I have tried a few treatments for my acne and rosacea but nothing has worked very well so far and someone in an acne chatroom I go to suggested I try photodynamic therapy with amnio...something acid. First of all, what the -bleep- is it? I've heard of Photodynamic therapy but not the acid treatment. Also, has this been known to be a good treatment for acne and/or rosacea? Thanks,
Is Photodynamic Therapy a Good Acne and Rosacea Treatment?
Doctor Answers (8)
PDT Helps Acne
Photodynamic therapy involves the pre-treatment with 8 aminolevulinic acid ( Levulan) before light treatment with the Blu-light or an equivalent light source. In other words the Levulan kerastick is applied to the intended area, there is an incuatiion period of one half hour and then a light treatment of approximately 16 minutes.
This has proven to be an excellent treatment for actinic keratosis. Typically, I use this in severe cases of actinic keratoses: either numerous actinic keratoses or actinic keratoses that are nearly becoming malignant ( squamous cell carcinomas).
This is an FDA approved treatment and is covered by insurance.
It is also being used for hidradenitis suppuritiva ( a condition of cysts in areas of apocrine glands such as the groin, armpits, breasts and curiously ears), psoriasis and even warts. Of course, these uses are off-label.
PDT is also used for photorejuvenation. Its effect is probably to a series of microdermabrasions, but since the cost is $180, this is less expensive and far more convenient ( one or two treatments opposed to six).
Now, for its use in acne. This works in a rather subtle manner. The bacteria that is incriminated as playing a villain role in acne ( though in actuality an otherwise harmless sort, P. acnes) produces a chemical called porphyins. The blue light is attracted to these porphyrins and zaps not only the porphyrins but the nearby bacteria. The 8 amino-levulinic acid is absorbed into the porphyrins and gives the blue light an extra punch. PDT used in this manner is about as effective as a good antibiotic. The kerastick costs about $104 ( though I think the company..DUSA.. recently raised their prices..so much for deflation) and the light treatment itself runs another $85.
I hope this explains PDT therapy.
Photodynamic therapy for acne and rosacea
Photodynamic therapy uses a medication called Levulan (aminolevulinic acid) and a light source such as red or blue light to activate the medication. Activation of the medication with intense pulsed light or pulsed dye laser treats the redness and veins of rosacea as well as acne. You should be assessed and treated by a board certified dermatologist.
PDT for acne and rosacea
PDT for acne is great – it works really well and seems to have lasting effects in many. It can also help with rosacea, and depending on the light source used, can also help with the redness.
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Photodynamtic therapy for acne
PDT works very well for acne. Alternating red and blue light for a series of 8 treatments over 4 weeks is effective even without Levulan. Topical retinoids and salicylic acid can be helpful in conjunction with this regimen. A series of 8 treatments over 4 weeks tends to cost between $500-800. Best results are achieves several weeks after the series of treatments.
Photodynamic Therapy PDT Can be Efficacious for Acne
While there is nothing that works better than Accutane, a series of PDT under the supervision of an experienced board-certified dermatologist can be a close second when combined with conventional therapies, e.g. oral/topical antibiotics, hormonal medication, topical acne creams. Photodynamic therapy otherwise known as PDT utilizes Levulan (levulinic acid, a naturally occurring breakdown compound of hemoglobin, part of red blood cells) and Blue light (~410nm wavelength). The effect of Blue light on acne is quite modest but gets potentiated substantially when preceded by application of Levulan. PDT involves 2 protocols, i.e. incubation time (duration of Levulan left on the skin) and exposure time (duration patient spends in front of a Blue light source). An experienced clinician can expertly manipulate PDT protocols to maximize clinical benefits while minimizing downtime. Staying away from bright light sources, e.g. sunlight, bright indoor lighting, computer screen, would be advisable for the first 48 hours. It is thought that PDT makes acne prone skin better by helping to shrink oil glands, minimizing colonies of bacteria responsible for acne and thereby making conventional acne therapy work even better.
Photodynamic Therapy and Blu Light for Rosacea
The only approved FDA indication for Blu Light is for the treatment of Acne WITHOUT levulan. However, most dermatologists, if using blu light to treat acne will do so with the addition of levulan. It is felt that the levulan which is photoactivated by the Blu light results in better treatment of acne than Blu light without levulan. Either way in my experience the results are equivocal. Blu light for rosacea though not an FDA indicated use has been used by many dermatologists. There are mixed reports of its success.
Generally, if other treatments have failed for acne or rosacea, blue light and levulan can be tried with the understanding that it may not work and it is an off label use of an approved treatment.
Photodynamic Therapy for acne
I have seen this treatment work well for acne and we use a system that employs Levulan and a special light (Called a Blu Light).
The Levulan is absorbed by the skin and then activated by the light. This results in a significant decrease in bacteria and oil.
Treatments are spaced out a month apart and require 2-3 to make a difference.
Expect to be very red (imagine the worst sunburn of your life) for about a week.
There is another drug calle Metvix out but I have no experience with it so can not provide any guidance with it and until it is out for a while, would stick with Blu Light and Levulan
Photodynamic therapy is great for acne
PDT is a great treatment for acne and usually takes 4 treatments at 2 weeks apart at a cost of $350 per treatment. Levulan solution is applied to the skin for 45 minutes then a Blu U light is applied for 15-20 minutes. It is totally painless and very effective. You do look quite red for 2-3 days but it is so worth it.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.