I have tried blue light treatments with ALA applied 1 hour prior. There was improvement on sebaceous hyperplasia, but no lasting result. Freezing didn't work at all. Any suggestions? How many light treatments are safe, and how closely spaced is okay? Is once a week, for say 4 weeks, okay? Thanks!
Blue Light Therapy for Sebaceous Hyperplasia?
Doctor Answers 4
Improved protocols for Sebaceous Hyperplasia
Sebaceous Hyperplasia is a stubborn condition that a few of our staff members have been dealing with. We currently use a combination laser treatment plan with the pulsed dye laser and the erbium glass laser. Unfortunately, as many as 8 or more treatments are required for optimal results. We also have used Levulan (aminolevulinic acid with photodynamic therapy) with fair results until we started incubating for a much longer period of time, activated with a puseld dye laser and then followed by a quick quenching with the Blu-U light. The slight change in our incubation period led to a much better, predictable outcome.
To answer the question posed -- we find that performing ALA/PDT (aminolevulinic acid with Photodynamic Therapy) every 2 weeks for a series of 3 treatments is a good treatment plan for most. We suggest that you speak with your practitioner about extending the incubation period well beyond the one hour.
Much better and Cheaper treatments than that
While there is some evidence in the dermatology literature that PDT (photodynamic therapy) works, there are much more effective and cheaper alternatives. The pulsed dye laser is actually considerably more effective for the treatment of sebaceous gland hyperplasia. ( Incidentally, there are only two glands in the male which enlarge as we get older, the prostate gland and the sebaceous gland!). We have a Blu-light, IPL blue and red lights but I have never felt the need to use them for tthese growths since the methods I mention below nearly always work.
I find that 85% TCA (Trichloracetic acid) is very effective. The acid destroys the sebum and the sebaceous cells, while the collagen protein resists the acid. The charge is minimal compared to lasers. We charge $60 for the procedure if a patient presents for treatment of this problem and no charge if the patient consults us for something else.
Gentle cautery is also quite effective and rarely leaves a scar.
Cryotherapy is also used but I have not found this to be particularly useful.
If these do not work it is time for the pulsed dye laser.
I have not found ALA with blue light effective for sebaceous hyperplasia. I feel very superficial electro-cautery gets great results. It is not a cure and the lesions will continue to grow, but it is an effective way of keeping them flat and its not expensive.
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Treatment of oily skin and rosacea with pulse dye laser
In my practice, I treat sebaceous gland hyperplasia with a combination of chemical peels and pulse dye laser. This works effectively and is cost effective for patients. Blue light does not provide satsifactory results in a meaningful period of time.
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