Acne

Acne is a localized inflammation and or infection of the pilosebaceous glands of the skin. The pores of the skin become blocked with whiteheads and/or blackheads. The pores become inflamed and the bacteria propionibacterium acnes may increase in the blocked pores and cause actual infection.

Traditional Treatments

Treatments have traditionally involved removing the whiteheads and blackheads, exfoliating the skin, and treating the bacteria with antibiotics or other topical bactericidal creams. Salicylic Acid topical is usually recommend to chemically exfoliate the skin. Many patients with active acne cannot tolerate mechanical exfoliation with microdermabrasion. Occasionally, a micropeel, mechanical scraping with a scapel can be performed around the active acne lesions. The bacteria can be killed with topical chemical agents such as Benzoyl Peroxide or topical antibiotics.

Systemic oral antibiotics are occasionally recommended. A Vitamin A derivative such as Retin A is very helpful for acne control. It treats the hyperkeratinization of the pore linings that cause the blockage with whiteheads and/or blackheads. More severe cases may require a systemic vitamin A derivative, Accutane, which can cause serious side effects. Most patients find the traditional treatments frustrating, difficult to follow, and with limited effectiveness.

Cutting-Edge Treatments

At Truffles, we are proud to present a most revolutionary treatment for acne: Photodynamic Therapy (PDT). The face is treated with a topical medication, delta amino levulinic acid. The medicine is left to incubate for one hour. The incubated amino levulinic acid is preferentially taken up by the fast-growing bacteria and sebaceous cell. The 5 amino levulinic acid (Levulan Kerastick) is then activated with a BLU-U light, which is in the visible light spectrum and is therefore safe. The BLU-U light contains no ultraviolet light. The activated molecule will destroy the bacteria and shrink the hyperactive sebaceous gland, thus clearing the acne. This may take a series of four treatments, each spaced about 3 or 4 weeks apart. To maximize the long term results, we recommend that patients continue with acne washes that contain salicylic acid and use Retin A in low doses.

PDT with BLU-U and 5 amino levulinic acid (Levulan Kerastick) is an excellent treatment with minimal side effects. One peer-reviewed study using Levulan Kerastick and BLU-U light reported greater than 75% improvement in global severity score with no adverse reactions. Disease-free periods of up to 13 months were reported, with one investigator reporting clearance of moderate to severe acne for more than 2 years in 50% to 60% of patients who had 3 treatments.