ALA Photodynamic Therapy for Acne vulgaris
Acne vulgaris, commonly known as “acne”, is the most common chronic inflammatory sebaceous disorder of the hair follicles in dermatology. It occurs in young men and women, and therefore affects them psychologically and socially to varying degrees. The occurrence of acne is closely related to a number of factors, including sex hormone levels, heavy sebaceous gland secretion, abnormal keratinization of follicular sebaceous ducts, proliferation of Propionibacterium acnes and inflammatory response. The treatment of acne should be based on different grading and selection of different treatment methods, including medication and physical therapy. For acne patients whose traditional treatments are ineffective or who do not want to receive medication, physiotherapy is the best choice. Currently, the commonly used physical therapies are photodynamic therapy, laser therapy and fruit acid therapy. In recent years, our department has applied photodynamic therapy to treat moderate to severe acne and achieved good treatment results. This treatment method acts on multiple causative links of acne and has the advantages of good efficacy, mild adverse reactions, does not affect daily life and work, can be repeated, and the treatment effect is more satisfactory.
The principle of action of photodynamic therapy for acne: topical 5-ALA can be preferentially focused by sebaceous glands on hair follicle sebaceous units and epithelial cells. Specific wavelengths of light irradiation activate protoporphyrin IX, generating singlet oxygen, superoxide anion radicals, and hydroxyl radicals, thus effectively killing Propionibacterium acnes, inhibiting the secretion of sebaceous glands, and inhibiting the keratinization of hair follicle epithelial cells. It effectively targets the pathogenesis of acne.
1.The scope of application of photodynamic therapy for acne.
(1) Acne cases where traditional treatments are ineffective, or cannot be controlled.
(2) Acne cases that are not suitable for antibiotic treatment (such as drug-resistant, or female mycosis, etc.);
(3) Acne cases that cannot tolerate the stimulation of topical medications.
(4) More severe cases of acne.
(5) Acne cases with liver or kidney function impairment.
(6) Severe acne cases that are prone to scar formation causing cosmetic problems.
2. Possible treatment reactions and preventive measures after the end of treatment.
(1) Edematous erythema at the treatment site: Generally, it can be relieved by itself in 2-3 days. Local cold compresses or cold spray can be applied during or after the treatment to reduce or relieve edematous erythema.
(2) Dry skin: It can be relieved by itself and can be improved by cold spray or topical moisturizer, mask, etc. on the affected area.
(3) Localized thin crusting and flaking: no treatment is needed.
(4) Slight burning and pins and needles sensation: This is a normal reaction and can be relieved by cold compresses.
(5) Reactive acne: i.e., a transient aggravation of acne, which can generally be completely relieved in about ten days to a month without special treatment, and does not leave scars. In case of severe reactive acne, topical antibiotic ointment can be applied to avoid infection, while cold compresses and moisturizing care can be strengthened to avoid scratching the affected area.
(6) Hyperpigmentation: can be relieved by itself, pay attention to sun protection.
3, contraindications.
(1) Patients with photosensitive diseases (SLE, chronic photosensitive dermatitis, etc.), skin photoallergy, porphyria, patients allergic to porphyrins.
(2) Patients who are allergic to any component of topical aminoketovaleric acid hydrochloride solution.
(3) Pregnant and lactating women are prohibited.
(4) Prohibited for those taking photosensitive drugs.
4.Course of treatment: single treatment interval of 7-10 days, 3 times as a course of treatment.