Photodynamic Therapy (cont.)
Gary W. Cole, MD, FAAD
Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- What is photodynamic therapy (PDT)?
- What photosensitizer drugs are available?
- What light sources are available, and how are they applied?
- How does photodynamic therapy work?
- Does PDT make me permanently more sensitive to light?
- How is PDT used to treat the skin?
- What is a typical skin PDT session like?
- How much improvement can I expect with photodynamic therapy?
- Where can I have photodynamic therapy, and who performs the procedure?
- What are the advantages with photodynamic therapy for treating actinic keratosis?
- Am I a good candidate for photodynamic therapy?
- What growths is PDT not good for?
- What are possible complications of photodynamic therapy?
- Is there scarring from photodynamic therapy?
- What are alternatives for photodynamic therapy?
- What about insurance coverage and costs of photodynamic therapy?
- How do I prepare for my procedure?
- How is recovery after PDT?
- Is there pain after PDT?
- How do I take care of my treatment area after photodynamic therapy?
- What is the chance that my actinic keratoses will recur?
- Find a local Dermatologist in your town
What is the chance that my actinic keratoses will recur?
While PDT is a very effective treatment, there is a reasonable chance that you may continue to need periodic treatments for actinic keratoses, depending on your individual skin, severity of prior sun damage, and your compulsion to avoid the sun. Often there are layers of underlying sun damage from prior years that rise to the surface over time.
Actinic keratoses may recur or a new cancer develop in the same or adjacent area even after photodynamic therapy or other treatments. Some skin actinic keratoses are more aggressive than others and need additional treatment and closer follow-up.
Sun-damaged skin frequently needs additional follow-up and possible further treatment, at least annual rechecks and further PDT treatments are advised. Several studies have shown that photodynamic therapy tends to have a cure rate comparable to the traditional treatment with fluorouracil (Carac, Efudex, Fluoroplex).
It is important to note that PDT is not curative in invasive skin cancer. This may require one or more procedures such as biopsy, surgery, radiation, or other procedures to fully treat those lesions.
Follow-up appointments with your dermatologist or physician are very important, especially in the first few years after photodynamic therapy. Many patients are seen every four to six months after their diagnosis of actinic keratoses of the skin.
Self-skin examinations monthly are good practice for patients with a history of skin cancer. Any changing or new growth should be promptly checked by your physician. More regular follow-up appointments may be needed for those with more aggressive tumors or tumors in high-risk areas. Your physician will recommend the proper follow-up for your specific condition.
Previous contributing author: Nili N. Alai, MD, FAAD
REFERENCES:
Ericson, Marica B., Ann-Marie Wennberg, and Olle Larkö. "Review of Photodynamic Therapy in Actinic Keratosis and Basal Cell Carcinoma." Therapeutics and Clinical Risk Management 4.1 (2008): 1-9.
"Photodynamic Therapy." DermNet NZ. July 1, 2011. <http://dermnetnz.org/procedures/photodynamic-therapy.html>.
Last Editorial Review: 7/30/2012
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