Does PDT (Photodynamic Therapy) Work on Back Acne?

Question

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??

Hooman Khorasani, MD · Answer

Yes, PDT with blue light can definitely help with back acne! It typically requires a series of treatments to get the acne under control. Blue light PDT works by targeting Cutibacterium acnes (the bacteria that contributes to acne). The blue light activates compounds in the bacteria or applied photosensitizers, creating reactive oxygen that destroys the bacteria and also helps reduce oil gland activity and inflammation.Since oral antibiotics made you nauseous, here are some other options worth discussing with your dermatologist:Less aggressive options:
Bleach baths: Taking a bath with about one capful of bleach added to the water once per week can help reduce bacteria on the skinHibiclens (chlorhexidine): Washing your back daily with this antimicrobial cleanser can be very effective at reducing acne-causing bacteria
More aggressive option:
Accutane (isotretinoin): This is a more intensive treatment but can be extremely effective for persistent acne. It's worth considering if other options haven't worked, though it does require monitoring due to potential side effects.
Given your history of persistent back acne and the stomach issues from oral antibiotics, I'd recommend starting a conversation with a dermatologist about PDT or these alternative approaches. Many people with similar situations have found good results with combination approaches, and there's no reason you need to keep suffering with this.

Sabrina Fabi, MD · Answer

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!

Donna Bilu Martin, MD · Answer

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.

Steven Swengel, MD · Answer

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!

Martie Gidon, MD, FRCPC, FAAD · Answer

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.

Michael Contreras, MD · Answer

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.

Steven F. Weiner, MD · Answer

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.

Ritu Saini, MD - Account Suspended · Answer

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.

Does PDT (Photodynamic Therapy) Work on Back Acne?

Answers (8)

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