WHAT'S NEW IN ACNE?

Most acne patients realize that acne is not an easy fix. For most, there have been many over the counter products that might have "helped for awhile". Many have graduated to prescription topicals or pills, with reports of improvement followed by complete relapse. Some patients will experience scars as a result of nodular or cystic (deep) pimples. Others will notice a residual brown stain where the pimple healed. The cumulative total of the brown stains may add up to spotty skin. Those with scarring or severe acne may be offered the "Big Gun", a pill taken for 4 – 8 months with a goal to remission, and possibly a cure. This medication certainly has been a salvation for some patients who might have had severe scarring acne, but it is not without its serious potential risks such as birth defects, blood disorder, liver damage, etc. The patient requires monthly follow up and frequent blood tests to monitor closely. Not surprisingly, not all people are willing to "go there" with such a medication. And furthermore, others may not be a suitable candidate for this oral medication on the basis of their acne or their medical profile. Fortunately, there is a new alternative, and a very good one at that.  

Photodynamic Therapy is another way of saying "light-action". More specifically, the skin is soaked with a clear medicinal fluid that soaks selectively into skin problem cells, including over-active oil gland cells, acne bacteria, pimple and pus cells, and other sun-damaged cell lines. After a one-hour waiting period, the skin is then exposed to a couple of special lights. The lights have several functions, but mainly they "activate" the medication within the target problem cells, purging the skin of these "undesirables". There is a comfortable 4 day downtime while the old skin is sloughed in favor of a fresh new skin. The 4 days is spent indoors because the skin is highly photosensitive during this time. It should not be exposed to anything other than standard indoor lighting. By day 4 the skin peels off in sheets revealing fresh smooth clear skin.

The acne patient will very likely begin to notice a number of "blackheads" after the peel, not previously noticed. This may not seem like a desirable endpoint, but in fact, the clogged pore is the "root of the evil" when it comes to acne. This is the fundamental structural defect that must be addressed in order to bring about a cure. Exposing the clogged pores by the ALA peel opens the window of opportunity for the acne patient to begin to clear the skin of these clogs by a regimen of recommended home therapy. You will observe rapid reduction in the blackhead count during the next weeks, as you also appreciate a change in the pattern of your acne. Typically the pimples become infrequent, small and very short lived. There will be other attractive changes to the skin as well, including smoother surface texture, improved skin tone/elasticity, diminished appearance of pores, more uniform color, and overall a much brighter complexion. In other words, you don’t have to have acne to benefit from ALA Photodynamic Therapy. The acne patient might be satisfied after one treatment, but some require two, or rarely even three treatments. This is individual and flexible in time. The improvement after one treatment might be enough for some, but it is exciting and preliminary for others who wish to achieve "even better".

It is always important to ensure safety when performing a new therapy. Health Canada has concluded that ALA Photodynamic Therapy is both safe and effective in the treatment of acne. To the end of 2004, there have been no reports of scarring, presumably because this peel is limited to the epidermis, and not the dermis. Of course, the pregnant or lactating woman is exempted from this kind of therapy, because it is untested in them.

Not only will the acne patient improve, and the aging sun damaged face, but there are others skin conditions that might improve with this therapy, including some types of early skin cancer, unsightly seborrheic keratoses (a type of brown age spot), warts, suppurative hydranitis (boils on the bottom), and others. Time and research will continue to shed "light" on this exciting therapeutic concept.

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