Photodynamic Acne Therapy (PDT ALA, Levulan PDT)


Photodynamic therapy (PDT ALA)is a procedure that can significantly improve moderate to severe acne, including cystic acne. Prior to photodynamic acne treatments, the best available option for resistant forms of the condition, including cystic acne, was Accutane.

Photodynamic therapy uses a topical agent called Levulan (Aminolevulinic acid (ALA) in combination with specialized lasers and light sources. It  provides a viable alternative to Accutane with no systemic effects. PDT ALA treatments inactivate the bacteria that trigger acne, exfoliate the skin to unclog pores, and decrease the activity of overactive sebaceous glands in the skin. With three mechanisms of action, it has a long lasting effect in the majority of patients.





How many treatments are required and at what interval?

An initial series of three treatments are advised at two to three week intervals. Depending on the response to these treatments and the severity of your acne, we will customize a follow up plan for you

Photodyamic Therapy (PDT) + ALA (Levulan) = PDT ALA

What is Levulan?

Levulan is a 20% solution of Aminolevulinic Acid (ALA). ALA is a “natural” product found in all humans throughout the body. It is a precursor for hemoglobin synthesis.
What do patients look for alternatives to the use of Accutane?

Accutane is a useful drug for the treatment of severe acne but its use has steadily declined due to the risks associated with its use. Accutane may cause several systemic side effects including birth defects, liver abnormalities, mood depression, and virtually all patients get dryness and night vision changes.

PDT Acne Treatment provides a viable alternative to Accutane as there are no systemic effects. PDT-ALA treatments inactivate the bacteria that trigger acne, exfoliate the skin to unclog pores, and decrease the activity of overactive sebaceous glands in the skin. With three mechanisms of action, it has a long lasting effect, even on severe acne, in the majority of patients.

Topical acne medications can be used in between the PDT ALA treatments once the redness has settled down, usually over a period of a few days. Antiviral medicines should be utilized for a patient that has a history of recurrent cold sores.


Photodynamic Therapy ALA Acne Treatment Procedure Details

Skin should be free of all makeup, sunscreen and moisturizers. Antiviral prophylaxis is initiated in patients with history of recurrent cold sores.

An acetone scrub or Microdermabrasion is done.

The Levulan (ALA), which is a clear painless solution, is applied to the skin and left on for 30-60 minutes. It is absorbed by active cells like acne sebaceous glands.

The Levulan is washed off with soap and water.

The skin is exposed to a specific wavelength of light with either the Blu U, iClearXL. Vbeam laser, IPL or Gentlewaves. This takes about 8-15 minutes. At times multiple lasers or light sources are sequentially used to activate the Levulan which has been absorbed under the skin by the sebaceous glands. This combined interaction of the Levulan solution and the laser or light is what gives rise to the term "photodynamic therapy."

Sun block is applied and a hat is worn out of the office. Sun exposure needs to be avoided for 48 hours after treatment. If possible, patients should remain indoors for the first 24 hours after treatment. Skin may become red with mild swelling and peeling for 3-7 days. 3-5 treatments are recommended at 2-4 week intervals

A minimum of SPF 40 sun block should be worn for one week.

Additional benefits of ALA PDT may include:
• Improvement in sun damaged skin, including sun spots
• Some improvement in fine lines
• Improvement in blotchy pigmentation
• Some reduction of pore size
• Reduction of oily skin
• Treatment of bumps of Rosacea
• Improvement in Sebaceous Hyperplasia