Cosmetic Dermatology

PDT Acne Care

What is Photodynamic Therapy?

Photodynamic therapy (PDT) is a non-invasive therapy that utilizes light treatments in combination with the application of the photosensitizing agent, typically a medicine called Levulan® (5-aminolevulinic acid).

First, the photosensitizing agent is applied to the skin, causing the skin to become more receptive to an activating light source. After the photosensitizing agent is applied a light treatment is administered. PDT was originally approved by the U.S. Food and Drug administration for the treatment of skin pre-cancers, but it has also been shown to be a safe and effective treatment for acne.

How does Photodynamic Therapy work in acne patients?

PDT is thought to treat acne by two primary mechanisms. First, it shrinks the skin’s oil glands (sebaceous glands) that contribute to acne formation. This can drastically reduce the amount of oil within the pores, thereby reducing comedones (blackheads and whiteheads). Second, PDT also kills the bacteria (Propionibacterium acnes) that live on facial skin and cause acne breakouts. In addition, PDT seems to improve the skin’s overall texture, and may speed the resolution of acne-induced discoloration (red or dark spots that remain after the pimples have resolved).

Is there evidence to support the safety and efficacy of PDT for acne?

There have been over 21 clinical studies evaluating PDT for the treatment of acne. These studies demonstrated that PDT is a safe and effective treatment for patients with acne.

Can you describe a treatment session?

First, excess dead cells on the skin’s surface are removed using an acetone scrub. This enhances the penetration of the photosensitizing agent. Next, the photosensitizing agent (Levulan) is applied to the skin and allowed to incubate for a period of 15 to 60 minutes. The skin is then treated with light for about 15 minutes to activate the Levulan. Many patients report feeling moderate warmth during the procedure but most do not feel any pain. Patients must avoid sun exposure for 2 days after the treatment.

How many treatments are required?

A series of 3 to 6 treatments are usually performed at 2 to 4 week intervals. The number of treatments recommended depends on the severity of acne. Some patients may notice results after the first treatment.

What kind of results can I expect?

The majority of patients report significant improvements ranging from a 50% to 75% reduction in acne lesions after a few treatments. However, a small amount of patients show only modest improvements and results vary for each individual patient.  For some patients the results can be permanent, others require touch-up treatments a few times a year. Some patients do not respond well to this treatment so other modalities are needed. While results are not guaranteed, the majority of patients are very satisfied with treatment.

What are the side effects?

The side effects of PDT may include redness and/or peeling of the treatment site. Patients have described it as being similar to sunburn. It is generally mild and resolves in 1 to 8 days.

Conclusions

Photodynamic Therapy is an exciting treatment for acne that has been well studied and benefits the majority of patients who undergo treatment. It is a great addition to our armamentarium against acne and may be particularly helpful to those who have unsuccessfully tried several therapies and are looking for something new. It is also a good treatment for those who are looking for a “jump start” to their existing acne treatment regimen.


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