Photodynamic Therapy - PDT - for Acne and Sun Damage

What is Photodynamic Therapy?
Photodynamic therapy (PDT) using Levulan® is a very safe and effective treatment for moderate to severe acne, aging, and severe sun damage.
At Cosmetic Laser MD, Susan Stevens Tanne, M.D. offers Photodynamic therapy with Levulan® and the BLU–U® light or FotoFacial RF (IPL) from Syneron to help reverse sun damage and treat acne. Photodynamic therapy (PDT) is a special treatment that uses a photosensitizing agent that is applied to skin and then activated with a light source. The beauty of utilizing PDT is its ability to rejuvenate skin — in addition to successfully improving such skin conditions as acne and severe sun damage — all in one procedure.
How does Photodynamic Therapy Work?
The Levulan® is absorbed by actively proliferating cells such as bacteria, oil glands and sun damaged cells. The light source used may be a visible blue light, intense pulsed light or laser light. It activates the Levulan® in the targeted cells which are then destroyed. Bacteria are destroyed, oil glands shrink and sun damaged cells peel away. Skin texture is improved, pore size is reduced, and skin appears smoother, brighter, and healthier.
What happens during and after the treatment?
The patient experiences a mild tingling during the treatment. The next few days feel like a sunburn as the old cells are shed off.
It is very important that you avoid direct sunlight for 36 hours (including car windows) after having the treatment. Sunlight contains the spectrum of light that can unpredictably activate the chemical and result in a much deeper peel than was expected.
What conditions can be treated?
• Sun damage: face, neck, shoulders, back, chest, hands, arms and legs
• Acne, oily skin, and enlarged pores
• Rosacea
• Keratosis pilaris (tiny bumps on cheeks and the back of arms)
What happens during PDT Treatment?
Clean your skin of all makeup, sunscreen and moisturizers. If you have recurrent cold sores, we'll start an Antiviral prophylaxis. We will perform an acetone scrub or microdermabrasion. A clear painless solution is applied to your skin and left on for 30–60 minutes. It is then activated by a light source, usually BLU–U®, LightWave blue LED therapy or IPL, for a few minutes and then washed off. Most people require three to five treatments, two to four weeks apart.
The treatment will also target sebaceous hyperplasia (those small, benign bumps on your skin), and the papules of acne rosacea. Skin oiliness is decreased, and the appearance of pores is minimized. The entire skin texture improves following a Photodynamic Acne Treatment.
PDT Acne Therapy
There are several different presentations of acne ranging from comedonal (blackheads and whiteheads), papular, pustular, and cystic acne. In many cases, many of these presentations of acne can be present on an individual simultaneously.
Prior to photodynamic acne treatment, the best available treatment option for cystic acne was Accutane. However, with Accutane there are many systemic side effects including birth defects, liver abnormalities, mood depression, and virtually all patients get dryness. PDT Acne Treatment provides a viable alternative for all types of acne treatment. For many people this means being able to avoid oral antibiotics or Accutane.
FotoFacial RF and PDT
Photodynamic therapy can be combined with our regular skin rejuvenation treatments using FotoFacial RF, which targets redness and brown spots, as well as stimulates formation of more collagen in the skin. There is normally no downtime for FotoFacial RF treatments without Levulan. However, one can enhance and boost the FotoFacial RF skin rejuvenation results by adding Levulan to the treatment process. The down time is a little longer than for a typical FotoFacial RF treatment but the results are phenomenal! The pores become finer, spots flake off and the result is a subtle air brushed look that your friends and family will compliment you on.
Is there any downtime? What happens after treatment?
We'll apply sun block and make sure you wear your hat out of the office. Patients are more sensitive to the sun for 36 hours after treatment and must avoid direct light. If possible, patients should remain indoors for the first 24 hours after treatment. There may be mild swelling around the eyes for 1 day and redness and peeling for about seven to 10 days. You'll use mild cleansers and moisturizers until the peeling stops. Sunscreen is mandatory. Topical acne medications can be used in between the PDT treatments once the redness has settled down, usually over a period of a few days. Again, if you are prone to facial cold sores, Dr. Tanne will prescribe antiviral medication to prevent a recurrence.
The advantages of PDT are rapid treatment of acne lesions all over the face without scarring or surgical excision. The skin appears refreshed and younger following these treatments. There are no systemic side effects.
Who should avoid Photodynamic Therapy?
Pregnant women, those who have taken Accutane® in the past three months, and those with active cold sores. Dr. Tanne will discuss whether this treatment is appropriate for you during your free consultation.
When is the BLU–U® light or LightWave LED therapy used without Levulan®?
Since the BLU–U® light and LightWave LED destroys bacteria that aggravate acne, mild to moderate acne can be improved with just the light. Treatment involves sitting in front of the light for a few minutes twice a week for 5 weeks. It is safe and painless, and can be used together with prescribed acne medication, microdermabrasion, and light chemical peels.

