Photodynamic Acne Treatment – Photodynamic Therapy

Hard-to-treat acne can require “power-level” treatments. This procedure combines light and a special light-activated solution that targets and destroys acne activity. This treatment also diminishes older acne scars leaving your skin smoother.

A photosensitizing agent (Levulan) is applied to your skin. The Levulan, which is a clear painless solution, is applied to your skin and left on for 60 minutes. The skin is then exposed to either the blue light for fifteen minutes or the IPL. Levulan is a special solution applied to the skin that is activated by a specific wavelength of light, which turns it on. Levulan has been used extensively for the treatment of a variety of different skin conditions.

Levulan is a 20% solution of Aminolevulinic Acid (ALA). ALA is a natural product found in all humans throughout the body. It is a precursor for hemoglobin synthesis. (You wouldn’t be able to make red blood cells to carry oxygen without ALA in your body.)

Acne results from the obstruction and inflammation of the sebaceous glands, and it affects 80% of the human population. Acne typically begins in adolescence with hormonal changes. However, there are many older individuals who suffer from adult acne as in a form of rosacea.

There are different levels of acne ranging from milder comedonal (blackheads and whiteheads) to moderate, pustular, on to severe cystic acne. In many cases, several or all of these levels of acne can be present on an individual simultaneously.

Acne is caused by overactive sebaceous glands in the skin. The sebaceous glands, triggered by the hormone androgen, produce sebum (oil) in the skin. Although androgen is a male hormone, it is present in both men and women. Production of this hormone is highest during puberty, but it is always present in the body.

When androgen levels increase, the sebaceous glands release sebum. Ordinarily this oily substance spills onto the skin. When cells from the lining of hair follicles shed too quickly clumping together and clogging pores sebum is trapped beneath the skin causing whiteheads and blackheads. Sebum can then mix with the trapped cells and cause Propionibacterium acnes (P. acnes – bacteria normally found on the skin) to grow in the clogged follicles. P. acnes can cause inflammation and pus and can result in papules or pustules. When the follicles expand as much as they can, bumps called nodules are formed under the skin.

Prior to Photodynamic Acne Treatment, the best available treatment option for resistant and cystic acne was Accutane. However, with Accutane there are many systemic* side effects including birth defects, liver abnormalities, mood depression, and virtually all patients get dryness and night vision changes.

*Systemic treatments are any medications that are taken orally, injected or infused that affect the entire body system. PDT Acne Treatment provides a viable alternative to all types of acne treatment without having negative systemic effects.

Advantages

  • Well-tolerated
  • Easily performed in a specialty clinic environment
  • Non-invasive (no needles or surgery required)
  • Excellent cosmetic outcome (particularly in cosmetically sensitive areas of the face)

What Is Photodynamic Therapy?
(PDT)
Photodynamic treatments remove sun damaged pre-cancerous zones and spots called actinic keratoses. Sun damage, fine lines, and blotchy pigmentation are also improved because of the positive effect of Levulan and the light treatment. ALA/PDT treatment also has the unique ability to minimize pores and reduce oil glands, effectively treating stubborn acne vulgaris, acne rosacea, and improve the appearance of some acne scars. Levulan is revolutionizing how we perform skin rejuvenation and how we treat sun-damaged skin with wavelength of light.

  • Removing pre-cancerous actininc keratoses
  • Preventing skin cancer
  • Improving wrinkles
  • Reducing pore size
  • Improving skin texture
  • Improving pigmentation
  • Treating moderate to severe cystic acne
  • Treating sebaceous hyperplasia

How Many Treatments Will It Take?

Levulan improves the whole facial area treated, creating all one color, texture, and tone rather than just spot treating with liquid nitrogen, cautery, and surgery.
It is easier for patients than repeated topical liquid nitrogen, Efudex (5fu), or Aldara because the side effects are minimal, healing is rapid, and only 1-3 treatments are required.

The ALA/PDT treatment at our clinic is less painful versus liquid nitrogen, d-FU, and Aldara. This results in reduced scarring and improved cosmetic outcome compared with cautery, surgery, and Efudex. Liquid Nitrogen can also leave white spots of your skin.

What Are The Disadvantages?

The downside of Photodynamic Treatment (PDT) is that your skin will be red and have some skin peeling (and crusting if you have skin cancers) for several days after the treatment. Usually, the first 1-2 days are the worst. Downtime can be 1 or 2 weeks depending on which series you are doing. Some people do a peel every 2 weeks for 4 treatments, which is very intense.

Proderma makeup (available in our office) will hide most of the redness. You must remain indoors the day following your treatment to avoid sun exposure, as you are photosensitive for about 24 hours after PDT. Topical acne lotions can be used in between your Levulan treatments once the redness has settled down over a period of a few days.

Moderate Acne

Sebaceous Hyperplasia

Actinic Keratosis