Kobe began breaking out last year, when he was 13. Pustules erupted across his forehead, nose and cheeks, like someone had taken a red Sharpie to his face. His skin was painful and throbbed constantly. A rough fingernail absently rubbed across his cheek felt like fire.
“Mom,” the East Bay middle schooler pleaded, “can you help?”
His mother, Ellie, who asked that her and her son’s real names not be used, offered up the usual treatments: benzoyl peroxide face washes, pimple patches, creams. Kobe’s skin didn’t improve. Ellie tried switching to a gentler laundry detergent and adding more whole grains and proteins to the family’s diet. The acne continued.
“His confidence took a hit,” she said.
At school, Kobe told Ellie, he was “getting ripped,” and he just wanted his skin to clear up. “Why can’t you fix this?” he shouted.
Ellie began taking her son to a facialist every six weeks for skin-clearing treatments, priced at $150. They helped a little, she said. Next, they visited a dermatologist who prescribed tretinoin, a vitamin A cream known for increasing cell turnover. There was maybe a 10% overall improvement in Kobe’s skin, his mother said.
Ellie hated seeing her vibrant, smart son so morose, and she felt helpless. “I was trying so hard to help,” she said, tearing up. “He just wanted his mom to fix it.”
Medication was the next step, but she was worried about side effects.
Then she heard about AviClear, a laser skin treatment introduced in 2022. The laser, created by Brisbane-based Cutera, offers a drug-free way to clear acne, by selectively targeting and suppressing the sebaceous glands via a specific wavelength. It works on all skin types and colors and has no recovery period. The promise was that three treatments spaced a month apart would significantly smooth Kobe’s complexion.
The price at The G Spa, a Union Square medical spa, was $3,000, but Ellie didn’t blink. “We were so desperate,” she said. “We were willing to try anything.”
After one treatment, which involved sitting in a chair for 30 minutes, while a technician ran the laser – which resembled a mini vacuum head attached to a nozzle and a giant white box – over his face, Kobe’s acne had shrunk, and after three, his skin was noticeably clearer. “It made such a difference,” Ellie said.
Ellie is one of a growing number of Bay Area parents who have taken a high-tech approach to targeting their kids’ acne. There’s a big market for acne-busting products — in 2022, the segment raked in $10 billion globally — but before that year, there had been little innovation. Sure, red-light therapy may help a little, dermatologists say, but the gold standard is medication.
Some parents, however, were troubled by the go-to crater-clearing prescription medication, isotretinoin (the generic name for Accutane), which the FDA has linked to an increased risk of suicide and depression. Despite these claims being partially debunked, parents have been wary, and researchers have scrambled to create alternatives.
Which brings us to acne-killing lasers. In 2022, AviClear and the Accure Laser System entered the market, both operating on a 1,726-nanometer wavelength to target the sebaceous glands and decrease oiliness. As of June, there were 33 AviClear providers within 100 miles of San Francisco.
The G Spa, the Union Square provider that treated Kobe, received its AviClear device in 2023. A G Spa spokesperson, Alex Lee, said teenagers account for around 20% of all AviClear treatments. The cost is $2,500 for three treatments, and $225 hydrafacials are also popular for spotty teens, said Lee. Many kids are dropped off after school and treated while parents go shopping. “We get a lot of calls from parents,” he said. “They’re frantic to make their kids feel better. … They say that AviClear will help their kids go to prom.”
That echoes what Dr. William Ting, an East Bay dermatologist with offices in San Ramon, Hercules and Livermore, has heard from parents. “There’s a lot of urgency, especially when they’re starting college soon,” he said of teen patients. Teens account for around 80% of his AviClear treatments, with the youngest at 14.
Teens with bad skin, especially those with cystic acne, often feel like it’s the end of the world, Ting said. They’d happily swallow whatever medication might improve their skin, but many parents prefer the more expensive lasers — which, unlike Accutane, are not covered by insurance — because of the limited side effects. For “the Berkeley moms, the Orinda moms, it’s worthwhile,” he said. They’re happy to pay to improve their kids’ quality of life.
At first, Ting was dubious of AviClear, having seen many too-good-to-be-true devices over the years. However, he has been consistently impressed with the results. “It even seems to be good at reducing acne scars,” he said.
