Laser light is rapidly effective at cutting inflammation and sebum production. However, when used alone, laser and light therapies often decrease sebum production only temporarily. While acne improves for a few months, the damaged sebaceous glands usually recover and acne returns.
Photodynamic Therapy (PDT)…
We prefer more lasting improvement. Photodynamic therapy (abbreviated PDT) is the answer. PDT is commonly used for acne in both sexes. For PDT to be most effective a series of treatments is needed. 3-5 are sometimes required in moderate to severe acne, 1-3 treatments are common in milder acne. In a Yale University study of mild to moderate acne using the Candela Vbeam® Perfecta laser the average patient required 3 PDT treatments for complete clearance of pimples from the face. In that study 13 months later significant improvement was maintained.
We often do acne cyst drainage, a chemical peel or an eMatrix radiofrequency procedure prior to PDT to unclog the pores and thin the skin. This allows for the levulinic acid to penetrate deeper into the acne oil glands during the PDT. A week or so later we clean the face thoroughly and apply levulinic acid, a photosensitizing agent, to the acne areas being treated. We then wait about 1-4 hours so the levulinic acid soaks deeply into the skin. It is then activated by laser, red or blue light. The activated chemical damages or kills sebaceous glands. The face peels, much like a severe sun burn, so most clients get some down time. After healing, there is typically long term improvement in acne, after one treatment a 20-50% long term improvement is common. An eMatrix treatment, a radiofrequency grid therapy system, is also effective at reducing oil production and also decreasing scar. This is a very safe therapy with minimal side effects.
Acne Case Presentation…
These photos are of an 18-year-old. Procedures included acne cyst drainage x 3, a light chemical peel followed in a week by Photodynamic Therapy (PDT). Time between before
and after pics–15 weeks.
Prescription Medication…
Prescription drugs to cut inflammation and sebum production are often used. Birth control pills and spironolactone are generally for women only, as they may cause breast development in males, but are often helpful. Antibiotics such as minocycline and doxycycline are quite helpful in cutting inflammation (reducing the reddish or pinkish comedones), but are not so helpful for blackheads. Accutane (oral isotretinoin) is a very effective, but toxic, drug. There are still a few patients that require Accutane (isotretinoin) when all else does not produce the desired result. It has many side effects and is not suitable for everyone. Serious birth defects in women using this drug are possible. It is a last resort used for severe acne that has been poorly responsive to other therapies.
Acne Cyst Drainage…
Acne cyst drainage has many names– acne surgery, incision and drainage, pimple popping, acne comedone extraction, blackhead removal, etc. The procedure usually includes some form of unroofing or piercing of the comedone (zit, pimple, blemish, etc.) with a sharp instrument such as a 20-gauge needle or tiny blade. The contents are then extracted using pressure from fingers or a comedone extractor. In some cases, such as with large cysts, the results can be dramatic and within 5 days the face is much flatter and less inflamed. One of the best things about cyst drainage is a reduction in scar formation, since after drainage the comedone can drain the sebum and/or pus better in the future as well. Acne lesions are both flatter and less inflamed shortly after drainage. Note the large cysts in the photos in our case presentation in the left profile view in the chin area. Normally, I’d expect significant scar after having such cysts, but her pictures look quite good after therapy! We love to combine cyst drainage with a light therapy such as Vbeam laser the same day, which further speeds healing, decreasing inflammation and redness. Insurance usually covers the cyst drainage, but not the laser treatment.
Schedule Your FREE Consultation Today…
To schedule a Free Consultation, with our licensed medical aesthetician or Dr. Van Reken here at the Reno Sparks MedSpa, give us a call.
