A new procedure is now available that treats active acne as well
as older acne scars leaving your skin smoother. The procedure is
called Photodynamic Acne Treatment using Levulan.
Photodynamic Acne Treatment
is a process by which a photosensitizing agent (Levulan) is applied
to your skin. The Levulan is then activated
with a specific wavelength of light, which “turns it on.” Levulan
has been used extensively for the treatment of a variety of different
skin conditions, and it is approved by the FDA and Health and Welfare
Canada for the treatment of sun damaged skin.
Levulan is a 20% solution
of Aminolevulinic Acid (ALA). ALA is a natural substance found
throughout your body, as it is a precursor
for hemoglobin synthesis. You would be unable to make a red blood
cell carry oxygen without ALA in your body. Consequently, it is
a “natural” product found in all humans.
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 several different presentations of acne ranging from
comedonal (blackheads and whiteheads), popular, pustular, and cystic
acne. In many cases, many of these presentations of acne can be
present on an individual simultaneously.
Prior to Photodynamic Acne Treatment, the best available treatment
option for 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. PDT Acne treatment provides a viable alternative
for all types of acne treatment.
Photodynamic Acne Treatment is done as follows: The Levulan is
applied to your skin and left on for 30-60 minutes. Levulan is
a clear solution and painless. Levulan is then activated with a
specific wavelength of light. This takes about 8 minutes. The Levulan
targets active cells. Acne sebaceous glands are active cells. These
cells preferentially absorb Levulan, and these cells are targeted
by the Levulan once it is activated; hence the term, photodynamic
therapy. The Levulan will also target sebaceous hyperplasia (which
are those small (1-3 mm), benign, bumps on your skin) and the papules
of acne rosacea. Skin oiliness is decreased, and the appearance
of pores is minimized. The entire skin texture improves following
a Photodynamic Acne Treatment.
The “downside” of
Photodynamic treatment (PDT) is that you 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. Liquid mineral base (available
in our office) will hide most of the redness. We advise remaining
indoors the day following your treatment to avoid sun exposure,
as you are photosensitive for about 24 hours after PDT.
The advantages of PDT are rapid treatment of acne lesions all
over the face without scarring or surgical excision. The skin appears
refreshed and younger following these treatments. We advise 2-3
treatments at 2-3 week intervals to obtain optimal results. There
are no systemic side effects.
These ALA treatments
can be combined with our regular Photorejuvenation treatments
using IPL, which targets redness and brown spots, as
well as stimulates formation of more collagen in the skin. There
is normally no downtime for IPL treatments without Levulan. However,
one can enhance and “boost” IPL photorejuvenation results
by adding Levulan to the treatment process. This is termed an activated
Fotofacial, or photodynamic skin rejuvenation when PDT is added
to regular IPL photorejuvenation.
Naturally, you can use your topical acne lotions in between your
Levulan treatments once the redness has settled down after a few
days.
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