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What Is Photodynamic Therapy?Photodynamic Therapy (PDT) is a special treatment performed with a topical photosensitizing agent called Levulan (5-aminolevulinic acid or ALA) activated with the correct wavelength of light. This is also known as “ALA/PDT treatment”. These treatments remove sun damaged pre-cancerous zones and spots called actinic keratosis. Sun damage, fine lines, and blotchy pigmentation are also improved because of the positive effect of Levulan and the light treatment. ALA/PDT treatment also has the unique ability to minimize pores and reduce oil glands, effectively treating stubborn acne vulgaris, acne rosacea, and improve the appearance of some acne scars. Patients with severe sun damaged skin manifested by actinic keratosis, texture, and tone changes including mottled pigmentation and skin laxity may see excellent results. You may also see improvement of large pores and pitted acne scars. Active acne can improve dramatically.
How Much Improvement Can I Expect?Patients with severe sun damaged skin manifested by actinic keratosis, texture, and tone changes including mottled pigmentation and skin laxity may see excellent results. You may also see improvement of large pores and pitted acne scars. Active acne can improve dramatically. How Many Treatments Will It Take To See The "Best Results"?To achieve maximum improvement of pre-cancerous (actinic keratosis) sun damage, skin tone and texture, a series of three treatments 2-4 weeks apart is the most effective. Some patients with only actinic keratosis are happy with just one treatment. More treatments can be done at periodic intervals in the future to maintain the rejuvenated appearance of the skin. What Care The Disadvantages?Following PDT, the treated areas can appear red with some peeling for 2-7 days. Some patients have an exuberant response to PDT, and experience marked redness of their skin. Temporary swelling of the lips and around your eyes can occur for a few days. Darker pigmented patches called liver spots can become temporarily darker and then peel off leaving normal skin. (This usually occurs over seven to ten days.) Repeat treatments may be necessary as PDT medicine is not an exact science. Treatment Advantages:Easier for patients than repeated topical liquid nitrogen, Efudex (5FU), or Aldara because the side effects are minimal, rapid healing, and only 1-3 treatments required.The ALA/PDT treatment at our clinic is painless verses liquid nitrogen, 5FU, and Aldara. Reduced scarring and improved cosmetic outcome compared with cautery, surgery and Efudex. Liquid nitrogen can leave white spots on your skin. Levulan improves the whole facial area treated creating all one color, texture, and tone rather than just spot treating with liquid nitrogen, cautery and surgery. In summary, PDT matches the “Ideal treatment” for photo damaged skin:
After Treatment the patient can expect and experience side effects such as:Burning/stinging, which could be severe and last up to 24 hours. Redness and swelling which may last up to 4 weeks. Scaling/crusting which may last up to 4 weeks. Photodynamic therapy may be used to treat other cancers and diseases in the future. Studies are now in progress to test the use of PDT for several types of cancer and pre cancerous conditions, including cancers of the:
Newer photosensitizing drugs now being studied may have advantages over the ones now being used:
Researchers are also looking at different types of lasers and other light sources. Some newer agents may respond to small doses of radiation as well as to light. This could allow doctors to use smaller amounts of radiation than the doses used in standard radiation therapy, which could lead to fewer side effects. Levulen has been used for the past 30 years and doctors know that it works. PDT takes very little time and it is performed as an outpatient. It is accurately targeted to the affected area, can be repeated, and has no long-term side effects. It also isn't as expensive or invasive as some other cancer treatment options and it has incredible results with those patients with acne. These are just a few of the advantages of PDT. Researchers continue to look for ways to improve this cancer treatment and find ways to combine it with other treatments to get even better results. Safety and Complications:Following PDT, the treated areas can appear red with some peeling for 2-7 days. Some patients have an exuberant response to PDT, and experience marked redness of their skin. Temporary swelling of the lips and around your eyes can occur for a few days. Darker pigmented patches called liver spots can become temporarily darker and then peel off leaving normal skin. (This usually occurs over seven to ten days.) Repeat treatments may be necessary as PDT medicine is not an exact science.
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