Laser Acne Treatment
Doctor Answers 8
Photo Dynamic Therapy (PDT)
I have been extremely impressed with the results of PDT for acne. Patients are pre-treated with a topical medication stick called Levulan, and then undergo IPL or blue light therapy. The results are amazing. Good luck.
Solutions to Acne utilizing Lasers
Topical creams and oral medications can be effective treatments for acne outbreaks, but they can be expensive and can dry and irritate sensitive skin.
Treating acne with pulsed light can deliver better aesthetic results, especially on inflammatory acne, without the side effects associated with topical and oral acne medications. You can also treat scars resulting from acne outbreaks with fractional laser skin resurfacing.
Acne IPL treatments target and destroy the skin bacteria responsible for acne to help prevent future breakouts from occurring on faces, chests and backs. It is important for you to know that it could take anywhere from 4 to 6 treatments.
Acne requires a multi-modality approach to treat
There are many different lasers which can be used to treat acne. The question is, are you treating active acne or scarring from acne? The lasers used for each are different. as many doctors have pointed out, photodynamic therapy (PDT), with or without a sensitizing agent, is good for active acne treatment. For acne scars, resurfacing lasers, mostly carbon dioxide, are useful for resurfacing. In either case, patients are always warned that treatment will never return a smooth skin surface but will improve things and multiple treatments will likely be needed.
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I need help with Acne!
In our practice, we take a step-wise approach to the management of acne. Initial management involves education and basic skin care recommendations tailored to the individual's skin type.
After a few weeks on the prescribed acne fighting skin care program, a retin-A containing product is added if necessary, and blue light therapy sessions scheduled. The bright blue light used is highly effective at killing the acne causing bacteria, but because these bacteria will eventually repopulate your skin, it is important that this treatment be repeated periodically.
For those with resistant acne, we have found photodynamic therapy, in which ALA (amino-levulanic acid, or Levulan) is first applied and then the face is treated with the blue light, to be very successful. This treatment is very simple, does not require anesthesia, is very affordable, and as mentioned, is highly effective.
Once the acne is cleared, recommendations would be made in order to maintain the lovely clear skin you have achieved.
Find someone in your area who offers this full range of treatments and discuss your options with them.
Good luck- I hope you get the skin you dream of soon!
Zapping acne from face with Lasers
There are several ways to treat active acne with laser and light based treatments. Below we detail different options and the method of action:
- Blu light treatments (kills acne bacteria)
- Pulsed Dye laser treatments (kills acne bacteria)
- Q-switched laser treatments (kills acne bacteria)
- Aramis laser treatments (shrinks sebaceous glands)
- Smoothbeam laser treatments (shrinks sebaceous glands)
- Photodynamic therapy with amino levulanic acid (shrinks sebaceous glands)
We often use a combination of these lasers and treatments for best results as not everyone responds to the different treatments.
Laser and IPL
There are two main light-based modalities for treating acne: IPL using the so-called blue spectrum, with or without Levulan and laser.
With PDT, photodynamic therapy, a liquid is applied with a special stick ( 8 -amino-levulinic acid,) Levulan, with a "kerastick". The patient then waits for 30 minutes and is then placed in front of a Blu-U light machine. Those who do not have a Blu-U light might use the IPL device.
The blue light does not contain the ultraviolet light which teenagers may have been exposed to in the 60's and 70's. UV light (used of course in psoriasis, eczema and a host of skin diseases) can damage the skin. Studies in the dermatology literature have shown that using the Blue light alone many patients see noticeable improvement with about 55% clearance.
Side effects to the blue light alone are mild and include temporary pigment changes, edema (swelling) around the treated areas and dryness.
Combining the blue light with Levulan ( PDT ) yields significantly more promising results. However, studies with this modality are more limited.
We have this device in our office and we do utilize it. While I think it is quite effective, and a useful weapon in our fight against acne, I would have to temper Dr. Persky's enthusiasm and say I have found it about as effective as a good antibiotic. In fact, that is one of its advantages: it helps fight acne without the use of an antibiotic. The cost is not by any means exorbitant, $180 with the kerastick and $80 without. Usually, two treatments are required, some dermatologists are recommending more such as eight sessions in a four seek period.
Side effects to the PDT are similar to the Blue light alone with the addition of a sunburn reaction. If you undergo PDT treatment it is important to use a top of the line sunscreen with a high SPF for at least two days.
PDT therapy works in an interesting manner. The bacteria that causes acne, P. acnes emits a chemical called porphyrins. The Levulan which is applied is attracted to the porphyrins and the porphyrins soak it up. Then the light uses the combination as a chromophore, a color to which it is attracted. The beam, attracted to the porphyrins-Levulan, then kills the nearby bacteria.
Lasers, notably the pulsed dye laser, the nd YAG laser and Diode laser work in an entirely different, and much less sophisticated mechanism. The laser basically damages the sebaceous (oil) glands. The oil glands then produce less sebum and acne improves. For fencing afficionados, it is the difference between epee and sabre. Laser is quite a bit more expensive and runs about $300 a treatment.
Two studies examined the pulsed dye laser with mixed results. A British study showed a 53% reduction in lesions and an American study did not find any improvement at all.
Using the diode laser, an American study showed a 58% decrease in lesions after two treatments, improving to an 83% improvement in three treatments.
A recent study using the ndYag laser was somewhat more promising.
A more recent treatment called Isolaz ( and gosh my FAX machine is constantly running out of paper due to this company) employs a broad band light ( BBL) of 400-500 nm with concurrent suction. This photoneumatic therapy was originally developed for hair reduction. The suction was to reduce the associated discomfort. Patients noticed their acne flared once this treatment was stopped.
The company proposes that the pneumatic energy leads to the sebaceous glands coming closer to the surface making the delivery of light more effective. Multiple treatments are required.
Obviously, these light devices are not the first choice in acne treatment but they are proving to be a valuable adjunct to more traditional treatment. They may be a first choice in treatment under certain circumstances. For instance, in a woman who is actively trying to become pregnant or if you have failed topical treatment and for whatever reason refuse systemic treatment. Of course, if you have failed systemic treatment light sources would be a valuable approach. For the rare patient who fails Accutane (for me it's been one in 28 years) or the patient who responds to Accutane, but whose cystic acne recurs repeatedly, PDT or the laser is a far safer than the alternatives of pulsing steroids or oral Dapsone.
You should be aware that nearly all insurance plans classify light and laser treatments as "experimental" or an "emerging technology" and generally does not cover such treatment.
Acne Treatment with laser
Light treatment also works well for patients already on a full acne regimen to help speed up results.
EFFECTIVE Laser Treatment for Acne
After having assured that you are properly cleaning your face, there IS effective treatment for Acne. If it is active acne, BLUE LIGHT therapy (IPL) is VERY effective at killing the skin bacteria causing acne. If you are inquiring about how to smooth acne scarring, these can be resurfaced with a variety of lasers. the most effective is the SCITON JOULE CONTOUR.
Dr. P. Aldea
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.