“We tend to mistakenly believe that this Inflammatory Skin Disease mainly affects teenagers. In reality, however, Acne does not discriminate in terms of gender or age and its treatment is not always easy”, says Dermatologist – Venereologist Dr. Amalia Tsiatoura. “Acne is the most common skin disease and the appearance of its symptoms is caused by the acne bacterium, Propionibacterium acnes (P. acnes). With the help of PDT Photodynamic Therapy, the treatment of troublesome and painful pustules and acne scars is now possible, with simultaneous regeneration and rejuvenation of the skin.”
It is known that acne improves considerably after exposure to sunlight, due to the antibacterial action and the effect of UV rays on the immune system.
For several years, UV acne phototherapy was the treatment of choice for active acne, but later it proved to be a factor in photocarcinogenesis and photoaging.
Since then, various wavelengths have been used to combat acne and until recently, light sources such as red/blue light, intense pulsed light (IPL) and laser have been used to treat acne.
The innovative method of PDT Photodynamic Therapy offers a solution where other methods of Acne Treatment do not work. As the Dermatologist – Venereologist Dr. Amalia Tsiatoura explains, in some cases, Local and Systemic treatments for acne are impossible to apply due to the patient’s individual or family medical history and the adverse effects that accompany them. At the same time, it is approved for use in clinical practice and is completely safe and effective.
Modern dermatology harnesses the power of light to address the main factors involved with the pathogenesis of acne without the undesirable effects of topical or systemic antibiotics, hormones and retinoids. Photodynamic treatment (PDT) has been shown to have antibacterial action, anti-inflammatory action, as well as action against seborrhea. It leads to a reduction in the number of P. acnes bacteria and a reduction in the secretion of sebum and the size of the sebaceous glands.
Life-giving visible light – blue (430-500μm) or red (550-700μm) – penetrates below the surface of the skin, targeting Porphyrins IX, products resulting from the metabolism of bacteria such as P. Acnes in the skin.
In Cosmetic Derma Medicine, the conduct of PDT Photodynamic Therapy relies on the epidermal application of a specific photosensitizing substance to target the hair glands and increase the production of Porphyrins IX (Porphyrins IX), which are activated by exposure to visible light and induce a photodynamic reaction that eliminates pathogenic bacteria.
Photodynamic Acne Treatment PDT requires 3 basic elements to work:
Light-based acne treatment relies on the ability of P. Acnes bacteria to produce porphyrins as a metabolic product. These porphyrins act as endogenous photosensitizers within the hair follicle and are activated by visible light, inducing a photochemical reaction that eradicates the bacteria. The external application of photosensitizer leads to an increase in the concentration of porphyrins, which when exposed to visible light produce free radicals that destroy the bacterium P. Acnes.
- Light source
The wavelength chosen for the light source depends on the depth at which penetration is desired. The absorption of porphyrins is within the visible spectrum, at a wavelength of 300-650 nm. Blue light has been shown to be more active in activating porphyrins than red light, but red light penetrates deeper into the skin. A special device emitting at this specific wavelength is used as a source of blue and red light.
- Oxygen (O2)
Porphyrin IX is stimulated by the application of visible light and reacts with oxygen, resulting in the production of reactive oxygen free radicals, which cause membrane damage and consequently cell death. This is how the bactericidal action is achieved.
The advantages of PDT Photodynamic Acne Treatment are multiple, as the method combats the main pathogenic mechanisms involved in the problem of acne, achieving:
- Antibacterial Action (Significant reduction in the concentration of the bacterium P. Acnes)
- Anti-inflammatory Action
- Action against seborrhea
- Action against hyperkeratinization of the hair follicle
- Increase in the production of fibroblasts
- Increase of collagen & elastin production
- Enhancement of vasodilation, blood circulation and oxygen to the tissues
Benefits of PDT Photodynamic Acne Treatment
Before – After Results
From the very first session of PDT Photodynamic Treatment, the skin appears brighter, clearer and more elastic. PDT Photodynamic Treatment achieves a reduction in sebum secretion, a reduction in the size of the sebaceous glands and a significant reduction in inflammation. The ideal number of sessions required to achieve the final desired result depends on the severity of the acne and its response to treatment. Usually, 4-8 sessions are required with an interval of 2-4 weeks.
