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Photodynamic Acne Treatment
Photodynamic Therapy
Photodynamic Acne Treatment
is a safe and highly effective method of treating a variety of skin
conditions- including the acne that plagues so many teenagers. Very few
of us pass through adolescence without experiencing some form of blemish
or pimple.
Contrary to popular belief,
acne is not caused by poor diet, stress or chocolate. Genetics,
hormones, clogged pores and bacteria are the major causes of acne. These
cause the sebaceous glands (oil producing glands in the skin) to produce
excess oil (sebum), which combined with dead skin cells, clog the
opening of the pores. Bacteria, Propionibacterium acnes (P. acnes) forms
in the pores creating red inflamed pimples, pus filled whiteheads or
black heads.
Photodynamic Acne Therapy is
an alternative to systemic oral drugs such as Accutane, which carries
significant risks and side effects. A clear, painless solution of a
photosensitizing agent called Levulan is applied to the surface of the
skin. Thirty to sixty minutes later it is activated by blue light that
activates the porphyrins in the bacteria, which results in a
photodynamic effect that kills the bacteria.
What is Photodynamic Therapy?
(PDT)
Photodynamic Acne Therapy
(PDT) is a process by which a photosensitizing agent (Levulan) is
applied to your skin. A Photosensitizing agent 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. 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.
Levulan is 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.)
Understanding Acne
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.”
There are different levels
of acne ranging from milder comedonal (blackheads and whiteheads) to
moderate, pustular, on to serve cystic acne. In many cases, several or
all of these levels acne can be present on an individual simultaneously.
Cause of Acne
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 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.
Moderate acne may include
blackheads and whiteheads in addition to papules- inflamed lesions that
appear as small, reddish or pinkish bumps that can be sensitive to
touch- or pustules- inflamed, white- centered bumps that can be red at
the base.
Severe acne is characterized
by nodules- large, painful, solid lesions that appear as lumps under the
skin- and cysts- deep, inflamed, pus-filled lesions that can be very
painful. Nodules and cysts are inflammatory and can cause scarring.
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 systemic effects.
Photodynamic Acne Treatment
Procedure
The Levulan, which is a
clear painless solution, is applied to your skin and left on for 15-60
minutes. It is then activated with a specific wavelength of light called
BLU-U or Clear Light. This takes about 8-10 minutes.
The Levulan is absorbed by
active cells like acne sebaceous gland, making the targeted acne cells
more sensitive to the light. This combined interaction of the solution
and the light is what gives rise to the term “photodynamic therapy.” The
Levulan will also target sebaceous hyperplasia (which are those small
(1-3 mm), begin bumps under your skin) and the papules of acne rosacea.
The treatment reduces skin
oiliness and minimizes the appearance of pore size. The entire skin
texture improves following a Photodynamic Acne Treatment.
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Removing pre- cancerous
actinic keratoses
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Preventing skin cancer
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Improving wrinkles
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Reducing pore size
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Improving skin texture
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Improving pigmentation
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Treating moderate to
severe cystic acne
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Treating sebaceous
hyperplasia
How much improvement can I expect?
Patients with severe sun
damaged skin manifested by actinic keratosis, texture, and tone changes
including mottled pigmentation and skin laxity may see excellent
results. You may also see improvements of large pores and pitted acne
scars. Active acne can improve dramatically.
How many treatments will it take
to see the “best results?”
To achieve maximum
improvement of pre-cancerous (actinic keratoses) sun damage, skin tone
and texture, a series of three treatments 2-4 weeks apart is the most
effective. Some patients with only actinic keratoses are happy with just
one treatment. More treatments can be done at periodic intervals in the
future to maintain the rejuvenated appearance of the skin.
What are the advantages?
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Easier for patients than
repeated topical liquid nitrogen, Efudex (5fu), or Aldara because the
side effects are minimal, rapid healing, and only 1-3 treatments
required.
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The ALA/PDT treatment at
our clinic is PAINLESS versus liquid nitrogen, d-FU, and Aldera.
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Reduced Scarring and
improved cosmetic outcome compared with cautery, surgery and Efudex.
Liquid Nitrogen can leave white shots of you skin.
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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.
Following PDT, the treated
areas can appear red with some peeling for 2-7 days. Some patients have
and exuberant response to PDT, and experience marked redness of their
skin. Temporary swelling of the lips and around your eyes can occur for
a few days. Darker pigmented patches called liver spots can become
temporarily darker and then peel off leaving normal skin. (This usually
occurs over seven to ten days). Repeat treatments may be necessary as
PDT medicine is not an exact science.
Acne Treatment with BLU-U
A special BLU-U blue light
treatment that destroys acne bacteria is an option which doesn’t depend
on medication. The special blue light kills the acne bacteria in your
skin. You will cleanse your skin and protect your eyes with special
glasses provided by the staff. You are then placed in front of a light
for a short time. Optimal results will be achieved if you follow the
twice a week schedule of blue light treatments. After several weeks you
will see improvement.
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