Kobe started breaking out last year when he was 13 years old. Pimples broke out on his forehead, nose and cheeks, as if someone had taken a red Sharpie to his face. His skin ached and throbbed constantly. A rough fingernail casually rubbing against his cheek felt like fire.
“Mom,” pleaded the East Bay student, “can you help?”
His mother, Ellie, who asked that her and her son’s real names not be used, offered the usual treatments: benzoyl peroxide face washes, pimple patches, creams. Kobe’s skin did not improve. Ellie tried switching to a milder laundry detergent and adding more whole grains and protein to the family’s diet. The acne continued.
“His confidence took a hit,” she said.
At school, Kobe told Ellie, he was “torn” and just wanted to clear his skin. “Why can’t you fix this?” he shouted.
Ellie began taking her son to a facial therapist every six weeks for skin-clearing treatments, priced at $150. They helped a little, he said. They then visited a dermatologist who prescribed tretinoin, a vitamin A cream known to increase the cell cycle. There was maybe a 10 percent overall improvement in Kobe’s skin, his mother said.
Ellie hated seeing her lively, intelligent son so vulgar and felt helpless. “I was trying so hard to help,” she said through tears. “He just wanted his mom to fix it.”
Medication was the next step, but she was worried about side effects.
Then he heard about AviClear, a laser skin treatment introduced in 2022. Created by Brisbane-based Cutera, the laser offers a drug-free way to clear acne by selectively targeting and suppressing 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 spait was $3,000, but Ellie didn’t blink. “We were so desperate,” she said. “We were willing to try anything.”
After a treatment, which involved sitting in a chair for 30 minutes while a technician ran the laser — which looked like 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 children’s acne. There’s a big market for anti-acne products—inside 2022the segment grossed $10 billion worldwide — but before that year, there was little innovation. Sure, red light therapy can help a little, dermatologists say, but the gold standard is medication.
Some parents, however, have been troubled by the prescription crater-clearing drug isotretinoin (the generic name for Accutane), which the FDA has connected to an increased risk of suicide and depression. Although these claims are partial demystifiedparents were wary and researchers tried to create alternatives.
Which brings us to lasers that kill acne. In 2022, AviClear and the Accure Laser System entered the market, both operating at a wavelength of 1,726 nanometers to target sebaceous glands glands and reduce fat. As of June, there were 33 AviClear providers within 100 miles of San Francisco.
G Spa, the Union Square provider that faced Kobe, received the AviClear device in 2023. AG Spa spokesman Alex Lee said teens account for about 20 percent of all AviClear treatments. The cost is $2,500 for three treatments, and the $225 hydrofacials are also popular for young teenagers, Lee said. Many children are dropped off after school and nursed while parents go shopping. “We get a lot of calls from parents,” he said. “They are frantic to make their children feel better. … They say AviClear will help their kids go to prom.”
This echoes what Dr. William Tingan East Bay dermatologist with offices in San Ramon, Hercules and Livermore, has heard from his parents. “There’s a lot of urgency, especially when they’re starting college soon,” he said of the teenage patients. Teenagers account for about 80% of his AviClear treatments, with the youngest being 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 any drug that could improve their skin, but many parents prefer the more expensive lasers — which, unlike Accutane, aren’t covered by insurance — because of the limited side effects. For Berkeley moms, Orida moms, it’s worth it,” she said. They are happy to pay to improve their children’s quality of life.
At first, Ting was skeptical about AviClear, having seen many too-good-to-be-true devices over the years. However, he is consistently impressed with the results. “It even seems to be good at reducing acne scars,” she said.
“Kids get 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, albeit at a slightly different energy concentration. Potozkin lasers about four teenagers a month and recommends four sessions, for a total of $4,000, to completely clear the skin. “Cost was never an issue,” he said.
The biggest problem for patients is “clearance” — a brief side effect after laser treatment in which the 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 for it to happen.
The treatments can be painful, warned Dr. Faye Jamali, who runs it Belle Marin Aesthetic Medicine medical spa in Mill Valley. To ease discomfort during the procedure, he gives patients laughing gas. He said only one patient, a teenage boy, refused to complete the series because of discomfort.
Every dermatologist and skin technician interviewed by The Standard said a personal consultation is required before starting laser treatments. Jamali, who said she treats about 10 teenagers a month, only works with kids who are fully consenting and invested in improving their skin. “Sometimes, it’s the parents who want it more than the kids,” she said.
He has met teenagers who are not bothered by their skin, but their parents, especially the “polished” guy from Mill Valley. “Moms have flawless skin and think a child with acne is a bad reflection on them,” Jamali said.
He emphasizes to patients that they must be committed to the process. “I like to make promises,” he said. “It may take three to six months to see full results.”
Kaela Sparler was a 17-year-old student at Redwood High School in Larkspur when she had a round of AviClear treatments in 2023 at its Greenbrae location Opulence Medical Spa (which also has a place in Nob Hill). Kaela struggled with breakouts for months. “It made me feel self-conscious,” she said.
She had bought serums, lotions and patches – ‘I spent hundreds of dollars!’ — but nothing made a difference. Her skin wasn’t as bad as some of the kids at school, but she was starting college in the fall and wanted to feel confident. Her mother’s friend connected Kaela with Opulence Medical Spa, which offered free treatments as she tried the AviClear laser.
The treatments weren’t comfortable, Kaela said, but they weren’t “spicy,” as the nurse had warned. She finished her course the summer before she started college and her skin cleared up completely. “It’s definitely worth it if it’s something you need,” he said. “It’s so nice to have good skin. all I wear now is a tinted sunscreen.”
However, he would never be able to afford the treatment he got for free. “It’s such a cost. … It would be hard to get my parents to pay for it,” he said. “If it was $800, then I would consider it.”
The price is often prohibitive for teenagers 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 were adults. “It’s perfect for teenagers, who find it difficult to be diligent with creams,” Rajagopal said. “But the word isn’t out yet.”
Sensitization can be difficult, dermatologists say. Laser treatments are generally marketed to affluent Gen Zers, millennials and Gen Xers, who could be turned off by the crazy Instagram before and after.
But once people know acne lasers exist, demand is steady year-round, said Dr. Anne Cummings, who treated Kaela at Opulence Medical Spa. While other skin care lasers, such as Fraxel, leave patients red-faced and forced to hide from the sun, AviClear has no downtime.
Six months after his initial treatment, Kobe, now 14, is feeling positive. He has “more of a spring in his step,” mom Eli said, and she loves watching him blossom. “The price is too much,” he 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 started, he said. He recently started taking prescription isotretinoin to clear up the “last part”.
Based on the results, Ellie has recommended the treatment to friends who have teenagers. The nurses were nice, he said – they told Kobe stories about their own skin problems, joked with him and made him feel comfortable.
“Financially, we could hack it, but it’s not cheap,” he said. “But I would have paid double, maybe as much as $12,000.”
