Does PDT (Photodynamic Therapy) Work on Back Acne?

I am a 30 year old male. I have had acne on my back and face ever since I can remember. Although face acne has cleared out a lot after I turned 22, back acne still persists. I tried taking oral antibiotics but they severely messed up my stomach. Does PDT (Photodynamic Therapy) work on back acne??

Doctor Answers 7

Photodynamic therapy for acne

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Photodynamic therapy (PDT) is FDA approved to treat actinic keratoses, or pre-cancers.  Dermatologists use the treatment off-label (not FDA approved) to treat acne.  It is a safe and effective treatment.  A chemical called levulan is applied to the area to be treated and sits on the skin for a certain amount of time.  The skin is then exposed to blue light in the office.  Following the treatment, there may be pain, swelling, and temporary worsening of the acne.  Sunlight must be avoided for 72 hours following the treatment.  Several sessions are required for best results. 

Aventura Dermatologist

PDT for acne

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PDT treatments for acne are all considered 'off label use' hence are not FDA approved nor covered by insurance.  All that being said, the levulinic acids used in the topical medication applied prior to light exposure are strongly absorbed by sebaceous glands, where acne occurs.  By shutting down these oil glands, the entire acne process will diminsh or stop..You need several treatments spaced at least 2 weeks apart.  Be prepared for some tenderness, swelling and light sensitivity to the treated areas.  All ALAs work, but right now the choices are Kerastick, Metvix and Allumera.  My personal preference for moderate severe acne, where even Accutane could be a choice is Metvix follwed by exposure to Red Diode Light rather than Blue Light.  Good luck!

Steven Swengel, MD
Los Gatos Dermatologic Surgeon
5.0 out of 5 stars 13 reviews

PDT & Back Acne

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Yes, PDT does work on the back. It may take more than one treatment, depending on the lasers and light devices used.  I would see a board-certified dermatologist who specializes in lasers and PDT to perform the treatment as there are things that can be done to maximize results. Good luck!

Sabrina Fabi, MD
San Diego Dermatologic Surgeon
5.0 out of 5 stars 91 reviews

PDT for back acne

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Photodynamic therapy is a great treatment for acne especially if you cannot tolerate antibiotics and are not a candidate for or do not want to try Accutane.  As mentioned below, at least three treatments are required typically and insurance doesn't cover the procedure.  Furthermore, it can be painful with redness, swelling and peeling of the treated area.  You must also stay out of the sun for a period of time after treatment.

Ritu Saini, MD - Account Suspended
New York Dermatologic Surgeon

Photodynamic therapy for back acne

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Photodynamic therapy does work for back acne.  Usually 5 treatments are required, about 3 weeks apart.  Since there is no cure for acne, you may require maintenance treatments every 3 to 6 months.

Martie Gidon, MD, FRCPC
Toronto Dermatologist

PDT works for back acne

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Photodynamic Therapy can be an excellent way to treat facial, chest or back acne while avoiding the side effects of oral medications like antibiotics or Accutane.  Unfortunately, it isn't covered by insurance and costs between $300-500 per treatment.  Currently, there is no standard protocol for treating acne with PDT, so responses may differ depending on the following:  

  • the type of chemical used (Levulan versus Metvix)
  • length of time the chemical is left on the skin before activation
  • the activating light source used (blue light versus red light versus IPL or laser).
  • the duration of exposure to the light source
  • the number of treatment sessions (commonly 3-4 total at 2 week intervals)

Side effects include:

  • pain
  • redness (up to 4 weeks)
  • swelling (1-4 days)
  • acne flare (3-4 weeks after treatment)
  • peeling, crusting, bruising, pustules

Generally, red light is felt to be more effective than blue light because it penetrates deeper into the skin.  I recommend that you see a physician experienced in treating acne with PDT.

Michael Contreras, MD
Greenwood Village Dermatologic Surgeon

PDT, Levulan, does work for back acne, or any other location, very well

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PDT is a great treatment for acne.  I requires 3 treatments generally.  You almost alway will get a flair of acne after treatment.  Full results take about 2-3 months to appreciate after a treatment.  The most common agent used for PDT in the states is Levulan.  Keeping the treated area out of light (sun or bulbs) for 36 hours is a must.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.9 out of 5 stars 75 reviews

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.