A C N E
State of the art treatments for the 21st Century
Many articles have been published in the medical journals about using laser and pulsed light on acne. The results have been very favorable with marked improvement noted in many patients including children and adults. The treatments are scheduled over a month and are usually once or twice a week for a total of 4-8 treatments. Acne scarring can be treated. Touch-ups are done as needed. We customize your acne treatment with our laser and pulsed light systems.
BEFORE & AFTER TREATMENTS
A computerized system emits laser or pulsed light to treat your acne (i.e. blue, green, red or infra-red light). It is very safe for all ages and FDA approved. For resistant acne, the most exciting acne advancement is Photodynamic Therapy with laser or pulsed light. We use a topical photosensitizer call Levulan to enhance the sensitivity of acne bacteria and sebaceous glands to laser or pulsed light.
The protocol is fairly simple:
- Topical anesthetic gel is applied 30 minutes before treatment.
- The computerized system emits laser or pulsed light to all acne areas.
- You must stay away from sunlight for at least 2 days after treatment and use sunblock.
- Patients have a sunburn "redness" for a few days which then fades after that.
Follow-up treatments, at intervals, are recommended to maintain the effect and to treat any new lesions. Medical articles and photographs are provided in the office and some are available on this web site. For a pictorial on Acne, click here ACNE PICTORAL (a pdf file).
BEFORE & AFTER TREATMENTS
Primer on Acne
The exact cause of acne remains unclear but
more is known about how acne forms. There are treatments to help deal with
this distressing condition. Acne
affects people of all races and skin colors. Many
teenagers and young adults suffer from acne. However, men and women in their
30s and beyond can also suffer.
Causes of acne
Acne is a skin condition caused by over activity of the glands that secrete oily substances on to the skin. Typically, people with acne get blackheads (comedones). These are caused by a blockage of the pores, which get their dark color through excess skin pigment. The blackheads usually occur on the face, where the greatest number of these oil-producing "sebaceous" glands exist. The back, chest and shoulders can also be affected. Whiteheads are also common. These occur near the surface of the skin when excess sebum gets trapped inside the follicle. The sebaceous glands can also become infected. In this more severe "inflammatory acne", cysts develop beneath the skin's surface. These acne cysts can rupture, spreading the infection into nearby skin tissue. This can result in scarring.
A cross-section
through the skin showing a sebaceous gland which produces sebum
Several factors are involved in the development of acne. Central to this are the sex hormones, which are produced at puberty. The male hormone testosterone - found naturally in women as well as in men – triggers the sebaceous glands to produce more of an oily substance called sebum, making the skin more greasy. However, most acne sufferers don’t have a hormone problem and their hormones are at normal levels in their blood.
When there is an excess of sebum, the area around a hair follicle and the opening through the skin – the pore – can become clogged. A germ, a bacterium called Propionobacterium acnes, that lives normally on the skin, can thrive within the blocked pore. This infection causes inflammation, which is responsible for the redness and swelling of a spot. Sometimes as in severe acne, the pocket of inflammation within a pore can rupture, causing damage to the skin that can result in scarring.
Drugs such as certain steroid tablets and some
beauty products that block the pores can contribute to acne. Contrary to popular
belief, acne is not caused by eating fatty food or chocolate.
Treatment
Acne is not a trivial complaint. It can be the
source of considerable emotional distress. But there is a range of treatment
options to tackle the problem.
Newest treatments - the 21st Century!
Lately, Laser & Pulsed Light Photo treatments of acne have been very favorable with marked improvement noted in many patients. The treatments are scheduled over a month and are usually once or twice a week. Dr. Battista has specialized Laser and Pulsed Light computerized systems to treat acne in children and adults. For resistant acne cases, the most exciting acne advancement is Photodynamic Therapy with Laser and/or Pulsed Light. Dr. Battista uses a topical photosensitizer call Levulan to enhance the sensitivity of the sebaceous glands to laser and pulsed light. Periodic touch-ups may be needed.
Home treatments
It’s important to keep acne-prone areas clean, so wash the affected area twice a day with an unperfumed cleanser. Antibacterial face washes and soaps specifically for greasy skins are also available. However, the skin needs a certain amount of oil to maintain its natural condition, so avoid aggressive washing and scrubbing with strong soaps and "buff-puffs".
Also try to avoid the temptation to pick at
spots: over-enthusiastic squeezing can cause scarring. Acne tends to be less
of a problem in the summertime. This is due to the sunshine helping the skin.
No home treatments for acne will work immediately. It can take months, for
significant effects to be noticeable.
Non prescription remedies
Over-the-counter remedies are available from
a pharmacy to treat mild acne. Lotions that contain benzoyl peroxide dry out
the skin and encourage it to shed the surface layer of dead skin. Benzoyl
peroxide also has an antibacterial action. Together, these effects make it
harder for pores to become blocked and for infection to develop. Benzoyl peroxide
can cause redness and peeling, especially to start with. This tends to settle
down within a few days.
