What is Gold PTT Acne Treatment?
Gold Photothermal Therapy (PTT) treatment is an acne treatment based on Selective Photothermolysis of sebaceous follicles with topically delivered light-absorbing gold nanoparticles.
Gold PTT treatment uses gold nanoparticles together with specialised lasers to effectively reduce acne by cleaning the sebaceous follicles, reducing sebum production and alleviating acne lesions.
How does Gold PTT treatment work?
During the treatment, gold nanoparticles are delivered into the pores and glands via sonophoresis (a method of drug delivery using ultrasound). The nanoparticles are then excited and heated with a dermatology laser. This targeted heating modifies overactive pores and glands that are responsible for acne to produce less oil, thus treating acne at the core.
Gold PTT enables laser energy to be delivered accurately and precisely to the pores. The gold nanoparticles act as focal points for laser energy, concentrating the heating effect of the laser at specific points. This allows for a highly localised therapeutic hyperthermia of tissue, lysing the overactive sebum-producing glands. Noble-metal materials such as gold are selected due to their highly desirable and tuneable optical properties for various therapeutic applications. The preciseness of Gold PTT allows doctors to specifically target the sebum-producing glands and kill acne-causing bacteria without affecting the surrounding tissue.
Gold PTT treatment procedure
- Step 1: Apply Gold PTT nanoparticles to the epidermis
- Step 2: Induce absorption of gold nanoparticles into the pores with 10 minutes of ultrasound sonophoresis at 40kHz with Bellasonic.
- Step 3: Remove the remaining gold particles that are not absorbed into the epidermis
- Step 4: Using a specialised laser to excite the gold nanoparticles, the sebaceous glands and lysed their activity is reduced, alleviating acne symptoms.
Is Gold PTT effective?
In series of clinical trials investigating the effectiveness of Gold PTT, almost all the participating patients have significant improvements after receiving Gold PTT treatment. In one such study, patients with severe symptoms such as large numbers of papules and pustules on the face, saw an average of 50% improvement in symptoms after up to 8 sessions of Gold PTT treatment over 16 weeks.
Most, if not all participants suffered no or only mild side effects. Furthermore, the treatment is practically painless, and most patients only report experiencing mild tingly sensations during the treatment.
I tried Gold PTT but it did not work!
There are many factors that can contribute to the success of Gold PTT. Each individual component of the treatment is designed to work with one another in very specific ways. Hence, even minor differences in any of the variables can significantly reduce the effectiveness of the treatment. Here are some of the reasons why Gold PTT treatment may not have worked correctly for you.
Is the right ultrasound frequency used to deliver the gold nanoparticles?
In the first stage of Gold PTT treatment, gold nanoparticles are delivered into the pores via sonophoresis, which is a form of drug delivery though the skin using low-frequency ultrasound. Vibrations from the ultrasound opens micro-channels in the skin, pushing the gold nanoparticles into the pores effectively. At The Clifford Clinic, we do this using Bellasonic, an ultrasound device imported from South Korea specifically designed for this purpose. Bellasonic emits ultrasound at 40khz, the only frequency where gold nanoparticles can be pushed into the pores effectively. Clinical trials have shown that ultrasound at 40khz is up to 15.4 times more effective than higher or lower frequencies at delivering the gold nanoparticles into the pores. If the wrong ultrasound frequency is used, the gold nanoparticles will not be delivered into the pores, and the subsequent laser treatment will have little to no effect.
Hence, it is important that the ultrasound of precisely 40khz is used in sonophoresis. The low-frequency ultrasound from Bellasonic is specifically tuned for this purpose and is therefore the only machine on the market compatible with Gold PTT.
Are gold nanoparticles being activated with the right lasers?
During the laser treatment stage, specialised lasers have to be used to excite and heat the gold nanoparticles. The silica coated gold nanoparticles are specially designed to have a peak absorbance at near-infrared wavelength of between 800 to 2,500 nm. This means that the nanoparticles have maximum efficiency in converting photo energy to heat when excited with lasers at these wavelengths. Specifically, the 808nm Diode Laser and the 1064nm Long-pulsed Laser emits lasers with wavelengths within this range and is to be used with lasers at these wavelengths, where the most efficient conversion of laser energy to heat occurs and effectiveness of the treatment is maximised. Using other lasers may introduce other beneficial effects but will reduce the efficiency in which laser energy is converted to heat energy, which is counterproductive. This not only reduces the effectiveness of Gold PTT treatment itself, the dissipated laser energy affects the surrounding tissues, reducing the specificity of the treatment.
Even if the right lasers are used, are the settings correct?
Even if the gold nanoparticles are delivered effectively into the pores and the right laser is used, gold PTT would still not be as effective if the wrong laser settings are used. In all laser machines designed for skin treatment, there are adjustable settings such as:
- Fluence, which roughly determines how much power is used in the laser. The higher the fluence, the more laser energy is delivered during treatment. More energy generally translates to a more effective treatment, but high energy settings can cause more pain during treatment, at may cause unnecessary damage to surrounding tissue
- Pulse length, which is the duration of the individual pulses used during the laser treatment. in general, shorter pulses gives a more precise treatment as the laser energy has less time to dissipate into the surrounding tissue, while longer pulses deliver more energy per pulse.
During Gold PTT treatment, it is crucial that the correct laser settings are used. Using incompatible settings would not only reduce the effectiveness of the treatment, it may also lead to unwanted side effects.
In general, the fluence setting should be sufficiently high for the treatment to be effective, but not to the extent that it becomes too painful, which is typically between 10–50 J cm−2. Also, the pulse duration should be in the milliseconds range, long to effectively heat the gold nanoparticles, as opposed to microseconds and nanoseconds in other lasers. These nanoparticles focus the laser energy, providing effective, localised and precise treatment of acne.
Effective Gold PTT treatment requires a combination of the right ultrasound frequency to deliver the gold nanoparticles, the right laser to excite them and also using the correct laser settings. Even if one of variables are incorrect, it will greatly reduce the efficacy of the treatment.
The Clifford Clinic is the first clinic to offer Gold PTT treatment in Singapore. Hence, our doctors are highly experienced in providing this treatment