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All About Youth!

Pittsburgh's Premier Cosmetic Laser Center

ALA-PDT Frequently Asked Questions

What is ALA-PDT?

ALA-PDT or aminolevulinic acid HCl PhotoDynamic Therapy is fast becoming a standard treatment for photorejuvenation, acne vulgaris, actinic keratoses (AK's), rosacea and sebaceous gland hyperplasia. ALA-PDT has become a therapy that is routinely used to enhance laser and light treatments. For our photodamage patients, more than 90% achieve outstanding results, and about 75% of the paients treated for sebaceous related conditions achieve greater than 75% improvement. Decreased oily skin and pore reduction is seen in most all patients, as well as, improvements in smoothness and texture. ALA-PDT is becoming a very popular procedure, producing incredible results.

Can acne be prevented? How is it treated?

Acne is a fact of life for many adolescents. Approximately 90% of all adolescents and 25% of all adults experience acne at some point in their lives. In adolescents, acne breakouts are related to the natural release of androgen hormones, which occur during puberty. In adult women, acne is often related to the monthly menstrual cycle. Contrary to popular belief, acne is not caused by eating chocolate, greasy foods or bad hygiene. In the U.S. alone, over one billion dollars is spent on acne medications and treatments each year. In many instances, the money spent yields less than satisfactory results, is cumbersome or causes side effects. Conventional treatments include over-the-counter cleansers and lotions, prescription antibiotics, retinoids and hormonal therapies. NOW there is a NEW treatment- Blue and/or Red light enhanced with ALA-PDT!

What is ClearLight and Blu-U™? How does it work?

The ClearLight and Blu-U systems use a unique high-intensity blue-violet light that activates the bacteria-fighting militia called porphyrins. The porphyrins start a chemical reaction that produces peroxide, which destroys the P. acnes bacteria. These lights are used to activate the ALA.

What is a Blue Light treatment, enhanced with ALA? How does it work?

When ALA enters the skin, it becomes metabolized. The skin cells turn it into a photosensitizer called a porphyrin. The sebaceous glands are the most active part of the skin for creating porphyrins and the sebaceous glands are the root cause of acne. Up until now, the only proven therapy for to makedly impact the sebaceous glands was Accutane or isotretinoin. Accutane has however, numerous and fairly toxic systemic side effects. ALA is a very effective and viable treatment alternative. Blu-U stimulates the ALA to reduce the size and activity of the sebaceous oil gland and increses the protoporphyrin destruction of the bacteria. ALA-PDT also causes collagen rejuvenation which decreases pore size! We have found that Blu-U light treatments alone are effective for treating mild to moderate acne but it's proving much more effective on moderate to severe acne or cystic acne when enhanced in combination with Levulan ALA. .

What happens during a treatment?

The face is first washed with soap and water. Second the face is mildly scrubbed down with Acetone. (We are pretreating the face with mild Erbium YAG resurfacing prior to application of the ALA on severe cases) ALA is then painted on the entire face and the patient sits for 30 minutes while the ALA incubates. (longer incubation is used for subsequent visits) The ALA is then washed off and the patient sits for 8 minutes behind the Blu-U. A sunscreen is then applied and the patient is instructed "TO AVOID DIRECT EXPOSURE TO THE SUN FOR 48 HOURS!"

Will I feel any discomfort during the treatment?

YES, many patients report STINGING and mild BURNING sensation while behind the Blu-U light. The stinging increases as you sit behind the light and plateaus in intensity at about 6 minutes. SWELLING and temporary REDDENING may be experienced immediately following the light treatment. This discomfort may be present for 1-2 weeks.

How many treatments are required?

The ALA-PDT / Blu-U protocol is usually 3 treatments with 3 weeks between each treatment.

How effective is ALA-PDT Blu-U treatments?

The treatments are proving to be very effective providing long lasting results. Results are especially impressive when compared with conventional treatments, such as topical creams and oral antibiotics.
ALA-PDT/Blu-U treatments are providing similar results to Accutane without the systemic side effects. Most patients who receive the treatment said they would use it again.

Will skin be blemish-free at the end of the ALA-PDT / Blu-U Treatments?

Though the inflammation will be gone for a majority of patients, some may experience residual redness where the inflamed blemish was located. The redness will dissipate over time.

Are the results from ALA-PDTpermanent?

ALA-PDT treatments usually help control acne breakouts for 4 to 16 months; after that, an occasional touch up may be necessary. Many clients are able to control their acne with topicals after initial ALA treatments and do not require future ALA maintainance.

Are there any side effects?

Photosensitiveity! It is extremely important to be out of the sun and even indoor bright light for 2 days after the procedure and to wear a wide-brimmed hat if they are going outside after the treatment. (that means leaving the office and the ride home as well) Most 95% of the clients have no problems-with minimal and tolerable erythema and peeling. 4 to 5% experience 24 hrs of discomfort. 1% have what could be charicterized as extreme reactions with significant exfoliation and a week of downtime. This group of clients includes those who have significant sun damaged skin and those who do NOT comply with warnings about strict sun avoidance! Skin that feels dry and itchy for several days following treatment can benefit by using moisturizers. Stinging can be decreased by using fans and icepacks.

If I wear sunscreen, will that be sufficient to avoid exposure to light?

NO! After the treatment you must stay out of strong, direct light. You must stay indoors as much as possible. When outdoors, wear protective clothing and wide brimmed hats to avoid sunlight. You must avoid beaches, snow, and bodies of water where strong light may be reflected.

Who can benefit by the treatment?

Most people can benefit from treatment. ALA-PDT has proven to be very effective on mild to moderate to severe inflammatory and cystic acne. Actinic keratoses, rosacea, sebaceous gland hyperplasia, sun damaged skin, hyperpigmentation, fine lines and wrinkles, and those who wish to decrease pore size can also beefit! We will not treat 'pregnant women' and people with photosensitivities may have increased downtime..

Do patients need to prepare their skin before coming in for a ALA-PDT treatment?

Yes. The affected area should be washed with a mild acne cleanser, then rinsed with water and dried. Women should remove makeup before treatment sessions, and should only wear oil-free make-up between appointments.

What type of skincare is needed between ALA-PDT treatments?

Patients daily use of a non-irritating, anti-acne cleanser such as salicylic acid is recommended. Patients should avoid touching or picking blemishes at all times. The use of Salicytic acid enhances the effectiveness after treatments.

Are ALA-PDT treatments covered by insurance?

Insurance reimbursement varies from state to state and carrier to carrier. It’s best for prospective patients and/or their families to consult with individual carriers for more information. It has been our experience that insurance companies are resistant to reimburse for these procedures.

What are the benefits of ALA-PDT/ Blu-U treatments?

ALA gives you 3 things you can not get without it:

• It provides a degree of skin clarity that is a whole magnatude greater than that produced by photorejuvenation alone.
• The skin is bright, it shines and looks newer.
• ALA-PDT shrinks pores!
• Finally, the ability to rid the skin of precancerous keratinocytes yields the potential of providing a health/wellness benefit that cosmetic procedures usually don't offer. LOOK BETTER, SHRINK PORES and PREVENT SKIN CANCERS! It's a WIN, WIN, WIN!

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