“Kids come in so sensitive about their skin,” said Dr. Jerome Potozkin, who runs the Potozkin MD Skincare and Laser Center in Danville. “They come in, and they’re covered in makeup, they don’t make eye contact, they have low self-esteem.”
In October, Potozkin purchased the Accure laser, which, like AviClear, works by reducing the amount of sebum produced, though at a slightly different concentration of energy. Potozkin lasers around four teens a month and recommends four sessions, for a total of $4,000, to fully clear skin. “Cost has never been an issue,” he said.
The bigger problem for patients is “purging” — a brief post-laser-treatment side effect in which skin can actually get worse — which can feel like a nightmare for self-conscious kids. It’s temporary, Potozkin said, but teens should be prepared that this might happen.
Treatments can be painful, warned Dr. Faye Jamali, who runs the Belle Marin Aesthetic Medicine medical spa in Mill Valley. To alleviate discomfort during the procedure, she gives patients laughing gas. She said only one patient, a teenage boy, has refused to finish the series due to discomfort.
Every dermatologist and skin technician The Standard interviewed said an in-person consultation is needed before starting laser treatments. Jamali, who said she treats around 10 teenagers a month, works only with kids who fully consent and are invested in improving their skin. “Sometimes, it’s the parents who want this more than the kids,” she said.
She has encountered teens who aren’t bothered by their skin, but their parents, especially the “polished” type from Mill Valley, are. “The moms have flawless skin and think that a kid with acne is a bad reflection of them,” Jamali said.
She stresses to patients that they must be committed to the process. “I like to underpromise,” she said. “It can take three to six months to see the full results.”
Kaela Sparler was a 17-year-old student at Redwood High School in Larkspur when she had a course of AviClear treatments in 2023 at the Greenbrae location of the Opulence Medical Spa (which also has a location in Nob Hill). Kaela had been battling breakouts for months. “It made me feel self-conscious,” she said.
She’d bought serums and lotions and patches — “I spent hundreds of dollars!” — but nothing made a difference. Her skin wasn’t as bad as that of some kids at school, but she would be starting college in the fall and wanted to feel confident. Her mother’s friend connected Kaela to the Opulence Medical Spa, which was offering free treatments as it tested the AviClear laser.
The treatments weren’t comfortable, said Kaela, but they weren’t “spicy,” as the nurse had warned. She finished her course the summer before starting college, and her skin completely cleared up. “It’s definitely worth it if it’s something you need,” she said. “It’s so nice to have good skin; all I wear now is tinted sunscreen.”
However, she would never have been able to afford the treatment she got for free. “It’s such an expense. … It would be hard to get my parents to pay for it,” she said. “If it was $800, then I’d think about it.”
The price point is often prohibitive for teens and their parents. Dr. Usha Rajagopal, a cosmetic surgeon who runs the San Francisco Plastic Surgery & Laser Center in Nob Hill, said all of her AviClear patients have been adults. “It’s perfect for teens, who find it hard to be diligent with creams,” said Rajagopal. “But the word hasn’t really gotten out yet.”
Awareness can be difficult, dermatologists say. Marketing of laser treatments is generally targeted to affluent Gen Zers, millennials and Gen Xers, who could be turned off by pimply Instagram before-and-afters.
Still, once people know that acne lasers exist, demand is pretty constant year-round, said Dr. Anne Cummings, who treated Kaela at Opulence Medical Spa. While other skincare lasers, like Fraxel, leave patients red-faced and forced to hide from the sun, AviClear has no downtime.
| Source: Tâm Vũ/The Standard
Six months after his initial treatment, Kobe, now 14, is feeling positive. He has “more spring in his step,” mom Ellie said, and she loves seeing him flourish. “The price is exorbitant,” she admitted of the laser treatment. “I wish insurance would cover it. They kick you when you’re down.”
Kobe’s skin isn’t perfect, but it’s night and day from where it began, she said. He recently started taking prescription isotretinoin to clear the “last part up.”
Based on the results, Ellie has recommended the treatment to her friends who have teenagers. The nurses were nice, she said — they told Kobe stories of their own skin struggles, joked with him and made him feel comfortable.
“Financially, we could hack it, but it’s not cheap,” she said. “But I would have paid double, maybe up to $12,000.”