| NEW YORK (October 22, 2003) – Acne, rosacea and sun damage are some of the most prevalent skin conditions
treated by dermatologists. Fortunately, recent advances in laser therapies
are providing new hope for millions of people who struggle with these
conditions everyday.
Speaking today at the American Academy of
Dermatology’s (AAD) Derm Update 2003, dermatologist Mark Steven Nestor,
MD, PhD, Clinical Associate Professor, Department of Dermatology and
Cutaneous Surgery, University of Miami School of Medicine, Miami, Fla.,
discussed how lasers and light devices used alone or in conjunction with
certain photo sensitizing agents, or photodynamic therapy, is improving
the treatment of acne, rosacea and sun damage.
“Lasers are typically thought of as
cosmetic devices, but from their inception in the field of dermatology
almost 30 years ago, lasers have been used for the treatment of clinical
conditions, as well,” said Dr. Nestor. “In addition, photodynamic therapy
has been used investigationally to treat various conditions such as
retinal problems associated with the eyes and precancerous conditions
of the esophagus or bladder. However,
dermatologists have recently combined the use of lasers and light devices
with elements of photodynamic therapy to make great strides in the
treatment of prevalent facial skin conditions.”
Photodynamic therapy using a topical
medication called aminolevulinic acid has been approved by the Food and
Drug Administration (FDA) to treat actinic keratosis (AKs), an early
potential sign of skin cancer. Unfortunately, initial treatment using this
medication overnight, combined with laser therapy, was found to be both
difficult and uncomfortable for the patient. However, recent developments
using aminolevulinic acid with lasers and light sources for shorter
treatment periods (i.e. one hour), called “short contact” photodynamic
therapy, have yielded much more positive results.
A typical short contact photodynamic
therapy treatment begins with a light microdermabrasion. This technique is
used to remove any dead skin cells on the surface of the face, which
allows for better penetration of the aminolevulinic acid. The
microdermabrasion is followed by a topical application of aminolevulinic
acid, which is left in place for approximately 30 to 60 minutes. The
medication is then removed using an alcohol swab, soap and water. Finally,
the patient is treated with a laser or light source.
According to Dr. Nestor, “Photodynamic
therapy is an essentially painless procedure for the patient. While
initial results may be seen as early as the first session, some patients
require a series of three to five sessions to see significant results.
However, it really depends on the patient and the severity of the skin
condition being treated.”
Short contact photodynamic therapy has
proven successful in the treatment of moderate to severe cystic acne, a
condition usually treated with the long-term use of antibiotics or
isotretinoin. However, antibiotic treatments and isotretinoin can be
associated with certain side effects, and antibiotics have limited
effectiveness in many patients. Acne treatments using short contact
photodynamic therapy with aminolevulinic acid and lasers or light sources
appear to have positive effects in significant numbers of individuals.
Patients usually undergo three procedures, and side effects have included
some slight facial redness. New studies also highlight that certain FDA
approved light sources (blue light) can improve inflammatory acne in just
a few short sessions without any side effects.
“It generally takes around two to six weeks
to see significant results for patients with acne,” said Dr. Nestor.
“While it is still early in the investigational process, photodynamic
therapy, as well as light-based therapy for acne, appears to provide
long-term improvement for patients. It is anticipated that FDA trials on
this treatment will begin very soon.”
Short contact photodynamic therapy, as well
as intense pulse light photorejuvenation, have also been used to
successfully treat patients with rosacea, a common skin condition that
causes redness and swelling on the face, as well as thickening of the
skin. Until now, the primary treatment for rosacea has been antibiotics
(both oral and topical). Antibiotic treatment has had some success in
reducing the blood vessels and redness associated with rosacea. However,
dermatologists are finding that intense pulse light photorejuvenation and
short contact photodynamic therapy, again using aminolevulinic acid, may
also successfully improve the redness and thickening skin of patients with
this condition.
In addition to acne and rosacea, short
contact photodynamic therapy treatments have made significant cosmetic
improvements in patients with long-term sun damage.
“The symptoms of sun damage, such as rough
skin, pigmentary problems, wrinkles, and certain early signs of skin
cancer, have exploded in recent years due to the thinning ozone layer and
various lifestyles associated with sun exposure. Therefore, sun damage is
one of the most prevalent conditions treated by dermatologists,” said Dr.
Nestor. “The latest photodynamic therapy techniques are giving patients
another option for the treatment of sun damage and are improving their
cosmetic outlook.”
Short contact photodynamic therapy appears
to be an important step in the treatment of acne, rosacea and sun damage.
This combination treatment is also finding success in a variety of other
conditions such as keratosis pilaris (severely dry skin), certain types of
warts, molluscum (a non-cancerous skin growth), and excessive oiliness of
the skin.
The American Academy of Dermatology,
founded in 1938, is the largest, most influential, and most representative
of all dermatologic associations. With a membership of over 14,000
dermatologists worldwide, the Academy is commited to: advancing the
diagnosis and medical, surgical, and cosmetic treatment of the skin, hair
and nails; advocating high standards in clinical practice, education, and
research in dermatology; supporting and enhancing patient care for a
lifetime of healthier skin. For more information, contact the AAD at
www.aad.org
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