What is Photodynamic Therapy (PDT)?
Photodynamic therapy (PDT) is one of the few FDA approved modalities for field treatment of actinic keratoses. Actinic keratoses are pre-cancerous growths marked by scaly pink bumps on sun exposed skin that continually recur or do not resolve. Actinic keratoses are considered the earliest stage in the development of a skin cancer call squamous cell carcinoma. Most insurance companies cover the medical treatment of actinic keratoses with PDT.
PDT is also used for the treatment of mild to moderate acne, facial rejuvenation and other skin ailments which insurers do not cover.
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How does PDT work?
PDT utilizes a selective medication called Levulan Kerastick or Ameluz (aminolevulinic acid HCL), a clear, painless medication which acts as a photosensitizing agent. It is selective in that it is only absorbed by any atypical or damaged cells within the epidermis. These cells are then destroyed after exposure to the light.
What are the advantages of PDT over other treatments?
An advantage of PDT is that it allows for treatment of large surface areas in one sitting, thus allowing potential treatment of actinic keratoses that are not yet clinically apparent.
The treatment takes about 17 minutes and recovery begins immediately. Most patients can expect 1-3 treatments with retreatment annually as needed. Treatment is usually less painful with fewer side effects, quicker recovery, higher cure rates and improved cosmetic outcome when compared with individual spot treatments such as liquid nitrogen or topical chemotherapeutic agents.
What are my pre-operative instructions leading up to my PDT session?
Prior to your appointment, let your physician know any oral and topical medications you are currently using. Stop any topical retinoid products 5 days prior to your procedure unless advised by your physician.
What should I expect the day of my treatment?
On the day of your appointment, the skin will be cleansed and prepped with acetone. Application of Levulan is often preceded by microdermabrasion to allow better penetration of the medication. After application of the Levulan, you can wait in our waiting room or return to the office after the incubation time determined by you physician. Usual incubation time ranges from 1-3 hours.
After returning to the office, you will be placed under a low intensity blue light for 17 minutes to activate the medication. During the treatment, you may experience mild to moderate burning and stinging. The skin may appear red, swollen and scaly as if you had a sunburn. Most of this will resolve within 5-7 days.
What are my post treatment instructions?
After your treatment, it is important to avoid sun exposure for 48 hours. Any additional sun exposure could intensify your reaction. You may be sun sensitive for up to 2 weeks after treatment. Wash the treatment area with a mild cleanser and apply Aquaphor to keep the area moist. Keep the area protected from sunlight with clothing and a wide brimmed hat. Apply sunscreen with a minimum SPF of 30. Your physician will let you know when to return to the office for follow up.