FREQUENTLY ASKED QUESTIONS - SUN DAMAGED SKIN/PDT

 

PHOTODYNMIC THERAPY FOR ACNE

Recent phototherapy (light therapy) research using visible blue and red light has proven effective in the treatment of mild to moderate acne. Clearance rates have exceeded over 60% in a number of studies, indicating the effectiveness of this treatment. If blue light is combined with a red light, stubborn and severe cases of acne can be treated with significantly fewer side effects and most importantly, no downtime or pain . This is a great advantage for acne sufferers. Recent research has shown that blue light therapy works by destroying the bacteria responsible for causing acne. Red light penetrates more deeply into tissue, and also has anti-inflammatory properties. Consequently, substances are then released that induce fibroblasts and growth factors. This is a positive aspect for sufferers to consider if they have a tendency to scar. Combination phototherapy works through the antibacterial and anti-inflammatory nature of blue and red light. However, only by delivering the right wavelengths in proper sequence can optimum results be seen.

In a recent study of combination blue/red light phototherapy a marked improvement in lesion counts after the final treatment was seen. There was a noticeable improvement up to 12 weeks after the final treatment session. After a series of eight sessions of alternate blue/red phototherapy (twice weekly treatments) over a four-week period, there was an average reduction of over 80% in acne counts compared to baseline, as well as a marked reduction in sebum production.

After combination therapy, optimal results are reached after the therapy has ceased. An added benefit is that the results of combination therapy are more durable. There are significantly fewer side effects and importantly no downtime, which is what most acne sufferers' desire. All skin types can be treated.

For more severe or stubborn cases of acne the Blue and Red light therapy is combined with 5- ALA application as in the treatment sun damage outlined above, for a more aggressive treatment.

The cause of acne is quite simple. The principle cause is the obstruction of the opening of a pore (hair follicle) by dead skin cells and oil from overactive oil glands. This obstruction can lead to infection. The treatment works by applying the  5-ALA, which is then activated by the special  blue and red light.  It is expected that this treatment will improve moderate to severe infective acne.

PhotodynamicTherapy involves three mechanisms of treating acne; this is the reason why it is so effective. Firstly, it exfoliates the skin with Microdermabrasion to unblock the pores. The ALA is then applied and left on for 2 to 3 hours. Light will then activate the ALA and these treatments work to destroy the most common bacteria involved in acne. The third and most exciting mechanism of action is that it reduces oil production in the over-active sebaceous glands. This is the effect that provides long-lasting results for acne sufferers, including those with severe or cystic acne. This treatment is particularly exciting for people who have tried multiple other acne treatments, including medication and have not had a desirable result or cure. It is also a safe alternative to Roaccutane treatment for people with severe acne.

Most people find the Microdermabrasion and application of ALA quite comfortable. The Continuous Light will cause a hot, stinging sensation in the skin. Your skin will be red following the treatment and may gently peel or swell. You will be required to stay out of the sun or bright light for 48 hours following treatment as your skin will be very light sensitive. Most people stay indoors at home for 2 days as any discomfort felt will be caused by light exposure during this time. There may be some residual redness for one week and the skin will flake or peel for 3 days. Most people will have two to three treatments.

PDT – why is it a great option?

  • Healing is usually rapid, as there is relatively small damage to healthy cells.
  • It provides an excellent cosmetic result.
  • Scarring has not been reported.
  • There is no systemic reaction.
  • The treatment is able to be customized to your individual needs (especially cost vs downtime)
  • Can be repeated if needed.
  • Does not prevent you from undergoing any other cosmetic procedures in the future.

How does PDT work?

The photosensitizing solution is 20% aminolevulinic acid (5-ALA). This is applied to the surface of the skin to be treated, where it is absorbed preferentially by abnormal or pre-cancerous skin cells as well as oil glands and pores, making these more sensitive to laser or light. It specifically targets sun damaged or unhealthy skin cells and is not absorbed into normal, healthy skin cells. After the incubation period(the time the solution sits on the surface of the skin) of between 2-5 hours, the ALA is then activated by Continuous Blue and Red LED Light and / or IPL or Laser, which produces free radical molecules that destroy only the pre-cancerous and unhealthy cells. Large areas can be treated quickly and effectively with long lasting results.

How many treatments are needed and what happens post-treatment?

Most people will need 1-3 treatments. Occasionally more treatments are required. After being treated, the skin will look irritated, reddened and will peel. This usually resolves in 5 days, however it may last 7-10 days. It is extremely important to stay out of the sun for forty-eight hours after treatment. Exposure can result in burning and redness. Even a sunscreen will not protect against the photosensitivity of the skin at this stage.

1 - 2 Days - Extreme sensitivity to light so keep indoors as much as possible.
3 - 5 Days -  The treated skin will be red and tender and may peel, scab and flake off. This is a normal result and means the treatment has worked by destroying damaged skin cells.
6 - 9 Days - Redness starts to disappear. Skin may still feel itchy, tight or uncomfortable but is starting to heal.
10 - 14 Days - Days Healed, healthy, smooth, clear skin will be revealed.

What does it feel like?

There is some discomfort at the Continuous Light stage of the procedure as it can feel like a severe sunburn. We have a series of protocols to make the procedure more comfortable, such as use of a patented product called PDT-EZE and use of a Zimmer cooler which blows ice cold air onto the skin. After the treatment, your skin will be very red and will feel hot and sunburn, and slightly itchy. Post PDT lotion should be applied to the treated area and you will need to be completely covered with clothes, hats, and scarves for your journey home. Do not expose the area to sunlight even briefly during this time as you will be extremely sun sensitive You will experience redness and/or peeling for 2-3 days.. You may resume your normal skin care after the peeling stops or immediately if there is no peeling

Less than 1% experiences a very severe reaction resulting in redness and peeling for 1 week and very rarely longer. This usually happens when there is severe sun damage with multiple Actinic Keratoses present.

Is this treatment safe?

Photodynamic therapy is safe for all skin colours and types and is effective at all ages. There has never been a case of scarring reported. The alternative treatments for actinic keratosis such as cryotherapy or skin cancer creams can cause scarring.

Optimising your PDT results?

To get the best results from PDT, follow the allmedic pre PDT treatment program for at least two weeks prior to your first treatment: Wash / Cleanse Remove dirt, grime, and make up with allmedic Face & Body Cleanser, twice a day. Exfoliate / Repair Remove dead, dry, flaky skin cells with the allmedic Face & Body Repair. For best results use in conjunction with the allmedic Skin Rejuvenator. Protect Apply the allmedic daily face and body moisturiser with sun protection to all exposed areas of the body.

Other things you should know

Before undergoing PDT make sure you tell your Doctor about any medications you are taking especially Roaccutane and/or Tetracyclines. If you have a history of cold sores (herpes simplex 1) you may need to take prophylactic treatment prior to your PDT treatment.

allmedic PDT - why it is a great option?

Remember it’s never too late to repair and protect your skin.

www.allmedic.org.au/pdt