308 nm Excimer Laser in acne, cosmetic use and new indications

308 nm-Xtrac Excimer laser therapy can be applied to an increasing number of dermatoses that respond to either phototherapy or photochemotherapy, since UV B 308 nm targets T-cell infiltrates in the epidermis and dermis, is more effective than UV B 311nm and penetrates as deep as PUVA. There are new approaches how and when to use an excimer laser at the right time before or after other therapies or at the same time with or without combination of other treatments. The Excimer laser can be particularly useful in the treatment of acne and subtypes. Beside the 1 st line factors: hyperceratosis of follicle and hyperplasia of sebaceous gland, the 2 nd line microbiological factors, Inflammation and immune response are the reason, why topical 308 nm excimer laser is able to avoid systemic treatments, like in severe inflammatory acne in early pregnancy. There is proof for significant inhibition of micrococcaceae and propioni bacteria. Short term use for anti-inflammatory effects, efficacy and safety of the 308 nm excimer laser compared to other options is discussed. The cosmetic use of the excimer laser includes repigmentation of scars and striae or of postinflammatory hypopigmentation and is part of scar management It also can be used in alopecia areata. New indications are documented in case reports, like the fast clearing of seborrhoic eccema after 3 sessions, also in special locations (retroauricular, lids, scrotal), in prurigo, folliculitis sclerotisans, lichen ruber, combined vitiligo with psoriasis. More indications are likely to be reported and could include those known from guidelines of photo- and photochemotherapy.