"name":"Accure Acne Inc. Boulder Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aubrey","family":"Eck","sequence":"additional","affiliation":[{"name":"Accure Acne Inc. Boulder Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred","family":"Intintoli","sequence":"additional","affiliation":[{"name":"Accure Acne Inc. Boulder Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"Hofvander","sequence":"additional","affiliation":[{"name":"Accure Acne Inc. 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Rox","family":"Anderson","sequence":"additional","affiliation":[{"name":"Wellman Center for Photomedicine, Massachusetts General Hospital Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda H.","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"Wellman Center for Photomedicine, Massachusetts General Hospital Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.12149"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2006.05.048"},{"key":"e_1_2_9_4_1","first-page":"27","article-title":"The Role of Inflammation in the Pathology of Acne","volume":"6","author":"Tanghetti E. 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