Hard-to-treat acne can require "power-level"
treatments. A new procedure that treats resistant, hard-to-treat active
acne 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. The procedure is called Photo Dynamic Therapy.
Dr. Pilest is a pioneer in the use of
Photodynamic Therapy and his patients show consistent major improvements.
3 PDT with Vbeam and Clearlight Results may vary
Photodynamic
Acne Treatment (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.
Levulan is a 20% solution of
Aminolevulinic Acid (ALA). ALA is a “natural” product found in all
humans throughout the body. Its 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 severecystic acne. In many cases, several
or all of these levels of 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 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.
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. An Acne Story
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.
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. Alternate treatmenst may use Omnilux Red Light which drives the Levulan deeper into the acne blemish.
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
(1-3mm), benign bumps under your skin) and the papules of
acne rosacea.
An important part of the treatment program is medical extraction of blackheads and acne pustules. This procedure will expedite the improvement in your skin condition by cleaning the pores of hardened sebum and infected debris.
The treatment reduces skin
oiliness and minimizes the appearance of pore size. The entire
skin texture improves following a Photodynamic Acne Treatment.
Advantages The advantages
of PDT are rapid treatment of acne lesions all over the face, no scarring,
no surgical excisions and no systemic side effects. The skin appears
refreshed and younger following these treatments. We advise 2-3 treatments
at 2 to 3 week intervals to obtain optimal results.
Downside
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. Pressed mineral base powder (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.
What is Photodynamic
Therapy? (PDT)
It is a special treatment performed with a topical
photosensitizing agent called Levuan (ALA activated with the correct
wavelength of light. This is known as “ALA/PDT treatment.”) These
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.
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?
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.
The ALA/PDT treatment
at our clinic is less painful versus liquid nitrogen, d-FU, and Aldara.
Reduced Scarring
and improved cosmetic outcome compared with cautery, surgery, and
Efudex. Liquid Nitrogen can leave white shots of your skin.
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.
What are the
disadvantages?
Following PDT, the treated areas can appear
red with some peeling for 2-7 days. Some patients have an 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.
In summary, PDT
matches the “ideal treatment” for photodamaged skin:
-
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).
Would you like
a call back from our Information Specialist about these or other
procedures?
You are invited to receive our monthly email newsletters. Learning
to care for and treat your skin is more effective when you have an
understanding of what the treatments are and how they can benefit
you.
