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News about skin treatments using ALA and PDT
from: New York, NY June 26, 2004 -- (Advanced Dermatology PC) The medical community is always searching for a “magic bullet” treatment that can cure any host of ills without delivering a laundry list of side effects. While dermatology experts are stopping short of using that term to describe Aminolevulinic Acid, they are finding that the drug can be highly effective in the treatment of numerous skin conditions, with only a few mild side effects.
Aminolevulinic Acid (ALA), an FDA approved treatment, in concert with Photodynamic (light) Therapy (PDT) is used to treat Actinic Keratoses which are skin lesions that can lead to skin cancer. Dermatologists and researchers across the country have been studying its effectiveness in resolving other skin conditions, with positive results. According to the American Academy of Dermatology, such investigational use of ALA with short-contact PDT can help to resolve moderate to severe cystic acne, rough and discolored sun-damaged skin, rosacea, severely oily skin, and some types of warts, achieving success rates between 25% and 90% in small-scale studies and single-practice surveys. (The AAD has recently called on the National Institutes of Health to engage full clinical trials of ALA-PDT therapy on these conditions.)
Joshua Fox, M.D., founder and director of Advanced Dermatology P.C. and a leading dermatological expert, believes that one of the most important benefits of ALA therapy is the absence of reported harsh or long-term side effects. He explains, “Many patients with severe cystic acne, rosacea and other serious skin conditions are prescribed antibiotics or isotretinoin – or both – as primary long-term treatments. Antibiotics are often ineffective, though, and can lead to immune resistance problems in the long run, as well as the questioned association with breast cancer, while the use of isotretinoin has been linked to a variety of difficulties, from headaches and fatigue to dry skin and vision troubles, birth defects and rarely suicide.”
Patients undergoing ALA therapy with short-contact laser therapy, on the other hand, are likely to experience only slight tingling or burning at the therapy site, and some mild swelling for a few days after treatment is complete. According to a study published in the January/February 2004 issue of the Journal of Drugs for Dermatology, researchers at the University of Montreal Medical Centre found no long-term negative effects of ALA-PDT therapy, even when used on large surface areas of the skin.
According to Dr. Fox, ALA-PDT is a classic example of a combination therapy, because neither step alone is as effective as both steps are together. Here’s how it works: a solution of the Aminolevulinic Acid is applied to the affected areas of pre-skin cancers of the skin for a period of 20-60 minutes and removed with a sterile swab. The skin is then exposed briefly to a special blue light or laser, which activates the drug. “When the ALA is activated by the laser, it generates a toxic reaction within the diseased pre-cancerous cells, and they die off – a process called necrosis,” Dr. Fox explains. Because practitioners are able to pinpoint the therapy only to the affected areas of the skin, patients are free from the worries and discomforts often associated with systemic necrotic therapies like topical chemotherapy that may blister and crust much of the face. “There is much less ‘collateral damage’ – healthy cell destruction – and faster healing - with ALA-PDT therapy,” Dr. Fox adds.
“Aminolevulinic Acid and Photodynamic Therapy offers patients with a variety of other dermatological issues hope,” Dr. Fox concludes. “Some of these conditions are both disfiguring and painful, and often the standard treatments for them can add even more discomfort. ALA-PDT therapy, on the other hand, offers an effective alternative that can be quickly and safely administered by a dermatologist, and is measurably gentler to the patient.”
Bio: Joshua L. Fox, M.D.
Joshua L. Fox, M.D. is a leading authority in the field of dermatology with an expertise in skin cancer, cosmetic surgery, and laser procedures. As an official spokesperson for the American Academy of Dermatology and the American Society of Dermatologic Surgery, Dr. Fox has been an expert resource on dermatologic topics for numerous television networks including ABC, CBS, CNN, NBC, Telemundo, talk shows, radio stations, newspapers and magazines. Dr. Fox has served on the board of the National Rosacea Foundation and has done clinical trials in both medical and laser therapy in Rosacea. He has received multiple research and clinical awards including recognition from Top Doctors, Who's Who, Journal of Dermatologic Surgery and Oncology, Community Service Award from the American Society of Dermatologic Surgery, the prestigious Husic Award as well certificates of recognition for service from multiple hospitals, civic, educational and community organizations. Dr. Fox has authored and presented papers of his research on lasers, cosmetic procedures, stretch marks, scars, skin cancer, bug bites, photosensitivity and various rashes.
As founder and director of Advanced Dermatology and The Center for Laser and Cosmetic Surgery, Dr. Fox and associates have expanded the practice to the one of largest in dermatology, laser & cosmetic surgery with more lasers than any hospital or dermatology practice on the eastern coast. Dr. Fox is a graduate of the New York University Medical Center of Skin and Cancer and has been on the advisory board of the Psoriasis Foundation and National Rosacea Foundation among others. He has also been a fellow of many societies including the International Academy of Cosmetic Surgery, International Academy of Cosmetic Dermatology, and the Society for Investigative Dermatology. Dr. Fox is the founder of the AAD Melanoma/Skin Cancer Prevention Program in Queens, New York since 1987. Dr. Fox has been Chief of Dermatology of several major teaching hospitals including Mt. Sinai Hospital of Queens and Jamaica Medical Center and is currently on the staff of ten NY area hospitals. Dr. Fox and Advanced Dermatology the Center for Laser & Cosmetic Surgery have been used as a resource center educating dermatologists, laser surgeons, & cosmetic surgeons and others about lasers, cancer and cosmetic surgery.
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