What is photodynamic therapy?

Photodynamic therapy (PDT) is a special treatment performed with a topical photosensitizing agent called Levulan (5-aminolevulinic acid , or 5-ALA) activated with the correct wavelength of light. These treatments are used for;

• Removal of sun damaged pre-cancerous zones and spots called actinic kerotosis.
• Sun damage, fine lines and blotchy pigmentation
• Minimize pores and reduce oil glands
• Effective treatment of stubborn acne vulgaris and acne rosacea.
• Improve the appearance of some acne scars.

Indications for PDT

ACNE:

• Mild to severe acne
• Acne unresponsive to other treatments ( topicals, antibiotics, accutane, etc.)
• Acne treatment in combination with other treatments.
• Acne treatment for people that do not tolerate or are allergic to other treatments

ACTINIC KERATOSIS:

• Pre-cancerous skin lesions that may develop into squamous cell cancer.
• Patients previously diagnosed with BASAL CELL CANCER and SQUAMOUS CELL CANCER

What are the disadvantages?

Some redness 2-3 days after the treatment can be expected
May expect minor to mild peeling of the skin.

Before

After

Before

After

What are the advantages?

1. Safe and painless (vs. liquid nitrogen, Efudex and Aldara)
2. Easier and more convenient for patients than repeated topical liquid nitrogen, Efudex or Aldara
3. Reduced scarring and improved cosmetic outcome compared with cautery, surgery and Efudex. Liquid nitrogen can leave white spots on your skin.
4. Levulan improves the whole facial area treated creating all one colour, texture, and tone rather than just spot treating with liquid nitrogen, cautery and surgery.

In summary, PDT matches the “ideal treatment“ for photodamaged or acne skin:

• well tolerated (essentially painless)
• easily performed in our clinic
• non-invasive (no needles or surgery required)
• excellent cosmetic outcome (particularly in cosmetic sensitive areas of the face)

How does PDT work?

Topical application of ALA to dysplastic, neoplastic, non-malignant inflammatory and hyperproliferative skin lesions such as Actinic Keratosis (AK) and Acne, results in conversion of ALA to photosensitizing concentrations of Protoporphyrin IX (PpIX).

When such lesions are exposed to light of appropriate wavelength and energy, accumulated PpIX produces a photodynamic reaction, during which cytotoxic (cell destructive) chemicals are formed. This reaction leads to the eradication of the lesions treated.

Bacteria in the hair follicles and sebaceous glands are responsible for acne. PDT (with Levulan and Blu-U treatment) inactivates the bacteria and shuts down the sebaceous glands in the skin. It has no affect on hair.

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.

Patients with acne benefit from a single treatment of PDT. If necessary it can be repeated after a month. Another option would be weekly Blu-U light treatments following the initial PDT treatment.