Physical Treatments

Acne Vulgaris – Physical Treatments


Mechanism of Action: Microdermabrasion uses soft abrasion to partially or completely remove the outermost portion of your skin. It uses aluminum oxide crystals passing through a vacuum tube to remove surface skin.

Microdermabrasion is usually used for

Sun-damaged skin

Scars and dark spots on the skin

Comedonal acne (blackheads and whiteheads)

Side Effects: Microdermabrasion is well tolerated with minimal adverse effects. Temporary irritation and redness can occur. It must be repeated periodically to be effective.

Acne Vulgaris – Physical Treatments

Blue Light Photodynamic Therapy (TRU-BLU)

Class: Antibacterial Light Treatment

Typical Dosage: Blue light therapy usually consists of four treatment sessions, twice a week for two weeks. Each treatment session is approximately 16 minutes long. Before treatment, your face should be washed with a mild cleanser so that any make-up or topical cream/lotion is removed.

Side Effects: The TRU-BLU treatment is very safe. There are no known side effects associated with this procedure. No ultraviolet radiation is produced. There is no photoaging, sun induced cancers or hyperpigmentation associated with TRU-U treatment.

Special Notes: Even though there are no known complications, this treatment will not be performed if you are pregnant or breast-feeding.

Contraindications: Products which increase the sensitivity of your skin may contribute to some short-term redness after the treatment.

Mechanism of Action: Visible blue light in the range of 440nm has been shown to activate porphyrins in Propionibacterium acnes, which then produce free radicals that ultimately kill the bacteria causing acne vulgaris.

Acne Vulgaris – Physical Treatments

Glycolic Acid (Chemical Peel)

Class: Acid

Route: Topical

Indication: Comedonal acne, especially for deep set comedones

Typical Dosage: A series of 3 peels are usually performed at 6 week intervals using different concentrations. The first peel is applied at a concentration of 30% for 3 minutes. The second peel is at 40% for 3 minutes, and the 3rd peel is at 50% for 3 minutes. Of course adjustments are made to the concentration of glycolic acid and the duration of the treatment based on individual skin type and skin reactions.

Side Effects: You may experience some burning, stinging, and temporary redness when undergoing treatment with glycolic acid. It is important to avoid the sun for a week after the treatment.

Special Notes: Any potentially irritating topical creams, lotions, and gels must be avoided for 24 hours after undergoing a chemical peel.

Contraindications: None

Mechanism of Action: Due to its excellent capability to penetrate the skin, glycolic acid is used to improve the skin’s appearance and texture. It is effective for comedonal acne (whiteheads and blackheads). Once applied, glycolic acid reacts with the upper layer of the epidermis, weakening the binding properties of the lipids that hold the dead skin cells together. This allows the dead skin cells to “dissolve” revealing the underlying healthier, smoother, and brighter-looking skin.

Acne Vulgaris – Physical Treatments

Liquid Nitrogen (Cryotherapy)

Side Effects: Some possible side effects include redness and dryness of the treated skin.

Special Notes: Please keep in mind that this treatment is only intended to temporarily reduce the number of inflammatory papules appearing on your skin.

Contraindications: None

Mechanism of Action: Application of liquid nitrogen to the acne affected areas triggers an immune response, which induces the shedding and repair of the treated skin.

Acne Vulgaris – Physical Treatments

Photodynamic Therapy

Class: Acid

Route: Topical

Side Effects: Some possible side effects include redness, dryness, swelling, peeling, scabbing

Special Notes:Patients must wait one hour after application of the acid before sitting in front of the blue light machine. During this time and the next 48 hours, the patient must avoid any type of sunlight, even through a window.

Contra indications: None

Mechanism of Action: Photodynamic therapy first involves the application of a photosensitizer, such as ALA, to the acne affected areas of the skin. A waiting period of a few hours is allowed to elapse, during which time the ALA will be absorbed by cells. The patient will then sit in front of the Blu-U machine for up to 30 minutes, depending on the severity of their condition. The light activates the photosensitizer, which reacts with oxygen in the skin to fatally damage some of the cells in the treatment area. Destroying the cells associated with acne allows for new and healthy cells to form.

Acne Vulgaris – Physical Treatments

Corticoteroid Injection

Indications: To treat inflamed acne cysts or nodules. The treatment helps reduce inflammation and prevent scarring

Mechanism Of Action: This treatment usually minimizes the pain, swelling and redness of acne cysts and promote healing.

Dosage: Each acne lesion is given a dilute cortisone injection using a very small needle. The injections can be repeated in a month or more if lesions are not responding.

Expectations: The cyst/nodule will soften in a few days and they become flat in a week.

Side effects: If too high of a concentration is used atrophy can occur at the sites of injections. Atrophy implies that scars can become depressed and look like dents in the skin.

Acne Vulgaris – Physical Treatments

Intense Pulsed Light (IPL)

Class: Laser

Clinical Indications:

Acne vulgaris: IPL can be used to reduce the redness associated with acne lesions and scarring. It is best utilized when the active acne lesions have resolved.

Rosacea: IPL is the most effective treatment for reducing redness associated with redness.

Special Notes: The number of treatments needed to clear or improve the condition of acne rosacea differs from patient to patient, depending on the severity and extent of the problem. It is encouraged for you to see the effect of one treatment, and book subsequent treatments accordingly. Although results may last for many months to years, recurrence of the disorder is possible due to genetics and environmental factors such as sun exposure.

Potential Risks and Complications: Redness and mild swelling immediately after the procedure is expected, and in most cases necessary, to achieve excellent results. Rarely, there may be bruising or blister formation at treated sites. Brown spots on the skin may appear darker for up to two weeks following treatment.

Mechanism of Action: IPL technology is commonly employed to treat, and reduce the redness associated with acne and rosacea. For dilated blood vessels, as seen in patients with rosacea, the light energy with high absorption by hemoglobin and oxyhemaglobin reached the dermal capillary bed and selectively destroys the abnormal vessels. The operator of the machine controls all aspects of the light pulse, including wavelength, energy level, pulse duration, pulse pattern, and delay time between pulses. This allows for precise control of light energy, which is utilized for customization for skin type, procedure progress, and other variables. All controls are computer driven, and the system houses a patient database that automatically records the parameters of the treatment and the treatment history for each patient.

Acne Vulgaris – Physical Treatments

Comedonal Extraction

Sometimes removing comedones proves beneficial to your acne treatment. To extract whiteheads and blackheads, a comedo extractor is used. It is a small instrument with a round loop that removes comedones mechanically. It squeezes out the blackheads and whiteheads while minimizing skin injury. This procedure should only be performed by an experienced medical professional. Patients’ attempts to extract comedones and drain cysts on their own by squeezing or picking, can lead to worsening of the acne, scarring and infection.