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nixnil

Photodynamic Therapy Log for Mild-Moderate Acne

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About me:

I am 25 years old, Asian with fair yellow tone skin. Had acne since I was 12 years old. Mild-moderate facial acne. Alot of comodonal acne (esp. blackheads) due to the use of Tazorax (I guess it purged it but didn't totally get it out). Always have 1-2 inflammed big, red, and ugly pimple on my face and occasionally have a cystic one. My acne is rather mild and can be covered with makeup but it's really stubborn. Also, bad habit of picking it always lead to scarring. I have about 5 pitted scars on my right and left cheek. Areas under my nose is always red and my chin has horrible blackheads. I have huge pores all over my face and most of them are clogged. My skin is also very oily and I blot constantly.

I've tried Differin, Retin-A, BCP, Clindamycin, Dorax (sp?) antibiotic pills, and now using the new Differin, Tazorac, Benzaclin. The Dorax helped to clear my back but did minimal for my face. Tazorac get rid of the inflammed acne quick but left red scars and takes forever to heal. My skin also got very itchy and dry from using all these stuff. I didn't want to try Accutane because of the side effects.

I went to Nuveau Asethetics in Houston, TX and the medical director is a medical doctor. She suggested I try PDT and after researching online, I figured, why not? I had extra cash to spare (just for the moment) and so I went ahead and made my appointment. Due to my move coming up in August, my treatment schedule was compressed to a month:

July week 1 - Levulan with IPL $500

July week 2 - 1319 Laser $100

July week 3 - Levulan with IPL $500

July week 4 - 1319 Laser $100

I shall start documenting my log and will provide photos. I have no clue what the outcome will be so please wish me luck!

Attached are photos of me 1 day before the treatment.

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Day 0 - Treatment #1 Day

Photos were taken of my face when I got there for documentation purposes. Then I was given a quick microdermabrasion at a very cozy 'spa-type' room. This is my first time having a microdermabrasion and it was interesting. Basically it was a tube shooting crystals and sucking it back constantly to remove oil and dirt from my skin. The aesthecian did it for me and it lasted about 5 minutes. Then she wipe it off with water and cleansed it with a cleanser. I was then moved to another room for the treatment.

This is a more private room with nice couches and it has 2 rooms within which contains the laser equipment. The medical director came in and talked to me about the treatment process. She's really friendly and talking to her ease my nervousness. She let me lie down and she checked out my acne condition. She told me that the blackheads are emerging due to Tazorac and I will require some physical extraction to get rid of them. This can be done before my next appointment. The good thing is those blackheads are easy to remove so it should be done with minimal impact if done correctly. I was excited to get rid of them so I agreed. Then she opened up a small acetone satchet and wipe it all over my face. It tingles a little but nothing unbearable. She took out the levulan which is in the form of a pen. She snapped both ends to get the powder and solution to mix. She shaked it a little and started applying on my face. It feels just like a roller perfume vial... and it didn't really hurt. There were tingles especially in area where I was having a breakout. It felt wet but the Levulan seem to absorb pretty fast and I was not drippy. She kept shaking it, squeezing it and trying to get the most out of it. After about 10 minutes, I guess she feels that she had gotten most of the solution out and she said I shall rest in the room for 30 minutes for the Levulan to absorb. She also turned off the light in case the Levulan start activating and cause pain.

30 minutes later, she came back in and started wiping the Levulan off my face using water. She then applied a cooling gel on my face to prep me for the IPL (intense pulsed light). She told me that it will hurt like 3 snaps from the rubber. I put on the small metal goggles she provided and she started using the IPL all over my face. IT HURTS! I can also feel the heat and see the bright light a little which makes me feel like someone was welding my face... She gave me a squeezeball and told me that if I need a break, I can let her know. I believed I called for a break at least 5 times. Each break was like less than 5 seconds so I can have a deep breathe and continue. She went through my face twice and did a thorough job covering all corners.

Right after the IPL, I was only red on a little corner around my forehead and around my nose. Nothing severe. She even turned the room light on and I wasn't even reacting to it. She told me that if my skin is not red by tomorrow morning, I should go out under the sun for less than 1 minute to reactivate the Levulan and run back indoor. I put on a visor and wrap a scarf around my face and went back to my car to drive home. I didn't feel any burn when I was driving and even when I was home, my face looks normal. I was not even red anymore. I was a little weird out because I was hoping for tomato red skin. But no.. my skin was the way it was when I woke up that morning. I got a little sad. It was like that all night and even after 6 hrs later. So all in all, there was no visible change to my skin on Day 0.

