Photodynamic therapy (PDT)
Photodynamic therapy (PDT) is a revolutionary treatment that involves the use of a photosensitizing agent in order to treat a particular skin condition.
PDT involves the use of aminolevulinic acid which is a topical substance absorbed and retained by precancerous and cancerous cells making them susceptible to die when exposed to certain wavelengths of light.
PDT is FDA-approved exclusively to treat actinic keratosis (pre-skin cancers), but in Europe it is used to treat superficial basal cell carcinomas and its off-label for acne and rejuvenation has been extensively documented.
PDT is a multi-step process done in the office. You will require a previous consultation to discuss the details of the procedure in depth as well as the potential side effects and complications (redness, swelling, tenderness, crusting, weeping, peeling and mild to moderate discomfort). In addition, pre-treatment with a retinoid or 5-fluorouracil cream is known to enhance the results of the treatment.
PDT usually involves the following steps:
1) Skin is degreased with acetone
2) Scrapping lesions with sand paper or curette
3) Ameluz gel is applied on the areas where actinic keratoses are present (face, neck, chest, back, shoulders, forearms, hands or legs)
4) Treated areas are occluded with a plastic wrap and left occluded for 3 hours
5) Ameluz gel is wiped and areas are treated with red light (650 nm)
6) Patients will remain sensitive to light for the following 48 hours
7) Use of vaseline, aquaphor or often times a topical steroid ointment are indicated to facilitate the recovery process
8) PDT is a procedure that is recommended to do once to twice a year and the recovery process is approximately 7 days of social down time.
There is a variant of this regimen called daylight PDT in which the patient exposes the treated area to sunlight in a shaded area for 2-3 hours. It has been proven to be equally effective and more tolerable than conventional PDT.