PDT Photodynamic Acne Treatment
Is PDT Photodynamic Therapy the ideal treatment for me?
Suitable candidates for Photodynamic PDT Treatment are patients with moderate to severe acne with predominantly inflammatory lesions. The treatment is suitable for all skin phototypes; however, phototypes I-III are preferred, in order to avoid the risk of post-inflammatory hyperpigmentation.
As Dermatologist – Venereologist Dr. Amalia Tsiatoura emphasizes, acne depending on the type, severity, location and age requires different treatment and photodynamic therapy can play a main role as an adjuvant treatment, but also as a monotherapy of acne.
Which photosensitizers are used in PDT Photodynamic Therapy?
For the treatment of Acne symptoms, the photosensitizing substance is applied locally to the lesions and not systemically to avoid generalized phototoxicity.
The main topical photosensitizers used are 5-aminolevulinic acid́ (ALA) at a concentration of 20% and its ester, methylaminolevulinic acid (MAL) at a concentration of 16%. MAL is converted to ALA after absorption by the skin. The topical photosensitizer penetrates to a depth of 2-3mm reaching the sebaceous pouch located at 1.3mm.
What light sources are used during PDT Photodynamic Treatment?
The choice of the appropriate method depends on the type, intensity and severity of the acne. The most expert in acne treatment is a qualified Dermatologist – Venereologist who will advise you on the type of treatment that best suits your needs.
How safe is PDT Photodynamic Treatment?
Phototherapy is a completely safe treatment since it is based on the regenerative properties of visible light. The occurrence of side effects is rare and includes symptoms of mild redness and/or scaling and rarely transient post-inflammatory hyperpigmentation, especially in darker skin phototypes. Furthermore, in addition to being a highly effective method of treating Acne, Phototherapy is approved by European agencies and the FDA for its effectiveness in treating Actinic Hyperkeratosis, superficially expanding and nodular basal cell carcinoma and Bowen’s disease. However, to avoid adverse effects the following are recommended:
- The use of special protective eyewear by the patient and the physician during treatment.
- Avoidance of eye contact in case of contact with the topical photosensitizer.
- Avoiding sun exposure for up to 48 hours after the session due to phototoxicity.
- Avoiding application during pregnancy, as its safety in pregnant women has not been adequately studied.
Are there any side effects from Photodynamic PDT Acne Treatment?
PDT Photodynamic Treatment is generally a very safe and effective method, with no side effects. In extremely rare cases, patients have reported the following side effects:
- Burning sensation
- Slight pain or itching
- Mild redness that lasts only a few hours
What are the contraindications of PDT Photodynamic Treatment?
PDT Photodynamic Therapy is not recommended during pregnancy or in young children.
It should also be avoided in case of history of photosensitivity and photoallergy or in cases of allergy to the photosensitizing agent (aminolevulinic acid).
The use of special products and reconstructive creams for acne and proper facial cleansing are necessary measures to maintain the result as Dermatologist – Venereologist Dr. Amalia Tsiatoura emphasizes.
Why should I choose Cosmetic Derma Medicine for the treatment of acne with PDT Photodynamic Therapy?
Cosmetic Derma Medicine Medical Group is the largest and most specialized medical group in the field of Dermatology and Plastic Surgery, with clinics in Greece and Cyprus.
The Medical Director of Cosmetic Derma Medicine is Dermatologist – Venereologist Dr. Amalia Tsiatoura, while the staff consists of a medical team of highly experienced and specialized doctors of many different specialties, as well as a fully qualified team of nurses. Our team is by your side every day, 24/7 for whatever you need.
Cosmetic Derma Medicine is one of the first clinics to introduce photodynamic treatment in Greece, while workshops and seminars for the training of new doctors from Greece and abroad are held in the clinics’ premises.