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Day 1 - After treatment #1

So I woke up this morning and my skin was still normal looking. I was rather disappointed. So I heed the doctor's advice and went under the sun for a little bit. It was 9am and the sun in Houston was rather bright. I was only out for 5 seconds and I felt the burning sensation. I toughened up and stayed for about 30 seconds and ran back into the house. I ran into my bathroom and My oh My, my face was red! It started swelling a little bit and it felt very tingy. I was pretty excited actually because that's what I was told I should be. It was not that painful but it was just different... feels like a sunburn.

I immediately took some photos and attached it in here.

Note: It's been 1 hr since I took the pictures. The redness have subside but still some redness persist. I am, again, disappointed that I wasn't as red and swell as what others have described. We'll see how it goes today and tomorrow.

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Day 1.5 - Night of the Day after treatment

So I have to say I notice some difference. My skin was not as oily as usual and I didn't even need a blotting paper today. I notice my overall skin is clearer and the redness around my nose is lesser. Somewhere around the edges of my nose I notice dryness and I assume it will peel soon. But some active pimples have died down and got flatten. Alot of blackheads popped out though and there was this small whitehead on my chin that came out and popped when I was in a shower! Leaving no scars. I am beginning to see some positive effect. I attached the photos I just took in here. I didn't see any difference with my left face but if you look at the front portrait and the right side and compare with the Pre treatment photos, you can tell that the overall skin looks clearer and more even.

Again, I'm still not red. The doctor told me that 1 minute under the sun maybe what I need everyday to reactivate the Levulan. I guess my skin is just that tough after the use of prescription =P

Ps: I also have a really bad headache this morning after the sun exposure. I came down with a fever which lasted for half a day. Also, I had a bad stomachache since last night and it subsided tonight. I am not sure if the stomachache was link to the Levulan at all. But i am sure the headache and fever was due to the morning sun exposure. So glad I saw the July 4th fireworks from my window. That helped alot.

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Day 2 - 2nd day after Levulan treatment

So I woke up this morning and my face was as normal as ever. I was a little oily and after a shower, I feel much better. I use a clarisonic twice a day so I did notice a piece of dried skin around my nose. It was a small 1/4 inch big piece. It fell out easily through the day without me doing anything. I also noticed some dry patches but they were so small I didn't do much with it. I didn't notice any reduction in the redness since last night. I also didn't notice any increase in pimples or anything.

I heed my doctor's advice and went out under the sun just to reactivate the Levulan a little more. But this time the sun didn't do anything. IT DIDN'T HURT AT ALL! Damn.. I guess all the Levulan had stopped working?? I have no clue. It didn't help that today was a cloudy day but there was still some sun. I stayed out for like a minute and didn't feel anything.. so I went back into the house disappointed.

Throughout the day. nothing really happened. My hands got a little bad and I started using a blackhead extractor to get those little blackheads out. I used it gently all around my face just trying to get those easy to extract ones out. Indeed a bunch were out effortlessly. Those that may require more effort I left them alone for the aesthecian to get them out. After all is done, I still didn't notice too much difference.

I'm not sure what to expect now. Like what my aunt always said, no pain, no gain. I did fork out lots of money for this treatment which is a pain in the behind... but I didn't feel any physical pain which makes me wonder how much have I gain.... I don't know... I plan to call the doctor on Monday.

I've read that some people didn't notice any difference or feel any redness in their first treatment but got worse during the 2nd treatment. I also read that sometimes you don't notice the difference until a month after your treatment. I am trying to stay optimistic and hope for the best down the road. I still have 1 deep cleansing facial, 2 1319 laser and 1 levulan+IPL treatment to go. Hopefully those will help me to notice more difference.

Attached is a photo I took just minutes ago. I took more but due to the limitation on attachment files, I can't include them all. Since I got the treatment at about the same time on Thursday, this will make it exactly 48 hours after treatment. Notice I have no change in redness and no change in # pimples. Basically, NO VISIBLE DIFFERENCE.... just a temporary broken heart. Maybe I shall go get some popeyes and cheesecake milkshake to cheer myself up.. 2 big sins I let myself indulge in couple times a year....

