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Skin Care Specialist

Richard D Gentile, MD -  - Plastic Surgeon

Gentile Facial Plastic and Aesthetic Laser Center

Richard D Gentile, MD

Plastic Surgeon located in Youngstown, OH & Akron, OH

Skin Care Q & A

Photodynamic Acne Treatment (PDT)

Is a process by which a photosensitizing agent (Levulan) is applied to your skin. A Photosensitizing agent is a special solution applied to the skin that is activated by a specific wavelength of light, which “turns it on.” Levulan has been used extensively for the treatment of a variety of different skin conditions.

Levulan is a 20% solution of Aminolevulinic Acid (ALA). ALA is a “natural” product found in all humans throughout the body. It’s it is a precursor for hemoglobin synthesis. (You wouldn’t be able to make red blood cells to carry oxygen without ALA in your body.)

Photodynamic Acne Treatment Procedure

The Levulan, which is a clear painless solution, is applied to your skin and left on for 15-60 minutes. It is then activated with a specific wavelength of light called BLU-U or Clear-Light. This takes about 8-10 minutes.

The Levulan is absorbed by active cells like acne sebaceous gland,.. Making the targeted acne cells more sensitive to the light. This combined interaction of the solution and the light is what gives rise to the term "photodynamic therapy." The Levulan will also target sebaceous hyperplasia (which are thos small (1-3mm), benign bumps under your skin) and the papules of acne rosacea.

An important part of the treatment program is medical extraction of blackheads and acne pustules. This procedure will expedite the improvement in your skin condition by cleaning the pores of hardened sebum and infected debris.

The treatment reduces skin oiliness and minimizes the appearance of pore size. The entire skin texture improves following a Photodynamic Acne Treatment.

Acne and Facial Scarring Treatments

When scars are present on a person’s face, they are especially noticeable to that person as well as others. Depending on the size and location of a scar, it may interfere with structures on the face, or detract from one’s natural attractiveness. Facial scars are most often caused by acne, injury, or birth defects such as cleft lip and palate.

For years, scar treatments consisted of topical creams that were applied to the face to create a change in the skin’s appearance. Over time, doctors and scientists discovered that most scarring affects many layers of the skin, and the majority of topical substances will not affect deeper skin tissue unless they are part of a more advanced skin care regimen.

Scar Revision Options

There are many cosmetic methods that can eliminate or lessen the appearance of a scar in the most noticeable area of existence – the face. Although numerous options are available, there are many factors that contribute to the planning of your facial scar treatment. At the initial consultation, Dr. Gentile will examine your scar, skin, and face to discuss with you which procedure best suits your individual needs.

Below are brief explanations of procedures that can remove or lessen the appearance of facial scarring. 

Scar Excision

With precision and skill, incisions are created in the skin of the face surrounding the scar so it can be removed. The open skin is then closed with small sutures so the new scar heals into a smaller, thinner, and less obvious mark.

Scar Relocationing/Scar Repositioning

During a Z-plasty an incision is created when triangular flaps are created after the scar has been excised from the skin, then sutured closed to form a tighter Z shape. This type of surgery not only camouflages the new scar within natural creases of the face, but also improves facial functions that were hindered by the preexisting scar. Not all scars are suitable for this type of surgery, so patient eligibility for a Z-plasty will vary.

Skin Grafting

The facial scar is surgically removed from the face, and healthy adjacent skin tissue can be transplanted to the area where the scar was present. This ensures the most natural end result because the new skin flap will be the same texture as the surrounding areas of flesh. A minor scar may be left behind from where the donor skin was selected, but often the location and mark are concealed within the face. Skin grafting is commonly performed for prominent scars, such as those left behind from adolescent acne and burns.


Dermabrasion is a facial cosmetic procedure that can drastically improve the overall quality of the skin. During a procedure, a motorized hand-held device is used to remove the superficial layers of facial skin. Dermabrasion is comparable to a sanding process, as the surface skin is sloughed off to create a smoother, more appealing surface by speeding up skin cell renewal. This procedure can lessen the appearance of acne scars by lowering the level of the surrounding skin to match that of deeper pock marks. Dermabrasion is also effective on raised scars due to the abrasive nature of the procedure.

Chemical Peel

Highly pigmented scars have shown significant improvement from the results of a chemical peel. During treatment, alphahydroxy acids, trichloroacetic acid, or Phenol may be used on the skin to deliver varying degrees of peeling action, which exposes healthy underlying skin tissue. AHAs are used for light peels, TCAs for medium peels, and Phenol for deeper peels, creating the most dramatic results. Dark scars become more lightly pigmented, and most cases of acne clear up following treatment. It may be necessary for patients to undergo more than one chemical peel procedure when the skin has healed. Dr. Gentile will be able to determine which acid solution will produce the best results for each patient.

Laser Skin Resurfacing

Blemish-free subjacent tissues can be revealed with a cosmetic procedure that vaporizes the outer layers of skin. The damaged tissue is removed from the face with great accuracy, layer by layer when the beam of radiation emitted from the laser is absorbed by the water from hydrated skin cells. The two types of lasers utilized in this resurfacing technique are the carbon dioxide (CO2) laser and the erbium:YAG laser. These lasers differ in strength; the CO2 laser often treats more extensive damage of the skin, while the erbium:YAG laser is more effective in eliminating the superficial layers of skin and minimal scarring or damage.

Injectable Fillers

Some wounds heal to create scars that are elevated above skin level, while other tissue damages heal inward at a level below the surrounding skin’s surface. Injectable fillers improve the appearance of the latter mentioned scars, and correct the skin exactly as the name implies. These injections can contain a number of different substances that temporarily or permanently raise the level of the scar to blend in with the skin.

  • Cosmoderm – Small acne scars, can be used in conjunction with other fillers
  • Cosmoplast – Larger, indented scars
    *Both injectable fillers are derived from collagen and results may last up to three months
  • Fat – Transferred from patients own body, results can improve the treated area for as long as three years
  • Hylaform – Created from hyaluronic acid, similar to collagen, plumps small scars, results remain for up to four months
  • Radiesse – Potent formula, fills some acne scars, lasts up to one year
  • Restylane – Highly concentrated form of hyaluronic acid, multiple uses for the face, results generally keep for six months
  • Sculptra – Made from polylactic acid which is biocompatible, the generic version of this filler is used for aesthetic purposes, Sculptra can last for as long as 18 months


Laser and Skin Rejuvenation