For the past few weeks, we’ve been discussing the complex condition that is acne. It can be more difficult to treat than expected, and an effective overall treatment often combines two or more types of medication. When more traditional methods aren’t doing the whole trick, light or laser therapy may help to alleviate some of your issues and boost your improvement speed.
Light therapy uses multiple wavelengths of non-collimated light (beams not lined up) in a limited spectrum to treat acne over a series of treatments. The first FDA-approved light treatment for acne was blue (visible) light, which studies have shown to be more effective at killing acne bacteria than other wavelengths. Blue wavelengths work best for mild-to-moderate inflammatory acne, rather than whiteheads (closed comedones), blackheads (open comedones), and cysts. The light works by activating molecules known as porphyrins in the skin, which accumulate in acne, leading them to destroy the acne from within.
Another type of light source available to treat acne is IPL (Intense Pulsed Light) therapy, which uses a broader spectrum of wavelengths (light colors) to focus on certain pigments to reduce redness, destroy bacteria, and fight inflammation by shrinking sebaceous glands to slow oil production. IPL therapy is most effective for those with light to moderate acne. Photopneumatic therapy combines IPL treatment with a gentle vacuum to remove excess oil and dead skin from clogged pores. It’s suitable for whiteheads and blackheads, but not cystic acne.
Photodynamic therapy (PDT), a treatment approved to fight precancerous lesions, is used as an off-label treatment for acne. PDT works by using the same light sources, but activating the involved sebaceous glands and/or acne bacteria by first applying aminolevulinic acid (ALA). This chemical is applied to the skin prior to treatment to achieve extra sensitization for more bacterial killing and sebaceous gland destruction. The challenge with this lies in the possibility of nerve cells absorbing the ALA (rather than cells responsible for oil production), which will cause pain to the patient. Research on photodynamic therapy and acne is limited, so be sure to visit only a board-certified dermatologist for this procedure.
Lasers, single wavelength collimated light, are helpful for inflammatory acne (think red papules and pustules) and are less effective for cystic acne, whiteheads, and blackheads. Lasers of the appropriate wavelength work to excite compounds living inside of acne bacteria called porphyrins, which in turns damages the cell wall enough to kill the bacteria. This works by the same principle as PDT.
As with others types of light treatment, ALA can be used prior to treatment because it helps activate even more porphyrins, which are responsible for killing the acne bacteria. Unfortunately, this can exacerbate some discomfort caused by the lasers and might darken skin or create folliculitis, which is inflammation of hair follicles. Regardless of which energy source it is used with, ALA sensitizes your skin so much that patients must completely avoid sunlight for up to 30 hours to minimize any side effects.
Laser treatments usually cost between $200 to $500 per treatment with patients usually requiring about three treatments overall to initiate improvement, with maintenance treatments dependent upon the given situation.
Light and laser therapy are good treatments when used in conjunction with other treatments; on their own, the results are usually temporary as acne bacteria can grow back rather quickly. As always, it is up to you and your board-certified dermatologist to determine what is best for you and your individual needs.
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