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Day 3 - 3 days after Treatment

Woke up today and didn't notice any visible significant improvement. 1 whitehead did came out on my left cheek but oh well.. I tend to get a new pimple every other day so I guess this is no surprise for me. But since I was expecting a much worse breakout after Levulan, this was pretty good enws already.

The sun was bright today so I went out for a <1 minute sun exposure... guess what! Surprise surprise.... no reaction =( Oh well. I was home for more than 50 hrs straight and it's driving me nuts. So I decided to go to the mall and then head to my favorite restaurant to buy some awesome dessert.

After I took a shower, I slapped on some moisturizer and started preping my face for makeup. I did notice that my skin have less flaws to conceal and even those that are there are easier to conceal. I am faithful to the Laura Mercier line and I uses their secret camoflauge concealer and their mineral foundation. I included a photo of me with makeup in here... if you take alook, you will see my face looks pretty good! I immediately felt more confident and put on a pretty dress to go shopping.

When I was at the mall, I checked out my usual Laura Mercier counter at Saks Fifth Ave. I was interested in trying out their liquid foundation as I felt that my flakey skin may show up more with their mineral powder foundation. The makeup artist took off my makeup and he even said that my skin looks healthy and is really not that bad. I told him that I was undergoing some prescription and treatment for my face which made my skin purged and all. He actually said my skin is pretty good and the pimples that are out seem to be healing. He claimed to be an acne victim as well and and he had to go through lots of prescription and treatment as well. I don't know if he was lying but I really dont' care because he made me feel a little more comforted. He went on to use an oil free foundation on me. He applied it flawlessly using a wetted sponge over their oil free primer and dab on my usual secret camoflauge concealer. Alright, I admit. I caved into his sweet talk and I bought the liquid foundation and primer. Oh well! I looked pretty much flawless for all day and even when I got home, my face looked great against sunlight.

When I took off my makeup using my usual Purpose cleanser and clarisonic today, I notice some skin around my nose and forehead are showing signs of peeling. The one on my forehead was actually red, leathery, and looked sun damged. I notice that this morning already but it just got more obvious. I read that some folks experienced this more after Levulan. This was also one of the only spot that was red after the IPL so I guess this spot really got affected and needed to come off. I took a picture of it and you guys can take alook.

Anyway, realized this post is going long and off topic. I'm going to end here and start attaching photos. I've reached maximum storage so I'm going to attach as internet link. Hopefully my skin will continue to improve.

Photo 1 - With makeup

(note, this is my own application, not by the LM makeup artist.. it looks ok but not as great)

Photo 2- After I remove makeup, front

Photo 3 - After I remove makeup, left

Photo 4 - After I remove makeup, right

Photo 5 - After I remove makeup, right of forehead (see red mark that is circled in red)

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Just wanted to say that I'm enjoying reading your updates and hope you'll keep posting them :)

Thanks! I'm holding on updates until my next treatment. I am going for a deep cleansing facial today and the 1319 laser on Friday. Will keep you posted. Thanks!!!

BTW, my skin is just the way it is the last time I posted. There were a couple new breakouts but they were small and were cleared within 2 days. My skin also got flakier but nothing like crazy peeling like what some people experienced.. just look like I rub my nose a little too often. However, I notice that whenever I uses vitamin E oil, it helps the skin heal faster. We shall wait and see!

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FYI: When I had PDT w/ Levulan I didn't see results until after the 3rd visit. Also, I saw full results about 2-4 months after the last treatment. Acne was better, but came back.

Also, I'm not sure what method you are using, but IPL is a laser and PDT is a blue light that you sit under. Maybe it's a new therapy?

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FYI: When I had PDT w/ Levulan I didn't see results until after the 3rd visit. Also, I saw full results about 2-4 months after the last treatment. Acne was better, but came back.

Also, I'm not sure what method you are using, but IPL is a laser and PDT is a blue light that you sit under. Maybe it's a new therapy?

