Objectives: "Photodynamic and photothermal therapies for acne in Asian patients"
1: Understanding the principles of photodynamic (PDT) and photothermal therapy (PTT)
2: Understanding PDT side effects and the concentration of photosensitizer suitable for Asians
3: Introduction to PDT and PTT treatments using IPL light source
Introduction: Phototherapies are emerging as alternative modalities for treating acne, utilizing light of various wavelengths to induce photochemical or photothermal changes within targeted tissues. Two common phototherapies, Photodynamic Therapy (PDT) and Photothermal Therapy (PTT), employ light and exogenous or endogenous absorbers to generate cytotoxic reactive oxygen species or increase local temperature, respectively.
Materials / method: I aim to share my experience regarding the optimal concentration of photosensitizer and light irradiation sources for PDT and PTT, aiming to enhance efficacy while minimizing side effects in Asian patients with acne.
Results: Intense pulsed light (IPL)-PDT was primarily utilized, with additional irradiation of blue/red light. In Asian patients, PDT requires the use of low-concentration photosensitizers (10% 5-aminolevulinic acid and 13% methyl aminolevulinate) and brief contact times to mitigate issues like pain, phototoxicity, and post-inflammatory hyperpigmentation. PTT involves the delivery of nanoparticles into sebaceous glands, typically employing 150 nm gold particles transported via the trans-appendageal route with sonophoresis. Commonly employed light sources include 1064 nm Nd-YAG and IPL.
Conclusion: PDT serves as an effective adjunctive treatment for mild to severe acne, particularly in patients unresponsive to topical therapy and oral antibacterials or those not suitable for isotretinoin. Gold-based PTT has emerged as a safe and effective alternative treatment for recurrent acne, functioning by photothermal disruption of sebaceous glands without causing collateral skin damage.
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