Blue light with a 400 nanometer wavelength by itself is not very useful to doctors for skin treatment. However, by pretreating the skin with a new class of drugs called photosensitizers, we have a revolutionary new way to treat common skin conditions such a sun damage and acne. It is simple, safe, and efficacious. Not only does it treat the real diseases of aging skin, it produces skin that is clearer and smoother.

    The combination of using a sensitizing agents and its activation by a specialized light source is generally called Photodynamic Therapy (PDT). You may recall your dentist activating the restorations of your teeth with a blue light. This is a very similar process called Photoactivation. Currently there are more than 20 different brands of light sources that can be used to perform PDT.

    In our office the photosensitizer is aminolevulonic acid (ALA), and the blue light source is BLU-U. We refer to the combination as ALA-BLU-U. You may see other doctors call it ALA-PDT. The only difference is that the term ALA-BLU-U is very specific, while the term ALA-PDT is generic and applies to any number of other machines.

    The sensitizer, ALA, is absorbed more rapidly by abnormal skin cells than by normal, healthy skin. Once absorbed, ALA is converted to protoporphyrin-9, and when exposed to blue light, produces free radicals that selectively destroy abnormal cells. This is very exciting because it does not damage normal skin.

    Sun-damaged skin is the primary indication for treatment in my practice. People with fair skins (class I and II skins, for example, English, Irish, Scandinavian and Middle Europeans) almost always have significant sun damage in Southern California. Manifestations of this are scaly, flaky skin, pre-cancers, actinic keratoses, early skin cancers, and many pigment conditions. All of these conditions caused by sun damage, as well as aging, can be effectively treated with ALA-BLU-U. Of great advantage is that one can treat the face, neck, scalp, chest, hands and arms. Because large areas can be treated at one session, it is very cost effective (about $800 per treatment). Most patients are satisfactorily treated with one or two sessions.

    ALA-BLU-U is also effective in disorders of the sebaceous glands, such as common teenage acne, middle-aged female acne, the acne that accompanies rosacea, and the condition of sebaceous hyperplasia (little small, round target lesions with a dimple in the center). Rhinophyma (thick, oily nasal skin, and also a late-stage variant of rosacea), is effectively treated with ALA-BLU-U, too.

    The first step in treatment is the application of ALA. The ALA contact time ranges from 30 minutes to 18 hours, and the BLU-U exposure time ranges from 5 to 16 minutes. The variation in exposure and application times varies with the condition being treated, the thickness of the skin, the age of the patient, and the known effects of previous treatment.

    The eyes are protected from the BLU-U light by goggles. During exposure time, most patients experience a mild stinging sensation during the treatment, but this is usually quite tolerable. The stinging is often described as like a sunburn.

    Following ALA-BLU-U treatment, we advise avoiding the sunlight for 1-2 days. Staying indoors, or wearing a broad hat outdoors will lessen the chance of reactivation of the ALA. This reactivation is not dangerous, but light exposure does seem to set off the stinging sensation all over again.

    This stinging (much like the stinging of a sunburn) may last for a few days. This is usually followed by flaky skin shedding as the damaged areas heal. It is perfectly okay to wash your face and put on moisturizers and makeup during the healing process. Two or three Advil and a vitamin C tablet taken regularly every six hours works very well to speed the healing process. The erythema (redness) that follows the treatment usually resolves nicely in two to four weeks.

    The results of an impressive number of studies have shown dramatic improvement in all of the conditions treated. I, myself, am most excited about sun-damaged skin. With one treatment, you can treated your entire face and neck for those flaky actinic damages, precancers and early skin cancers, and improve age spots, too. Following treatment, your skin will look clearer and smoother and makeup will go on much easier and stay on better. I think that you get more bang for your dollars with this treatment than anything else I offer.

    If you are 40 years old, have fair skin, and have sun exposure (almost a certainty in Southern California), this is truly a preventive medicine for you. I, myself, am using ALA-BLU-U once per year to avoid the progressive changes of sun damage to my skin. When educated to its many benefits, patients have been very enthusiastic about this treatment.