Therapy of Acne
There has been some interest and some research in photodynamic therapy of acne. With photodynamic therapy, a drug that is activated by light is applied to the skin. After a certain period, the drug is then washed off and the skin is exposed to light. That light energy causes the release of singlet oxygen molecules, which have the biologic effect of killing P. acnes, the bacteria responsible for acne. The light also seems to cause involution of the sebaceous glands. Treatment involves a several-step process, done in the office: First, the skin is scrubbed off with acetone and then ALA® is applied to the skin. After a four hour waiting period, the ALA® is washed off and the skin is exposed to a light source which, in the case of acne, may be blue light. The skin is then carefull washed after the treatment. It is important to guard against sun exposure for forty-eight hours after the treatment because some of the photodynamic agent may still be in the skin. Some patients notice skin irritation for twenty-four to seventy-two hours; however, generally this treatment is well-tolerated. Generally, we are recommending treatment every four weeks for a total of four to five treatments. In summary, photodynamic therapy represents an entirely new modality of treating acne, which seems to be well-tolerated. It may, in fact, become the best treatment for mild to moderate, or even severe acne.