Hi, thanks for sharing. I've only had 1 treatment so far and it's been 8 days. I have seen some results but nothing too obvious yet because there's alot of things going on for me... extraction, laser, Rx.. but I've notice that my pores are less clogs and I have less active pimples (Other than those caused by extractions).

I'm going to update my laser treatment today. Thanks!

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Day 8 - 8 Days after 1st Levulan treatment, Had 1319mm laser this morning, deep cleansing facial w/ extraction yesterday

So it's been 8 days since my first Levulan treatment... nothing bad came out from it but nothing significantly improved either. I went to a deep cleansing facial yesterday as suggested by my doctor and the aesthecian did helped to clean out my pores. She said that my pores were real clogged but they were not too difficult to clean out because the Tazorac already pushed them to the surface. I went home with 5 more pimply red marks on my face because of the extraction but the great thing I notice today is that they heal well and doesn't go crazy like my previous pimples.

And today I went to see the doctor for 1319mm laser. I was supposed to get that yesterday as well but my doctor was out sick... anyway, I talked to my doctor today and she said she saw some improvement and I should look better once all the active pimples calm down. However, because I didn't peel and didn't get that red over the first treatment, she wants to make the treatment more intense. Meaning the Levulan will be left on longer, for like 45 mins, since the 20 mins didn't do too much on my skin. To help with the Levulan PDT treatment, she did a 1319mm laser for me today. It's basically a collagen booster and it doesn't have any downtime. It was less painful compared to the IPL but it's still hurts alittle.. like getting tiny shocks around your face. But it was tolerable. The doctor did 2 passes around my face. She said I should see results in 6-8 months (yikes!) and it should reduce acne scarring and reduce sebaceous glands activity. For now, she suggests that I continue with my prescriptions... Tozarac, Differin, and Benzaclin.

About an hr after the laser treatment, I definitely noticed my pores were smaller, skin were tighter, and firmer. But after half a day, that effect died down. I think that's just temporary and over time, I will see more improvement.

I just washed my face and I took some photos. Here's what I look like today. Overall, if you compare to previous photos, no significant improvement. BUT I notice a high reduction in terms of blackheads and white heads. Some old pimples were gone but some new pimples came out. No surprise for me because that's pretty normal. Skin is just as oily. However, my skin was abnormally dry today and I had to put some aquaphor on. The aquaphor is on my face now and it stings a little. I have no clue. Oh well. I'll sleep over it. I have so much going on tomorrow and so many friends to meet up... I hope things will get better soon.

Today's photos:

Face Front

Face Left

Face Right

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Day 14 - Day of 2nd Levulan + IPL Treatment

So the day is here! It's my 2nd Levulan + IPL treatment and I was pretty excited! It was supposed to be Friday but something important came up for the weekend so I had to go for it earlier. Glad my doctor was able to accomodate.

This time, the Levulan was left on for a pretty long time. The doctor first did microdermabrasion for my skin, then used a pomegranate toner (she said it's a very light enzyme peel) to wipe my face clean. Then she put on the Levulan. She commented that my skin had gotten alot better(less active and bumpy pimples), with the exception of 3 big pimples that popped out after the deep cleansing and the 1319 laser. She applied more Levulan on my right cheek, under nose area and on my chin, which are still pimply. She took about 10-15 mins to apply the Levulan. After the last drop, she timed 30 mins for the Levulan to sit. So in fact, some parts of my face was soaked for about 45 minutes. Unfortunately, 10 mins before the IPL treatment, the doctor found out her machine wasn't working! Oh well. She called the repairman who said it will take about 2 hrs for them to come fix it. I was fine with it so when the time was up, she wiped the Levulan off my face and clean it up using the clarisonic. Since I live near the office, she said I should go home and wait and when the machine is up and running, she will give me a call. Since I do have half day off from work and I've a rather patient person, I was ok with that.