Doctor treatments for acne
If you go to your doctor, Dr. Battista will
start treatment for mild to severe acne with a program designed to work for
you. Be patient........treatments can take weeks to months to work.
There are several types of treatments you may be prescribed. Usually, these are used in combination for the greatest effect.
Topical treatments
- Benzoyl peroxide or
- Azelaic acid, which is an alternative to benzoyl peroxide, which may cause less skin soreness.
- Topical retinoids, which are medicines based on vitamin A (but NOT the same as those without a prescription or sold over the TV and Internet), and are rubbed into the skin once or twice a day. They work by encouraging the outer layer of skin to flake off, and may cause irritation and skin peeling at the start of treatment. Disadvantages of this treatment include them making the skin hypersensitive to sunlight.
- A topical antibiotic lotion applied to the skin can be used to control the Propionobacterium acnes bacteria. Treatment needs to continue for at least six months. Preparations that combine an antibiotic with other acne medication are available.
Oral treatments
- Oral antibiotics (tablets), taken daily can be prescribed for inflammatory acne. This acts to kill off the bacteria infecting the skin. The success of this treatment can be limited because the strains of bacteria are often resistant to the common antibiotics. It might take four to six months for the benefits to be seen. Antibiotics do not prevent pores from becoming blocked so treatment to prevent blackheads, such as a topical retinoid or azelaic acid, is often prescribed at the same time.
- Hormone treatment. For women, a standard combined oral contraceptive pill (containing an estrogen and a progesterone) can improve acne symptoms. But in some women, it can also make symptoms worse. One particular type of Pill, contains a medicine called cyproterone acetate which cuts the amount of male hormone in circulation and be an effective treatment for acne.
- Isotretinoin (Accutane®) is a powerful medicine known as an oral retinoid - which also exists in topical form (see above). It tends to be used in severe forms of acne that have proved resistant to other treatments. It works by drying up oily secretions. There are a number of side effects of this drug including dryness of the skin, aches and pains and headaches. It can also damage an unborn baby if taken by a pregnant woman. It requires that the patient be registered by the US government, have mandatory pregnancy tests, and be administered by a registered doctor (Dr. Battista is registered to administer Accutane®). Some people find this is a nuisance. This explains why many people do not always start Accutane®.
Laser and Pulsed Light treatments
Laser & Pulsed Light Photo treatments have shown marked improvement in many acne patients. The treatments are once or twice a week over a month. Dr. Battista has specialized Laser and Pulsed Light computerized systems to treat acne in children and adults. For resistant acne, Photodynamic Therapy with Laser and/or Pulsed Light combined with Levulan has worked in many patients. Periodic touch-ups are done.
News clips
........ The LuxV handpiece offers a long-term acne solution by treating the root cause of acne, which is the sebaceous glands. The LuxV emits pulses of intense light that alter the structure and function of the sebaceous glands to reduce acne lesions without the many side effects common to drugs....
In the past, a combination of over the counter cleansers and prescribed topical medications including topical antibiotics, peroxide compounds and topical retinoids have been traditionally recommended to treat acne.
“The advantage of Palomar’s approach to the treatment of acne is that it doesn’t involve medication. Use of the LuxV handpiece offers acne sufferers a non-drug, easy and effective alternative without the side effects commonly found with drugs. Patients have been extremely happy with the results and enjoy benefits of long lasting clear skin after just a few treatments,” said Christine Dierickx, a dermatologist at the Boom Laser Clinic in Belgium.
..............
Palomar Advances Pulsed Light Acne TreatmentAesthetic Buyers Guide
"LuxV is a promising alternative to current topical and oral anti-acne remedies."
....."A practical and effective light treatment for acne in the presence of pharmaceutical and device based treatments must meet certain performance criteria," said David B. Vasily, M.D., director of Aesthetica Cosmetic and Laser Center in Bethlehem, Penn. "It must be comfortable and tolerable without use of topical anesthetics; it must be quick (15-20 minutes per session is ideal)....
A treatment is considered successful when the patient exhibits at least 20% improvement in the number of lesions three weeks after treatment, and at least one grade improvement on the severity grading scale." While conducting clinical trials, Dr. Vasily found that the LuxV significantly reduced his patients' acne. All of the patients enrolled in the trials had suffered from facial refractory acne for a number of years and had used conventional topical and/or oral medications, such as Accutane, Benzamycin, Tazorac, Brevoxyl, Retin-A, Differin, Klaron, and Minocin, with unsatisfactory or mixed results.
Even those who responded to the medication developed acne again when taken off the medication. These inconsistent results are unfortunately typical of the antibiotics, topical retinoid and peroxide compounds used to treat acne. In addition, these medications often create severe side effects, such as night vision impairment, cracked lips, bone aches, and reversible hair loss, and can pose a danger to the fetus during pregnancy. These factors, combined with an aversion to long-term dependence on antibiotics, have made Palomar light-based acne treatments increasingly appealing to the general public.
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JOHN M. BATTISTA, M.D.
561 DUNCAN AVENUE SOUTH
CLEARWATER, FL 33756
(727) 446-3346