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Brief history: I'm 37 yrs old, & have been dealing with mild/moderate cystic acne since I was about 22 yrs old. I've been on every oral antibiotic imaginable, almost every topical cream made, Ortho Tricycline, OrthoNovum 777, ProActiv, BP, SA, glycolic cleansers, Mario Badescu products, Erno Laslo sea mud soap.... you know the drill. I could go on and on..... no permanant results. I live in South Florida, and am sure that my skin is worsened somewhat by the humid/hot conditions that I live in..... although, for about 5 yrs I lived in Illinois, up by Chicago, and while the cold helped alleviate the oiliness and breakouts somewhat, I still had problems.... I always had dermatologists for cortisone injections for the whopper cysts, and yes, I've been approached about Accutane - many times. But, seeing as I'm still in my reproductive years, I'm not open to the 2 forms of BC and fear of side effects that accompany Accutane. I've even gone to an endocrinologist to have my hormone levels checked......to which I was told, "they're fine". Ok - so if they're "fine", why am I having "hormonal acne"?!?
So, for a while, I did nothing about my skin. Cleansed with Dial antibacterial soap, moisturized with oilfree Clinique lotion, and my skin was pretty clear. This lasted about 8 months. Then, almost like a "remission" that ended, my skin went nuts. Cysts all along the jawline, hairline, chin, side of the nose, even cheeks - which were never a problem area before.
After much internet research on a particularly bad face day, I found a derm. office here in my area that offers PDT/ALA treatments. The Levulan (ALA - alphalevulanic acid) is an acid that is naturally found in our bodies, that when applied to the face, and super-heated with laser pulsed light, is activated and causes the acid to deeply penetrate the pores and damage the sebaceous gland - to stop overproduction of oil and to HELP kill p. acnes. Cool. Plus, this tx also helps with acetinic keratoses (skin cancers), and wrinkle reduction - - hey! Hit all kinds of birds with ONE stone!
So, I've had 4 treatments so far, the first one starting on August 29th - - and it hasn't been all roses, I will say. To do it, my derm cleanses my face with Acetone first - to remove any oils or residual makeup - then the Levulan is applied, via a "pen". Then I sit in the waiting area for about 45-50 minutes - to allow penetration/drying of the acid. Then, into the exam room I go again, put on some tanning goggles, and the MD then pulses this super WARM (not really hot) light via a hand held light that's attached to this big machine (like a washing machine!)....he pulsates the light back and forth all across my face starting at the forehead, at the hairline, and goes back and forth all across the face till he gets below the jawline. The light part takes no more than 3-4 mins, and then I'm on my way out - with a hat on and sunglasses... to hole up in my darkened home for about 2 days. The skin feels like a really bad windburn - like when you're on the beach, and it's not quite summer and you don't realize you're getting as much sun/wind as you are - then come inside and take off your sunglasses - - and wow! Tight, RED, swollen, yukk. Burning for a few days - I mean, hot to the touch - ice packs and ibuprofen help but it is uncomfortable.
Then the peeling starts. Small flakes, big pieces, all over. And for me, cysts come up almost immediately. NO ONE told me that my skin would get worse before it got better. I should've guessed, as it's pretty much the norm for ANY new skin treatment - it tends to get worse as all the old under the skin stuff comes up to cleanse out the pores.... but man: I was so discouraged. So not only red, swollen, ugly skin - but hey - new cysts and papules. Dang. And all for the low low price of $400 a pop. Yes, it's NOT cheap. But.......
I've now completed my 4th treatment, as of last Tues. And, so far: **fingers crossed** my skin's turning the corner.
I've only had about 2-3 small cysts come up after the tx, and the old blemishes are drying up nicely - and my skin that's NOT peely looks pretty dang good - if I do say so. I'm feeling better about how this is all going to turn out - - 
It's NOT an easy series of treatments to go through - I think many people go in, have one or maybe 2 treatments, and see what happens to their complexions, and then say HELL NO, AiN'T GOING BACK FOR THAT. But, it really does take perseverance. If you don't pummel the sebaceous glands repeatedly with that acid and superheat to do the damage that's necessary to STOP the cysts from coming back, then you're not going to get the results that you want. It's NOT easy to go back, every 3-4 weeks to have your face literally burned and then, walk around with a swollen, broken out, peely face, but let me tell you - I think it's gonna WORK.So there you have it. Sorry for the manifesto! But, there's so much to say - - it's been an interesting experience, let me tell you. But I wanted to relay as much as I could for anyone who is considering this form of treatment. It's not easy, it IS expensive, and it's something you really have to commit to to get the maximum benefit. But, for me, it seems to be worth it.
I'll keep you all posted on tx #5 - - and feel free to ask any questions you have..... I'll help out however I can!! Good luck to all of you in your quest for better skin! We ALL deserve it!! Patti