The drive home was ok. I wore a visor and sunglasses and my face was fine. The spots where the 3 big pimples were were red and swollen. The doctor said that's the Levulan acting up. So about 2 hrs later, the office called and they said they are ready for me. As I walk under the sun, I can feel the tingles on my face. My drive there is at most 5 minutes but I can definitely feel a slight burning sensation all over my face. By the time i got to the office, the doctor said my face was already red. She was so excited! haha. Since I did put on sunscreen when I got home, I had to clean my face again. She then did an acetone wipe (quick one) and we started the IPL. She said that my face was already red so she will just do 1 pass with the IPL to activate the Levulan. And this time, the IPL hurts ALOT more than before. It was skin deep and I can feel it burn!! Woohh.... I had to call for breaks sooo often. My face was pretty much on fire after the IPL. I looked in the mirror and I can see red all over my jaw and chin (where she applied more Levulan) and some parts of my cheeks were even swollen. That's a much greater effect compared to what I had in my first one. My doctor was so psyched she exclaimed that I will see great results this time. She said I should be redder tomorrow and should peel more. She even emphasize that I should start using hydroquinone cream tomorrow if my face is less sensitive. She said this could reduce the potential for hyperpigmentation that is common among asian skin.

I quickly put on my visor and drove home. This time, the drive was stingy.. but with the sunscreen and visor, I was ok. When I got home, my face was rather red and swollen. I used purpose cleanser and my clarisonic to clean off the gel on my face and applied oil of olay SPF15 lotion to sooth the skin.

It's been 4 hours and my skin is still red. It's less swollen but I can see some spots darkening already.. especially around my forehead and jaw. It's not dark brown.. just a darker red than a fresh red compared to this morning.

Here's some photos. Will keep you all updated about my progress for the next few days. I may skip work tomorrow but will like to go back to work on Friday and out for the weekend so please! Hope that my skin can handle it as well as the last time (last time have 1 day downtime only! oh, but i did notice improvement in skin and had some small gradual peeling for past 2 weeks).

Face Front

Face Left

Face Right

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Hey there, I've been following your post for a few weeks now and wanted to see how your last treatment went? I'm also Asian and have been thinking of getting Levulan + IPL done on my face (to help get ride of freckles and shallow acne scars). I'm VERY nervous, however, about hyperpigmentation. Has your skin healed fine since your last laser treatment? Has the redness subsided? Also, I haven't had acne in quite some time but am worried that this treatment may cause some purging- have you experienced this? Would you recommend this treatment to others?

Thanks!

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A month since my 1st Levulan treatment

- Had 2 Levulan treatments total, 2 weeks apart

- Has 2 1319 laser treatments in between.

So sorry for not posting after my 2nd treatment. I came down with a really bad fever and had been sick for the past 2 weeks. I was also moving this week so things were just all over the place.

My last treatment went especially well because my doctor was able to find the problem spots and she applied more Levulan on those spots (above my lips, around my chin) and those area PEELED like crazy in BIG pieces. They totally cleared up that area! I had a couple white heads flares since (last one subsided 2 days ago) but they healed well and quick. I believe my skin is still in the healing stage. After the 1319 laser last week, I can feel my skin tighter and pores smaller. Some stubborn red marks and bumps have also been improving.

My skin has healed fine since. My skin usually healed pretty fast after the treatment. It took 4-5 days with minor peeling throughout. It's been 2 weeks since the last Levulan and I am no longer peeling/flaking. I uses the clarisonic to wash my face and I can definitely tell my skin is firmer and smoother. Makeup also apply better. The laser treatment doesn't cause any problem to my skin. I may look red for like 1-2 hrs but after that, it was back to normal.

I did purged quite a bit throughout my treatment. Some lasted till today while others were gone quick. I still have some that started a month ago but I can see they are 'non-active' and slowly healing.

All in all, I will recommend Levulan + IPL to folks who have moderate to serious acne. They will not see 360 degree change but they will get more managable skin. Levulan is not a cure. It's another treatment, that should be coupled with other topical treatments to help curb acne flare. If you the $ to splurge, it's well worth doing. It doesn't have any side effects other than the discomfort for those few days after. As for me, Levulan didn't give me the flawless face I wanted but it definitely got rid of the unsightful pimples and blackheads that I hate. My skin is less oily and I feel more confident. To some extent, I feel more normal.

I am using my work computer now as I am now staying in a hotel while my house is getting moved. So I won't have any photos to show. But just you know, it's improved alot and if I wear makeup, I won't look like I have a pimply face.

Good luck to all and if you have any questions, please feel free to ask! And again, i apologize that my log is not as well documented as I want. Being sick and moving is just not that great to deal with, simultaneously.

Take care!

Lin

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