Folliculitis decalvans (FD) is a neutrophilic cicatricial alopecia characterized by erythematous follicular papules and pustules associated with follicular hyperkeratosis and tufted folliculitis. Here, we report the case of a 35-year-old man with recalcitrant FD successfully treated with Erbium-Yag (Er:YAG) laser, showing a rapid response and no hair loss. The effects on fibroblasts, skin microbiota, immune cascade, and angiogenesis are mechanisms through which the Er:YAG may improve FD, promoting hair growth and reducing hyperkeratosis. Nonetheless, further clinical studies are needed to investigate and better define its benefits.

Keywords: Laser Therapy; Folliculitis; Solid-State Lasers.

INTRODUCTION: Acne is a prevalent chronic disease that can cause physical, emotional, and social effects. Isotretinoin and chemical peels are available as treatment, but their combination has historically been avoided due to reports of abnormal healing. Recent studies suggest that the combination with superficial or medium-depth peels is safe, but there are no studies considering the specific characteristics of the Brazilian population.
OBJECTIVE: To evaluate the safety and efficacy of combining isotretinoin and chemical peels in the treatment of acne scars.
METHODS: A clinical trial was conducted with patients aged 15 to 25 years undergoing acne treatment with isotretinoin. The intervention group underwent three Jessner's peels during isotretinoin use, while the control group underwent the same peels after treatment with isotretinoin was completed. Outcomes were assessed using the QGSGS and IGA scales by two blinded evaluators.
RESULTS: Peels performed concomitantly with isotretinoin did not result in worse outcomes on the QGSGS and IGA scales compared to the control group.
CONCLUSION: The combination of isotretinoin and chemical peels proved to be safe, but further studies with larger samples are needed to establish recommendations.

Keywords: Acne Vulgaris; Isotretinoin; Chemexfoliation.