Photo Dynamic Therapy

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.

Photodynamic Acne Treatment (PDT)is a process by which a photo sensitizing agent (Levulan) is applied to your skin. A Photo sensitizing 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 severe cystic acne. In many cases, several or all of these levels of acne can be present on an individual simultaneously.

Different Levels of Acne

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 negative 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 (1-3mm), 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 of PDT

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 of PDT

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.

Acne Skin Care

Keeping the skin clean is an important part of acne treatment. There are special acne skin care cleansers that are designed for acne-prone skin. These come in varieties suited to different skin types such as dry or oily. Before choosing a skin care product you must first determine the type of skin you have. Many people have combination skin. This means that you have some oily areas and some dry areas. Oily areas on the face are usually in the middle strip and forehead, commonly called the "T-zone" because it is shaped like the letter T.

Over-the-counter formulas usually contain ingredients to help control the amount of oil on the skin, to normalize the amount of skin cells that are shed and kill the bacteria associated with acne. These products often cure mild to moderate acne when used properly.

Antibacterial products - Antibacterial face soaps or skin washes are designed to kill bacteria on the skin surface. The most common ingredient in these formulas is Triclosan. This is the mildest ingredient and is helpful for mild acne or as a preventative measure.

Benzoyl peroxide - Products that contain benzoyl peroxide work by killing the bacteria that can cause acne to spread. It is most effective on pimples. This treatment comes in various strengths from 2.5% to 10% solution. For mild acne choose the lowest strength possible. The strongest solution should only be used on body acne as it is too harsh for delicate skin on the face. This product does not unplug clogged pores. When washing with the liquid work it into a lather and let it sit on the affected areas for a minute or two. Then rinse with warm water. Always pat dry the areas instead of rubbing vigorously.

Salicylic acid - This common ingredient works to loosen clogged pores and helps to prevent pimples from forming. It also helps to lower the amount of dead skin cells that are shed so that less loose cells are available to form a clog. It does not kill bacteria that can cause acne. It does not affect production of oil in the skin so once you stop using it acne may begin to appear again.

Tea Tree Oil - This is a popular natural cure for acne that is found in skin cleansers. It can help to kill bacteria on the skin, leading to a reduction in acne. It can be found in health food stores.

Sulfur - Sulfur is a natural antiseptic. It is often found in soaps that are designed to reduce acne. The antiseptic properties can prevent bacteria from growing. It can, however, be drying to the skin.

The best way to fight acne is with a regular skin care regime. No matter what product you use you will need to use it faithfully for a while. Most products take several weeks or longer to work with acne. You may find that some products cause skin irritation. This is because many of them contain harsh ingredients. Always opt for the acne skin cleanser that contains the least amount of active ingredient so that your skin will not become red or irritated. See a dermatologist if your acne does not improve or worsens.

The Causes And Treatments For Back Acne

Back acne is a common skin condition that affects almost everyone at sometime in his or her life. Acne is often thought of as appearing only on the face, however it is often on other parts of the body including the chest, arms, neck and back. Aside from the face, the back is the most common area to have an outbreak of acne.

Acne happens when the hair follicles or pores become clogged. This can happen when the glands under the pores secrete excess oil. Additionally, the skin is always growing new skin and dead skin is removed through the pores. A combination of excess oil along with too many dead skin cells can plug the pores causing acne.

There are also many factors that contribute to acne. Perspiration may cause acne on the body, particularly on the back. Sweat that is allowed to sit on the body for periods of time mix with the oils to form clogs of the pores. People often get sweaty backs when they sit in a hot chair for a long time, such as when driving.

Always take a shower after heavy sweating. Wear loose fitting, cotton shirts to allow the skin to breathe better. Cotton and other natural fibers help to wick perspiration away from the body. Avoid synthetic shirt fabrics such as nylon. Carrying a backpack can contribute to acne on the back by causing friction and sweat. Use another type of pack or carry the backpack until your acne clears up. Sporting clothing or equipment can also cause an acne breakout on your back. Wear clean clothes and avoid using tight fitting pads.

Getting rid of acne on your back may be difficult because you can't see or sometimes reach certain areas. Many over-the-counter acne treatments work very well on the back. Start with an acne cleanser. Use a small amount and work it into lather. Wet your back and apply the suds. Let it sit for several minutes before washing off. Use the acne cleanser daily on only your back or any other areas that have acne. After showering, dry your back thoroughly but gently.

Products that contain benzoyl peroxide help reduce acne by killing bacteria on the skin. These come in varying strengths based on the severity of your acne. The back is made of tougher skin than the face and can therefore tolerate stronger solutions. Try using a strong 10% solution. Apply to the affected areas on your back. Apply only to dry skin. Let the product soak in or dry before putting on a shirt.

Another common product in over the counter treatments is salicylic acid. These products help to loosen clogged pores and prevent new clogs from occurring. Often you may need to use a combination of treatments to help cure acne. Remember that most medications take several weeks or more to work so be patient. If your back acne persists or worsens, even after topical treatments, you should see a dermatologist. He can help determine the best course of action. He can prescribe stronger topical creams as well as oral treatments that can help clear your acne.

Tetracycline and Pimples

Tetracycline and pimples are a common combination because tetracycline is the most prescribed antibiotic to treat acne. It can be taken orally or applied as a cream.

Before a doctor prescribes you tetracycline, he will ask about your allergies and advise as to the pros and cons of using an antibiotic like tetracycline.

If tetracycline is prescribed for you, it is important to let the doctor know if you are taking any other medication or applying any other creams to help your acne because they may potentially react with tetracycline causing your pimples to get worse.

Even if your acne starts to clear up within a few days of using tetracycline, you must continue and complete the entire treatment cycle. Otherwise, your acne may return. Be aweare that it may take 4 - 6 weeks before an improvement is seen. If there is no improvement, or the condition gets any worse in this time period, then it's time for another visit to your doctor and he may change your antibiotic prescription.