Photodynamic therapy (PDT) has been used for many years to treat cancer and is now being used to treat other conditions, including acne. PDT is a relatively new form of acne treatment that uses light or laser treatments with the help of photosynthesizing agents to destroy P. acnes, which is the bacteria that cause acne. A physician administers the treatment in her office during repeated sessions over the course of several months. There are many advantages of using PDT, but until more research is conducted, the long-term safety and effectiveness of PDT is unknown.
How It Works
During PDT, a photosensitizing agent is applied to the patient's skin, and then the skin is exposed to a pulsed-dye laser, intense pulsed light, red light or blue light. The photosensitizing agents typically used in photodynamic therapy are aminolevulinic acid (ALA) and methyl aminolevulinic acid (MAL). ALA and MAL make the light treatment more effective than it would be without these agents.
Evidence
There have been very few clinical trials that have evaluated the efficacy of PDT for acne. The studies that have been conducted show that PDT is a promising treatment for acne.
Advantages
A key advantage of PDT acne treatment is the fact that it does not require the patient to remember to take acne medication. Photodynamic therapy does not have many side effects. It is also excellent for treating difficult-to-reach areas of the body. Acne scars can also be treated with PDT.
Disadvantages
Photodynamic therapy kills the bacteria that cause acne, but it does not target all of the causes of acne, such as clogged pores or hormonal imbalance. Therefore, PDT alone is not comprehensive enough for some acne patients. Side effects of PDT include stinging, burning, redness and swelling that can last up to one week after treatment. Many insurance companies do not cover this new technology, resulting in high out-of-pocket patient expenses. There is little information about the long-term side effects of PDT or how long treatment results last.
Experts
In 2009, the Global Alliance to Improve Outcomes in Acne published a review of the evidence for acne treatments in "The Journal of the American Academy of Dermatology" and concluded that light-based therapies such as PDT may work best when added to other therapies or as a solo treatment for patients who can't or won't take other acne therapies.
Physicians
Patients considering PDT should find a dermatologist who has experience in performing PDT.
References
- "Journal of Investigative Dermatology";. Topical ALA-Photodynamic Therapy for the Treatment of Acne Vulgaris; W. Hongcharu, C.R. Taylor, Y. Chang, D. Aghassi, K. Suthamjariya, R.R. Anderson; August 2000
- "Journal of the European Academy of Dermatology and Venereology"; Evidence-Based Review of Lasers, Light Sources and Photodynamic Therapy in the Treatment of Acne Vulgaris; M. Haedersdal, K. Togsverd-Bo, H.C. Wulf; March 2008
- "Journal of the American Academy of Dermatology"; New Insights into the Management of Acne: An Update from the Global Alliance to Improve Outcomes in Acne Group; D. Thiboutot, H. Gollnick, V. Bettoli, B. Dreno, S. Kang, J.J. Leyden, A.R. Shalita, V.T. Lozada, D. Berson, A. Finlay, C.L. Goh, M.I. Herane, A. Kaminsky, R. Kubba, A. Layton, Y. Miyachi, M. Perez, J.P. Martin, M. Ramos-E-Silva, J.A. See, N. Shear, J. Wolf, Jr.; May 2009
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