
Acne is a genetic, hormonal disease characterized by overproduction of oil by the sebaceous glands, plugging of the sebaceous glands to form micro- and macro-comedones (blackheads) and, finally, action of skin bacteria on oil trapped underneath the skin, to produce red inflammatory cystic lesions.
We treat acne patients with photodynamic therapy, where a aminolevulinic acid HCL that is activated by light is first applied to the skin. After a certain period, the drug is then washed off and the skin is exposed to light. That light energy causes the release of singlet oxygen molecules, which have the biologic effect of killing the bacteria responsible for acne. The light also seems to cause involution of the sebaceous glands. Treatment involves a several-step process, completed in the office.
First, the skin is scrubbed off with acetone and then Levulan is applied to the skin. After a thirty minute waiting period, the Levulan is washed off and the skin is exposed to a light source. The skin is then carefully washed after the treatment.
It is important to guard against sun exposure for forty-eight hours after the treatment as some of the photodynamic agent may still be in the skin. Some patients notice skin irritation for twenty-four to seventy-two hours while most patients experience minimal discomfort.
There have been some patients who have an excellent response to single treatments and others need a series of treatments. Generally, we recommend treatment every other week for a total of four to five treatments.
The doctor may make one of several recommendations about diet modifications and the use of cleansing products. Photodynamic therapy represents a new modality of treating acne, which seems to be well-tolerated by a majority of patients. It may, in fact, become the best treatment for mild to moderate, or even severe, acne and eliminates the fear of toxicity that may be occurring when using certain, traditional medications often prescribed for acne