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 keratoses?
- Am I a good candidate for photodynamic therapy?
- What growths is PDT not good for?
- What are possible complications or side effects 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 photodynamic therapy (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
Does PDT make me permanently more sensitive to light?
No, PDT causes a temporary sensitivity to light, including natural sunlight and some indoor lights. The light sensitivity resolves with time, depending on both the photosensitizer drug and dosage used.
Light avoidance is generally required after PDT. The duration depends on the drug and dosage used. Intravenous porphyrin may make the body, including the skin and eyes, sensitive to light for about six weeks after treatment. Proper protection, including long sleeves and sunglasses, may be required. Topically applied aminolevulinic acid or methyl aminolevulinate may cause skin sensitivity only on the treatment areas for approximately 24-72 hours. These do not usually cause sensitivity on other body parts other than where the drug was directly applied. Your physician will need to discuss with you the required sun- and light-avoidance period required after your particular treatment.
How is PDT used to treat the skin?
PDT using Levulan and a proprietary blue light is currently FDA approved for the treatment of early skin precancers called actinic keratoses (rough scaly spots generally on sun-exposed skin). PDT is also known as "ALA/PDT treatment" or "Super Blue Light." It has been referred to as a "super photo facial" when the photosensitizer is used with a machine called intense pulsed light or IPL. These treatments may help remove sun-damaged precancerous skin. Sun damage, fine lines, and blotchy pigmentation may also be improved because of the positive effect of PDT. PDT seems to reduce oil gland function and so is helpful in treating acne and rosacea.
Although PDT's use in skin was first investigated in 1990s for actinic keratosis, it was not as popular or widely used because of the required long incubation times (usually 18-24 hours) and limited indications. Since approximately 2001, PDT has become more widespread primarily because of advances including shorter incubation times (30-60 minutes). In Europe, studies utilizing the exposure to ambient sunlight after application of the photosensitizer and a chemical sunblock (to prevent exposure to ultraviolet light) seemed to be effective in the treatment of actinic keratoses. This could eliminate the need for treatment to be administered in a physician's office.
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