At the USF Health Cosmetic & Laser Center, our scope of treatment is broad and not only includes laser, peels, Botox, and filler, but also suits the needs of our younger and older acne patients.
Thinking outside of the box
Acne can be a pesky situation to get rid of. Many of our patients come to us after years of unsuccessful acne treatment in search of new hope. Treatment is based on patient age, the cause of the acne, as well as the type and severity of the acne present. Typically patients are started on topical medications, but some may need oral antibiotics or isotretinoin if their acne is moderate or severe. Due to the long list of side effects and complications surrounding oral isotretinoin use (remember Accutane?), many patients seek a safer alternative. At USF Health Cosmetic & Laser Center we use combinations of all treatment options, but when treatment resistant moderate to severe inflammatory or cystic acne presents, we offer our patients an alternative: Acne Dynamic Therapy (ADT).
How does ADT work?
To understand how ADT works, we must first understand how acne starts. In our skin lies tiny sebaceous glands that are connected to hair follicles. These glands secrete an oily/waxy substance called sebum. When hormones are rampant in adolescence, sebum production increases. Eventually, the lining of hair follicles can become plugged with sebum and sloughed cells that are not removed properly. This plugging leads to a collection of sebum and cells which dilates the lining around the follicle. In time, the bacteria known as propionibacterium acnes contributes to rupture of the dilated follicle lining and resultant inflammation.
ADT uses blue and red lights as well as a topical lotion. 5-Aminolevulonic acid is the medicine applied to the skin before a light treatment. The purpose of this medicine is to make acne prone areas more sensitive to light, a process that we call photosensitization. Lights have different wavelengths that when used on the skin, will travel to different depths. The blue light wavelength ranges from 415-445 nm and travels superficially to the top layer of the skin. Here the blue light will be absorbed by chemicals called porphyrins which will react to the light. This reactivity will cause antibacterial activity against the nasty acne causing germ p. acnes. In contrast, red light has a wavelength of 550-700 nm. Since the sebaceous glands are located in the deeper dermis layer, red light will penetrate further to reach the glands and destroy them. This destruction prevents sebum production and buildup.
Where can it be done?
ADT can be performed on the face, neck, chest, and back.
What does ADT involve?
Once all treatments options for acne have been exhausted without success, patients with moderate to severe inflammatory or cystic acne are candidates for ADT. Certain acne medications may be stopped before treatment. Patients will degrease their faces in office and apply a special lotion (Levulan) to the skin. While the special lotion is on the face, a blue light will be on in the room. After an hour, the lotion will be washed off and the patient will proceed to sit in front of the red light for about 8-10 minutes with a fancy pair of goggles on. During this time, the patient may feel some “ant bites” or heat on their face, but it will subside shortly. A cooling fan called a “Zimmer” can also be used to help deal with the temporary uncomfortable feelings. After the red light has ended, patients will be coated with sunscreen and given post-treatment instructions. Treatments are typically done 2-3 times at monthly intervals.
After all is said and done…
After treatment, patients must avoid the sun or excessive light exposure for 48 hours. Patients can expect to have a range of responses to treatment including redness, swelling, crusting, peeling, or mild discomfort. Most side effects will dissipate within a few days and can easily be tamed with gentle moisturizers and ice over a cloth. Results of acne clearance or decreased acne breakouts can be expected for 6-9 months after treatment has been completed!
If your acne has been bothering you and you just can’t seem to get it under control… stop on by and see us at the USF Health Cosmetic & Laser Center!
Erika Dare, ARNP-C
By: Erika Dare, ARNP-C, Cosmetic Practitioner at the USF Health Cosmetic and Laser Center