Acne |
An Overview of Acne
Acne is a fact of life for many adolescents. Approximately 90% of all teenagers and 25% of all adults experience acne at some point in their lives. In adolescents, acne breakouts are related to the body’s natural release of male hormones, called androgens, which occur during puberty. In adult women, acne is often related to the monthly menstrual cycle. Contrary to popular belief, acne is not caused by eating chocolate, greasy foods or bad hygiene.
How Does Acne Form?
Acne results from the obstruction and inflammation of the sebaceous glands, and affects 80% of the human population. Acne begins usually in adolescence, when hormonal changes cause sebaceous glands to enlarge, and then become blocked. The obstruction of the gland openings causes sebum to accumulate, which allows acne-causing bacteria to grow. This results in painful, inflammatory pustules and cysts, which can result in permanent scarring. Although there are many available treatments for acne, some patients may not respond, or may develop side effects.
What are the Standard Treatments?
In the United States, over one billion dollars is spent on acne medications and treatments each year. In many cases, the money spent is not effective, or causes side effects. Standard treatments include non-prescription cleansers and creams, prescription antibiotics, retinoids (such as Retin-A), hormonal therapies, and Accutane. Topical acne medications may irritate the skin, and oral antibiotics may cause stomach upset, or interfere with birth control pills in women. Even worse is the fact that more than 40% of acne bacteria are resistant to oral antibiotics. Accutane therapy, while very effective in reducing sebaceous gland activity, is associated with other side effects. Accutaneis also extremely costly, and requires approximately 5 months of therapy. Often repeat treatments are necessary.
But now there is a NEW treatment-Photodynamic Therapy, enhanced by ALA-PDT.
What is Photodynamic Therapy?
Photodynamic Acne Treatment, also called Photodynamic Therapy or PDT, is a new procedure that treats acne, unresponsive to other treatments. It is known that Propionibacterium acne, the bacteria that causes acne, produces porphyrins as part of its normal life cycle and metabolism. Visible light in the blue range, or to a less extent in the red range, destroys P. acne, and may explain why acne improves during the summer. A high-intensity blue-violet light or laser activates porphyrins in the sebaceous gland. Theseporphyrins start a chemical reaction that produces peroxide, which destroys the P. acnes bacteria. PDT, used alone, is effective for mild to moderate acne. Light treatments, enhanced with Levulan ALA, are very effective for treating severe or cystic acne.
What is PhotoDynamic Therapy (PDT), enhanced with ALA? How does it work?
For severe acne, PDT (PhotoDynamic light Therapy) is combined with Levulan. Levulan is a special light-activated, topical photosensitizing agent. It is a clear, dilute solution of Aminolevulinic Acid (ALA), which a natural product found in all humans throughout the body.
The Levulan (which is made up of ALA) is applied to the skin and left on for 15-60 minutes. ALA is absorbed by the sebaceous gland, which is where the acne problem originates. Laser light of a specific wavelength activates ALA to reduce the size and activity of the sebaceous oil gland, and increases the destruction of the bacteria in the sebaceous gland. ALA-PDT also causes collagen rejuvenation which decreases pore size! The treatment target and destroy acne activity, leaving your skin smoother, and in many cases makes it possible to discontinue the use of antibiotics and Accutane, which have certain side-effects that ALA/PDT does not.
How is a treatment done?
The face is first washed with soap and water, and then gently scrubbed down with Acetone. For severe acne, a mild Erbium YAG resurfacing is done prior to application of the ALA. ALA is then painted on the entire face and the patient sits for 30 minutes while the ALA incubates. Longer incubation is used for subsequent visits. The ALA is then washed off and the patient has the laser used to treat the ALA covered areas. Sunscreen is applied and the patient is told to “AVOID EXPOSURE TO THE SUN FOR 48 HOURS!”
What side-effects can I expect?
Some patients report stinging or mild burning while the laser treatment is being done, but this lasts approximately 5 minutes. Swelling and temporary redness may be experienced immediately following the laser light treatment.
It is extremely important to be out of the sun and even indoor bright light for 2 days after the procedure. 95% of the clients have no problems with minimal and tolerable redness and peeling. Less than 5% experience 24 hours of discomfort. Stinging can be decreased by using fans and cold packs.
Is sunscreen sufficient to avoid exposure to light?
No. After the treatment patients must stay out of strong, direct light for 48 hours. You must stay indoors as much as possible. When outdoors, patients should wear protective clothing and wide brimmed hats to avoid sunlight. Beaches, snow, and bodies of water where strong light may be reflected should also be avoided.
How many treatments are required?
The ALA-PDT/laser light treatments usually require 3 treatments with 3 weeks between each treatment.
How effective is ALA-PDT laser-light treatments?
The treatments are very effective providing long lasting results. Results are especially impressive when compared with conventional treatments, such as prescription creams and oral antibiotics. ALA-PDT/laser light treatments are providing similar results to Accutane without the systemic side effects. Most patients who receive treatment said they would use it again.
Are the results from ALA-PDT permanent?
ALA-PDT treatments usually help control acne breakouts for 4 to 16 months; after that, and occasional touch up may be necessary. Many clients are able to control their acne with topical after initial ALA treatments and usually do not require future ALA maintenance.
Is ALA-PDT Therapy useful for other conditions?
Many people can befit from this treatment. ALA-PDT is also very effective for other conditions, in addition to severe inflammatory and cystic acne. It can treat pre-cancerous skin conditions (actinic keratoses), rosacea, enlarged sebaceous glands, sun damaged skin, increased pigmentation, blotchy skin, and fine lines and wrinkles. It is even effective for decreasing pore size, shrinking oil glands, and reducing oily skin.
What are other benefits of ALA-PDT/laser light treatments?
- It improves skin clarity more than photo-rejuvenation alone. The skin is bright, it shines and looks newer.
- ALA-PDT shrinks pores, and reduces oily skin!
- Lastly, it rids the skin of pre-cancerous cells, and gives a health/wellness benefit that cosmetic procedures usually don’t offer.
LOOK BETTER, DECREASE OILY SKIN, SHRINK PORES and PREVENT SKIN CANCERS!
