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Howdy ya'll, here is my progress topic for Levulan with Blu U for moderate acne with VERY oily skin. I have chosen this treatment as a last ditch effort before going on accutane again, as it is marketed to shrink the sebaceous glands. I previously chickened out of accutane due to the severe dry skin (literally could not eat at times). Granted, I was taking what I feel to be a rather high dose (80 mg a day), so any future courses will probably be much lower (10 mg first month, 20 next month, etc).
Previous attempts at controlling the problem include vitamin B5 (2003), accutane (2012, only lasted a month) vitamin D (present), and dairy free gluten free diet (on and off since 2003). The vitamin B5 worked well but who wants to take a mountain of vitamins every day for the rest of their lives?
Day 0, Nov 1, treatment day: It's a Friday, and head to the dr. I am escorted into an exam room and my face is cleansed with St. Ives apricot scrub (tacky much?) and acetone. I hold a mini fan to help the solution dry, then the tech applies the levulan with a stick applicator (Google image search to see what I mean). The application is quick and I am sent to a private waiting area to allow this solution to soak for an hour and a half.
After what seems like forever I am called back to the exam room, where I am seated and the BLU U machine is positioned in front of my face. I am given some sun tan salon style goggles, which I put on, and the machine is turned on. Other reviewers describe this as intense pain, but I didn't think it was bad at all. After about five minutes, my skin does indeed start to feel as if it is slowly cooking, so I give it some breif blasts with the cold air hose.
16 minutes later, the machine turns off (hooray for making it through the whole thing), and I get a look at myself in the mirror. Nothing too bad, just some moderate redness. I am instructed to rinse off the solution with cold water at the sink, and given a cloth to pat dry my face.
Since it is important to stay out of the sun for at LEAST 48 hours after this treatment, I put on a giant wide brimmed hat before leaving the building and make my way home. Fellow motorists couldn't help but notice the guy with the red face and the giant hat, giving second and third glances.
After getting home, the pain started to become more intense, so I took some tynenol and went to bed. Redness was very noticeable, but not terrible.
Day 1: Waking up today, I notice some white deposits on my pillow case. I head to the bathroom to see what's up. My face is purging. A LOT. And it's not pretty. Tons of white heads have surfaced and made their presence known. Some are still closed, while some have broken open on their own. A quick shower takes care of most of the weeping sores, but some remain. Redness is more intense than day 0. While showering, I feel my nose to see if I can feel the oil slick that is typically there. Unfortunately it is 
. Hopefully the treatment will continue to close this area off, so to speak.
Day 2: Some spots appear to be healing and new skin seems to be forming around the temples and sideburn area (sorry, don't know the technical name). Redness is more intense around the under-eye area and around the mouth - I'm guessing these are going to be the areas that peel. I have to go to work tonight and I'm not looking forward to it.
Day 3: One word to describe the condition of my face: Chunky. Chunks of dried expelled matter, chunks of dying skin, and chunks of facial hair caught up in the mess (fellas, get a beard trimmer with a guard if you're going to do this). Work was ok, got some interesting stares, most people assume I was in the sun too long. I am egar for the week to be over. Redness is better. Tightness is begining to set in, will probably get much more intense later today or tomorrow.
Day 4: Tightness becoming very noticable, swelling is increasing. Need to have ibprofen and tramadol (ask for it at the apt if you can) handy. Benadryl for intense itching. Skin purging continues, although new whiteheads are not as frequent. I am using a pair of brand new nail clippers soaked in alc for 20 seconds to clip off dead skin without pulling. Some good news: I am starting to see what my "new" nose is going to be like, half of the right side has brand new skin on it and it looks very nice, with very tiny pores! Perhaps the pore closing mechanism indeed takes a while to commence. This is probably the worst I have looked during treatment overall though, with dried pus everywhere.
Update, day 8: Healing very well now, and seeing some nice new skin forming. Some minor initial breakouts, which have been healing very nicely with some newly prescribed Aczone. Oil production seems to be down by 50%. I am a few days behind in healing time vs other pdt patients, which is somewhat of a good thing (I think) because it means that the treatment has had a greater/deeper effect.
Notes: Day 5 and 6 were some of the most painful of my life! It's vital to have a thick cream like Cetaphil (in the jar) around to help with the burn and itch. I was trying to get by with the thinner lotion the derm sold me, but that just wasn't cutting it. Wear a cetaphil mask with pride, and to hell with what anyone else thinks.
Day 12: Healing is still in progress. Right now I look "normal", but I can see a distinct difference in skin color from where the levulan was applied if I look closely. Some hard, lumpy nodules have surfaced on my right cheek. Unlike the breakouts during the first 72 hours of my healing, these aren't going away quickly. The tech warned me that I might break out if I didn't use an antibiotic after my treatment (and I'm using Bactrim and getting them anyway, go figure). I've dotted some queen helene mask on them (gentle enough for now I think) to hopefully hasten their lifespan. On the plus side, MUCH less oil! I think it's 33% of what it usually is. I do still have pores on my nose that appear to have blackheads still, but I'll worry about those some other time.
Overall, the goal seems to have been reached, and once these stubborn nodules are gone, I should be looking much better.
interesting, keep us posted, and I like your 2014 goal, a lot!
thank you mrsrobinson 
Friends, it's been a while since I updated - I wanted to give a few weeks of healing time to see if the results are any better. First, the good (which is not very much):
- Less oil, pores on nose seem smaller
Now, the bad:
- Hyperpigmintation, quite severe near the under eye area
- Overall red/orange hue to the face
- General pain, flushing, need to take an ibprofen every morning to reduce this
- The worst acne I've had in years! Specifically on the forehead and cheeks, when usually I just break out near my nose, lips and chin.
- Possible aging of the skin!!!!
Right now I'm giving this treatment 2/5 stars, due to the reduced oil production. I'm controlling the active acne with Dan's BP, which I have to apply every third day since I'm still in the healing process. The healing is taking much longer than I thought. The outbreak is lasting longer than the two weeks mentioned by the tech. One of the reasons I got this treatment was that I DO NOT WANT TO USE TOPICALS OR ORAL ANTIBIOTICS ANYMORE! I'm still using both, at higher doses too!
Overall, the treatment I don't think is worth it. The reduced oil is a small benefit. It is not worth looking like someone blow torched your face for this. I look at my before photos and am kicking myself in the butt. I had moderate but controlled acne, with oily but healthy skin. With a touch of sun and some powder, I looked fine.. Now I have less oil, but with severe acne that takes forever to heal, potential skin texture changes/roughness, and possible loss of facial volume. I won't be able to go outside for at least another month. As with accutane, this treatment is at the far, far end of the spectrum and all other options should be considered. Even though I hate the feeling of topicals, I wish I had given the DKR another go for three months before considering this.
I've had small breakouts after microderms and TCA peels. These breakouts are NOTHING like that. These are severe, extremely painful and slow healing breakouts - with red marks that will more than replace any "removed" by the PDT treatment. I was excited at first because I thought that the aggressive nature of the treatment would net me great skin in a month - it certainly is taking longer than that. Each day gets better and I am not going to get all depressed about doing this to myself. I simply must make the best of this situation by applying the cetaphil and perodic BP and Aczone as my skin allows.
Next year I will start the DKR with a positive attitude. I might also do Blu-U WITHOUT the bloody (literally) levulan, I had seen some modest clearing with it by itself with no dryness.
Buyer beware! If you decide to do this, do NOT do the full time under the light! 5-6 minutes tops!