Blue Light Special

This light source can target acne and early skin cancer without injuring healthy cells

July, 2004

A new treatment for acne or early skin cancer may have the added benefit of inducing a short siesta. Light-emitting-diode (LED) technology is increasingly being used to treat acne and eliminate precancerous cells. The process is so noninvasive that, after donning protective eye gear and reclining with their faces three inches from the light panel, most patients fall asleep during the 20-minute treatment.

Rather than delivering a series of sharp or hot pulses of light to the skin, such as intense pulsed lasers (IPL) used for skin resurfacing, this LED system slowly delivers light at low power, less than that of a 25-watt bulb. Last year, this light source was approved by the Food and Drug Administration to treat acne, but was originally developed to eliminate actinic keratoses, precancerous cells that could turn into squamous-cell carcinoma, the second most prevalent type of skin cancer in the nation. In Hawaii, 62 out of 100,000 residents have squamous-cell carcinoma, five times the incidence among Caucasian males on the Mainland.

Hawaii’s first adopter of this technology was Dr. Greg Caputy, chief surgeon of the Aesthetica Laser Surgery Center, who has had the system since November. With adjustments to its wavelength for either acne or early skin cancer, the light can target areas requiring treatment while doing minimal damage to surrounding cells, says Caputy.

“For mild to moderate acne, it kills off the acne-causing bacteria. Unlike antibiotics, it leaves your normal flora to then grow and protect you against recurrences,” says Caputy. The biggest downside, he says, is the frequency of treatments – twice weekly for five to six weeks.

Treatment for precancerous cells starts with aminolevulinic acid, which goes into rapidly dividing cells. “When you shine this particular wavelength of light on it, the acid is broken down into a chemical that then kills the cells when it’s irradiated,” says Caputy, a process called photodynamic therapy. “Generally, one treatment will reduce the number of actinic keratoses and sun damaged areas by 90 percent to 95 percent. Most people will need only two treatments, usually six to eight weeks apart,” he says. “The downtime is minimal, two or three days, and most people can wear their regular makeup from day one.” In contrast, Effudex, another nonsurgical, early skin-cancer treatment using only a topical cream, leaves patients’ skin red and flaky for two months.

Plastic surgeon Dr. Norman Goldstein acknowledges that the technology is promising. However, he says, “If a patient gets too much sun, the skin gets too dark in the places where the treatment was done.” Caputy says that he advises his patients about sun protection, but esthetician Nancy Wilder says that’s not enough. Wilder advises consumers to be wary. “I’d rather go to someone who’s been doing a procedure for five years. As a patient, I don’t want to be a guinea pig, ” she says. As of mid-May, Caputy had treated 80 patients over a six-month period. He says he is upfront with his patients. “I’ll tell them what we know so far and tell them that we haven’t done a thousand patients, you’re going to be No. 5. Many patients will wait, and others will give it a try, if they think the new technology fills some gap.”

Both Goldstein and Wilder say that Hawaii’s multiracial population may not be well represented in U.S. mainland clinical trials. However, Caputy stresses that his treatments are FDA-approved. “I’ve contacted the people who have done the studies, and if they say, every non-Caucasian got splotchy pigmentation afterwards, then we’ll pre-treat the first few patients to prevent that, based on our experiences with other light sources.”

Aesthetic industry analyst Michael Morretti says clinical trials have proven so successful that home-use applications could arrive on the market by next year. Until then, the prospect of taking a 20-minute nap at the doctor’s could make an appointment with the blue light something patients actually anticipate.

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