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Cosmetic Dermatology Procedures - Dr. Nissan Pilest

Photodynamic Therapy

PDT for resistant acne

Nothing is more painful to those in their teens than poor self-image. Acne creates a terrible cycle of self-consciousness, anxiety, depression and self-isolation.

PDT Goals

  • clear your skin
  • stop future breakouts
  • reduce existing scars
  • prevent future scarring

Photodynamic Acne Therapy is the quickest and most effective way to control acne and clear the skin. It does not require dangerous oral medication or long term dosing of antibiotics that requires strict compliance and can create antibiotic resistance and other complications.

 

How PDT works

Photodynamic Therapy is an especially effective in-office “power-level” treatment. PDT controls resistant, hard-to-treat active acne by combining light and a special light-activated solution that targets and destroys acne activity. PDT also diminishes older acne scars leaving your skin smoother.

Dr. Pilest is a pioneer in the use of Photodynamic Therapy and his patients show consistent major improvements.

PDT Before and After 3 Sessions
3 PDT with Vbeam and ClearLight
Results may vary

Patient being treated with PDT for acne
PDT Patient in Progress – Residual Redness/Scarring will be corrected with Vbeam/Fraxel
Future Photos to be posted

Advantages

  • rapid treatment of acne lesions all over the face
  • no scarring
  • no surgical excisions
  • no systemic side effects
  • skin appears refreshed and younger

How many treatments will I need?

We advise 2-3 treatments at 2 to 3 week intervals to obtain optimal results. Particularly severe cases may require 5 sessions for the most complete control.

What to expect after your PDT session

We aren’t going to tell you that PDT is side effect free. PDT is a process that you will feel and see.

Redness and Peeling: Your skin will be red and you will have some skin peeling (and crusting in some instances) for several days after the treatment. Usually, the first 1-2 days are the worst. These effects are a small sacrifice for the major improvements you will gain.

Staying Inside: You must remain indoors 48 hours following your treatment to avoid sun exposure, as you are photosensitive for during that time and sun exposure could cause severe burns. Topical acne lotions can be used in between your Levulan treatments once the redness has settled down over a period of a few days – but only on the guidance of Dr. Pilest.

Camouflaging redness: Pressed mineral base powder will hide most of the redness and is suitable for either males or females as it does not “look” like makeup. There are a number of brands you can choose from in department stores and drug stores. We don’t recommend liquid products that may contain oils or waxes.

What is a PDT treatment like?

Photodynamic Acne Treatment (PDT) is a process by which a photosensitizing agent (Levulan) is applied to your skin. A photosensitizing agent is a  special solution applied to the skin that is activated by a specific wavelength of light, which “turns it on.” Levulan has been used extensively for the treatment of a variety of different skin conditions.

Levulan is a 20% solution of Aminolevulinic Acid (ALA). ALA is a “natural” product found in all humans throughout the body. It is a precursor for hemoglobin synthesis. You wouldn’t be able to make red blood cells to carry oxygen without ALA in your body.

The Levulan, which is a clear painless solution, is applied to your skin and left on for 15-60 minutes. It is then activated with a specific wavelength of blue light called LightStim. This takes about 8-10 minutes. Alternate treatments may use Omnilux Red Light which drives the Levulan deeper into the acne blemish or Vbeam which can effectively multiply the bacteria-killing action of deeper cystic acne.

The Levulan is absorbed by active cells like acne sebaceous gland, making the targeted acne cells more sensitive to the light. This combined interaction of the solution and the light is what gives rise to the term “photodynamic therapy”. 

Prepping for PDT

An important part of the treatment program is medical extraction of blackheads and acne pustules. This procedure will expedite the improvement in your skin condition by cleaning the pores of hardened sebum and infected debris.The treatment reduces skin oiliness and minimizes the appearance of pore size. The entire skin texture improves following a Photodynamic Acne Treatment.

Understanding acne

Acne results from the obstruction and inflammation of the sebaceous glands, and it affects 80% of the human population. Acne typically begins in adolescence with hormonal changes. However, there are many older individuals who suffer from “adult acne.”

There are different levels of acne ranging from milder comedonal (blackheads and whiteheads) to moderate, pustular, on to severe cystic acne. In many cases, several or all of these levels of acne can be present on an individual simultaneously.

Cause of acne

Acne is caused by overactive sebaceous glands in the skin. The sebaceous glands, triggered by the hormone androgen, produce sebum (oil) in the skin. Although androgen is a male hormone, it is present in both men and women. Production of this hormone is highest during puberty, but it is always present in the body.

When androgen levels increase, the sebaceous glands release sebum. Ordinarily this oily substance spills onto the skin. When cells from the lining of hair follicles shed too quickly—clumping together and clogging pores—sebum is trapped beneath the skin causing whiteheads and blackheads. Sebum can then mix with the trapped cells and cause Propionibacterium acnes (P. acnes)—bacteria normally found on the skin–to grow in the clogged follicles. P. acnes can cause inflammation and pus and can result in papules or pustules. When the follicles expand as much as they can, bumps called nodules are formed under the skin.

Moderate acne may include blackheads and whiteheads in addition to papules —inflamed lesions that appear as small, reddish or pinkish bumps that can be sensitive to touch — or pustules which are inflamed, white-centered bumps that can be red at the base.

Severe acne is characterized by nodules — large, painful, solid lesions that appear as lumps under the skin—and cysts —deep, inflamed, pus-filled lesions that can be very painful. Nodules and cysts are inflammatory and can cause scarring.



Link to acne patient's storyAn Acne Story

What about Accutane?

Why Dr. Pilest does not prescribe Accutane: Prior to Photodynamic Acne Treatment, the best available treatment option for resistant and cystic acne was Accutane (isotretinoin). However, with Accutane-like drugs there are many systemic* side effects including major birth defects if a child is conceived during treatment (women taking isotretinoin are required to use RX birth control and have pregnancy test throughout treatment), liver abnormalities, mood depression, and virtually all patients get extreme comprehensive dryness and night vision changes.

*Systemic  treatments are any medications that are taken orally, injected or infused that affect the entire body system. PDT Acne Treatment provides a viable alternative to all types of acne treatment without having negative systemic effects.

Insurance Coverage

There is no insurance coverage for PDT – Since PDT for Acne is an “off label” use of Levulan, it is not covered by insurance. We are hopeful this will change in the future. Our office provides package pricing options and we can assist you in acquiring payment plans through Care Credit if you desire.

Other acne-realated treatments

Acne Scar Treatments
BlueLight LightStim
Isolaz

Acne Overview

Call to Schedule a Consultation

Send us a message or give us a call at 949-484-8660