hi, so I'm going to start of by saying the efficacy of this laser use really depends on how the technician operates it. I'm saying, yes it does work. However, the results were more parallel to my expectations I realized when my aesthetician treated the effected areas multiple times. This is because sometimes after getting some pus out of comedones, there tends to be more. If my aesthetician goes over this area multiple times, it is very effective; drawing out all the bacteria. This is what she would reference as "attacking" the face with Isolaz. However, if the affected area is only applied to Isolaz once, there is some reduction in inflammation, however the flaw may still be there, possibly. Perhaps the laser can only kill so much bacteria at a time. When you have many, many comedones that are tender to the touch, Isolaz can be painful; yet is tolerable. I do understand that as the victim, you may not ask the operator to go over the effected areas many times, since I tend to forget although I knew better; so if you are a technician reading this---I urge you to go over multiple times! Give these people their moneys worth! I have never experienced bruising from Isolaz, but have experienced "crusting." As long as the bacteria is removed from my face I do not mind. Isolaz is effective when consistent and I would also recommend this with extractions. Not many places have this machine, but the procedure was covered by my insurance, although it is still costly. Overall, I would only recommend undergoing this as long as it is covered by insurance and if you have many, many open pustules that you are going to urge your technician to attack!