Photodynamic therapy involves the use of a photosensitizing agent (Aminolevulinic Acid, brand name: Levulan Kerastick® ) that is applied to sun-damaged or pre-cancerous areas of the skin, and is allowed to penetrate for about 1 hour or longer. The treated area is then exposed to a specific wavelength of light (blue or red). The reaction of the light and sensitized skin leads to a sunburn-like effect that exfoliates the superficial damaged layers of the skin. The process takes about 5-7 days to heal, and the usual end result is mild to moderate rejuvenation of the skin and improvement or resolution of the pre-cancerous growths. This process if FDA approved for treatment of pre-cancerous growths when the sensitizer is pre-applied for 14-18 hours, however, we have found that more practical shorter incubation are just as effective. The cosmetic indication of photodynamic therapy, or any other indication including treatment of skin cancer, is considered an ‘off-label use’ of this technique.
When Should You NOT Use This Treatment?
You should not receive this medicine if you have had an allergic reaction to aminolevulinic acid or porphyrins, if you have porphyria, lupus or skin that is unusually sensitive to sun, if you are pregnant or breastfeeding, if you take deferoxamine (an iron chelator), hydrochlorothiazide or sulfa products.
A nurse or other caregiver will apply the medicine. After 1 hour, you will be treated with a special blue light for approximately 17 minutes. You may be given facial nerve blocks to minimize the pain of the procedure (optional). Alternatively, an anesthetic topical cream will be applied prior to the light exposure. During the blue light treatment, you will be given special goggles to wear to protect your eyes. During the blue light treatment you may feel stinging, tingling, prickling, or burning of the lesions, but this should go away after the treatment. After treatment, you should stay out of the sun or bright light as much as possible. Wear sunglasses and protective clothing when going outside.
The skin will turn red and swollen in the following 3-7 days. Some crusting may be noted. There should be some discomfort, but no significant pain. After 1 week, there might be some residual redness that will subside after a few days and can be covered with makeup.
Procedure Photos (Click images to enlarge)