Let There Be Light - A Bright Future for Your Skin

Achieving a porcelain-like complexion has long been a priority among Asian women. However patients in the U.S. are becoming increasingly aware of skin brightening products and services, and are also increasingly more interested in achieving luminous skin. While anti-aging treatments and products are still more popular, uneven pigmentation has joined the list of aging skin concerns. Treating hyperpigmentation properly begins with a consultation and digital skin analysis to determine the cause, and developing a treatment plan that will most effectively and safely give patients beautiful, luminous skin. Current skin brightening products and procedures allow treatment of all ethnic groups, as uneven pigmentation affects all skin types, tones, and colors, and is a top concern for women of color. As we diversify (half of the world and one-third of the U.S. population are people of color) skin brightening promises to continue to attract an increasing number of patients.

Treating Hyperpigmentation
Inflammation of the skin can cause redness, swelling, pain and heat. This is the body’s normal response to injury or infection. Many everyday events and exposures can also lead to a low level of inflammation that is less obvious but can result in damage to the skin, including hyperpigmentation and melasma. In addition, skin cells are exposed to inflammatory agents like smoke, pollution, and chemicals, as well as other factors like sunlight and stress. All of these can contribute to inflammation, which leads to an overproduction of melanin, causing hyperpigmentation and uneven skintone. Dark spots on the skin can also arise due to age, sun exposure, pregnancy and other hormonal changes, or acne scarring.

In my practice I treat hyperpigmentation with a combination of non-invasive cosmetic procedures, such as laser treatments, peels and at-home skincare. Exfoliation plays a key role in creating a smooth and glowing complexion, as it prepares the skin to more readily absorb ingredients. Microdermabrasion, SilkPeel and chemical peels may be used to remove accumulated dead skin layers that cause a dull appearance. These skin resurfacing techniques improve overall skin radiance.

I perform microdermabrasion just prior to FotoFacialRF Skin Rejuvenation treatment to improve the penetration of this light based treatment, making it more effective in treating hyperpigmentation. FotoFacial RF is a non-ablative laser treatment which gently and effectively treats age spots, uneven skin tone, small broken blood vessels, and sun-damaged skin. FotoFacial also tightens pore and reduces fine lines since it combines light and radiofrequency in each pulse. FotoFacial is safe and effective for fair to medium skin types and can even be used safely on Latin-American, Middle Eastern, East Indian and Asian skin tones.

To achieve the best possible results when addressing any skin imperfection, the energy, whether it be laser or light, must be delivered below the skin without overheating the top layer of the skin. For many of my patients who need to address texture issues along with their hyperpigmentation, I use Matrix RF Fractional Skin Resurfacing. With this treatment I can give my patients superb results with virtually no downtime. The beauty of this treatment is that it can be safely used on all skin types including black skin.

For my patients with dark skin tones I often use the Melanage Skin Lightening Peel. Melanage is the most effective and safest treatment that I have found to address hyperpigmentation on all skin types, but especially for those patients with darker skin tones who cannot tolerate FotoFacial.

Home skincare is an essential part of effectively treating hyperpigmentation. I remind my patients that although they visit their dentist twice a year, they still brush their teeth twice a day! The same is true for aesthetic skin treatments. I insist that my patients partner with me to maintain and continue to improve their skin with a dedicated program of home skincare. I have even been able to achieve significant results on patients who only use a rigorous program of home skincare.

One of the most important components of their skincare regimen is the daily use of high quality sunscreen which protects against both UVA and UVB radiation. We want our patients to use sunscreen that contains Zinc Oxide and/or Titanium Dioxide, to protect against sunburn, aging skin damage, brown spots, wrinkles and even skin cancer.

Medical science can help restore the radiance that we had in our youth. Skin brightening treatments are an excellent way for me to give my patients the younger, luminous complexion that they desire.

ZERONA™ Open House a Huge Success

On Wednesday, September 30th a ZERONA™ Open House was held in our newly renovated office at Cosmetic Laser MD in Livingston, New Jersey. With standing room only attendance we discussed this exciting new non-invasive body slimming technology and demonstrated its use on one of our patients. Guests enjoyed delicious food and drink while meeting with Susan Stevens Tanne, M.D., Ginny, our Cosmetic Coordinator and Zerona expert, and with Meaghan, our licensed esthetician. An interesting and informative presentation containing patient pre and post images and clear explanations of the science behind ZERONA™ led to many questions and individual consultations. One of our recent ZERONA™ patients was present to discuss her treatment and results which gave guests an opportunity to speak with someone who had completed the entire protocol. Her pre and post photos are shown below and at http://www.cosmeticlasermd.com/services/Zerona.html or at www.myzeronamd.com. For more information about Cosmetic Laser MD visit our newly updated website www.CosmeticLaserMD.com.

ZERONA™ has been featured recently on The Doctors, CBS News and the Rachel Ray Show. Dr. Tanne was recently interviewed by CBS News about ZERONA™ and demonstrated the entire procedure for them. The segment will be aired shortly. The exact viewing information will be posted. Interest has been huge since we started offering Zerona in our office several months ago.

With ZERONA™ you are treated six times over two weeks. Each of the six sessions takes 40 minutes. Treatment is delivered 20 minutes to the front of the body and 20 minutes to the back of the body. The protocol is completely non–invasive and you feel nothing during treatment. No downtime or recovery period is needed after treatment. You can resume normal activities immediately. In as few as six treatments, you can replace from 3–5 inches of unwanted fat with a slimmer, more youthful you.