Pore, Acne    Acne

여드름 소개
The reasons for worsening acnes is affected by hormones, cosmetics and stress, etc. It is an ideal to target the causes, but this is very difficult in reality.

Acnes generally manifest due to the following 4 pathophysiologies: Increased sebum production, abnormal follicular keratinization, proliferation of P.acnes, inflammation. Acne treatment is to control the entire or partial pathophysiologies.

There are a number of treatment options. But according to over 10 years of acne treatments experiences in JD clinic, the PDT(photodynamic therapy)+Microneedle radiofrequency treatment is essential.The early acne treatment is very important.Depressed acne scars influence the quality of life of an individual significantly.
1PDT (photodynamic therapy)
PDT(photodynamic therapy)

Mechanism & Principle
PDT needs photosensitizer, light source, oxygen. Photosensitizer(ALA) is activeated by visible lights and reactive oxygen is made. This induce apoptosis and necrosis of sebaceous gland cells.

PDT woks effectively in 4 kinds of pathophysiologies
• increase of sebum production
• proliferation of P. acnes
• inflammation
• abnormal keratinization

• Excessive sebum production
• Enlarged pore
• Hot flushing due to mild inflammatory acne
• Moderate~severe inflammatory acne
• Acne of children and pregnanant woman
• Skin rejuvenation (skin texture, elasticity)

• Porphyria
• Systemic lupus erythematosus, SLE
• Photosensitive skin disorders
• Allergy to ALA

Time of procedures
• 2~3 hours (PDT only)
• 3~5 hours (PDT+microneedle RF)

Processes of procedures
• Extraction of comedons (meticulous extraction is very important)
• Softening of comedons and skin
• BHA application
• Aquapeeling
• Laser extraction( if needed)
• Numbing cream about 30 min
• Microneedle RF
• Application of ALA
• Injection for inflammation reduction
• Irradiationf of blue and red light
• Soothing management

Interval of procedures
• 3~6 months (PDT only)
• 6~12 months(PDT+microneedle RF)

• Reduction of white head, black head, inflammatory acne
• Pore size reduction
• Sebum production decrease
• Skin texture and elasticity improvement

Progress and possible side effects after procedures
• Erythema, edema, burning sensation, pruritis
• Folliculitis
• Desquamation
• Hyperpigmentation
• Hypopigmentation

Cautions after procedure
• Washing face after procedure due to removal of ALA
• Minimize sun exposure for 48 hours for prevention of hyperpigmentation due to ALA. This hyperpigmentation disappears spontaneously with time. But it may be stressful until that disappears
• Some patients shows severe desquamation of the treatment areas. If it occurs, do not detach intentionally it but manage to be taken off spontaneously through 7 days.
2Microneedle Radiofrequency (DeAge, Scarlet)
Microneedle Radiofrequency (DeAge, Scarlet)

Features and principal
Microneedle radiofrequency treatment works by precisely delivering radiofrequency energy to the lower layers of the dermis using microneedles. This treatments stimulate collagen production and reshape skin elastic fibers gradually and continuously, restoring skin firmness and tone. It is also used effectively for the treatment of moderate to severe inflammatory acne vulgaris. It is suggested that the mechanism of action is mainly a reduction of sebaceous gland activity and the promotion of dermal architecture remodeling by thermal stimulation.

• Acne (recommend combination treatment with PDT)
• Scars (burn, postoperation etc.)
• Striae
• Skin lifting
• Elasticity
• Fine wrinkle
• Whitening
• Enlarged pore
• Skin texture

Time of procedure
• Anesthetic cream 30 min
• Procedure 20~30 min
• Post care 30 min

• none~mild

Progress and possible side effects
• Hot flushing for about 3 hours after the procedure
• Edema for about 3 hours (mild)
• Desquamation for about 7 days (mild)
• Dryness at the procedure sites for about 1 month
• Pruritis(itching) for about 14 days (mild)
• Allergy
• Postinflammatory hyperpigmentation (PIH)
• Infection
• Contact dermatitis
• Folliculitis
• The complete effect is observed around 8-12 weeks after treatment

Cautions before the procedure
• Avoid the medications and creams that affect skin condition profoundly for at least 1 month, for example isotretinoin

Cautions after the procedure
• Cold massage after the procedure for about 2 days for the fast recovery
• Moisturizing cream and sunblock
• Avoid rubbing the treatment area excessively for about 7 days
• Avoid irritating cosmetics and non-prescription cream for about 1 month
• In case of suspected infection or allergy, contact the clinic
3Antibiotics & Isotretinoin
Antibiotics is recommended to target pimple bacteria in some cases.
Since bacteria is a major reason for pimples, antibiotics can offer a quick relief.

Similar to PDT, Isotretinoin is able to deal with 4 major acne causes: however, due to the possibility of side effects, Isotretinoin is recommend only when other treatments do not work.
4Peeling & Extrusion
Peeling and extrusion are instrumental in preventing deterioration of pimples.

It is a basic option for pimple cure.
There are numerous methods that claimed to be effective in curing pimples.

However, resurfacing only cannot achieve improvement of conditions because pimple bacteria and sebum secretion are important causes for acne formation.

AHA, BHA, Gesner peeling are usually applied, and sometimes aqua peeling can be a good option as well.
5IPL & Laser etc.
These laser based treatments are not effective as PDT but these can be used to supplement

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