PHOTODYNAMIC THERAPY

Acne, rosacea and sun damage are some of the most prevalent skin conditions treated by dermatologists. Fortunately, recent advances in laser therapies are providing new hope for millions of people who struggle with these conditions everyday.

Lasers have been used in the field of dermatology for many years to treat photoaging, broken capillaries, hair removal and other conditions. Recent dermatologic applications for laser therapy include the treatment of acne. Recently, dermatologists have combined the use of lasers and light devices with photodynamic therapy (PDT) to achieve significantly enhanced results in the treatment of acne, rosacea and photoaged skin. PDT using a topical medication called aminolevulinic acid (ALA) has been approved by the FDA to treat actinic keratosis, the most common form of pre-cancerous skin change.

Unfortunately, initial treatment using this medication overnight, combined with laser therapy, was found to be both difficult and uncomfortable for the patient. However, recent developments using ALA with lasers and light sources for shorter treatment periods (i.e. 30-60 mintues), called “short contact” photodynamic therapy, have yielded good results with much less patient discomfort and recovery time.

ALA is a substance that occurs naturally in the body. When applied topically, it is selectively absorbed into fast-growing, rapidly metabolizing epidermal cells, including photodamaged skin, hair follicles and actinic keratoses. ALA is converted into a powerful photosensitizer. Activation by an appropriate light source treats the target, be it acne bacteria, rosacea or sun damage.

Short contact photodynamic therapy treatment often begins with a mild microdermabrasion. This reduces dead skin cells on the surface of the face, allowing for better penetration of the aminolevulinic acid. ALA is then applied for approximately 30. The medication is then removed and the patient is treated with a laser or light source, such as intense pulsed light (for example the Fotofacial procedure) or a pulsed dye laser (such as the NLite laser).

Photodynamic therapy is generally very well-tolerated. Most patients experience minimal to mild discomfort during the treatment. The recovery stage, typically consisting of some redness, generally lasts a few days. While initial results may be seen as early as the first session, most patients will obtain maximum benefit by a series of a few montly sessions.

Short contact photodynamic therapy has proven successful in the treatment of moderate to severe cystic acne, a condition usually treated with the long-term use of antibiotics or isotretinoin. However, antibiotic treatments and isotretinoin can be associated with certain side effects, and antibiotics have limited effectiveness in many patients. Patients usually undergo two to three procedures.

Short contact photodynamic therapy, as well as intense pulse light photorejuvenation, have also been used to successfully treat patients with rosacea, a common skin condition that causes redness and swelling on the face, as well as thickening of the skin. Until now, the primary treatment for rosacea has been antibiotics (both oral and topical). Dermatologists are finding that intense pulse light photorejuvenation and short contact photodynamic therapy, again using aminolevulinic acid, may successfully improve rosacea.

In addition to acne and rosacea, short contact photodynamic therapy treatments have made significant cosmetic improvements in patients with long-term sun damage. It typically improves the discoloration, broken capillaries, enlarged pores, fine lines and pre-cancerous actinic keratoses associated with sun damage.

Short contact photodynamic therapy is an exciting new treatment for acne, rosacea and sun damage. This combination treatment is also finding success in a variety of other conditions such as keratosis pilaris (severely dry skin), certain types of warts and excessive oiliness of the skin.