(Aminolevulinic Acid + Blue Light)

Photodynamic therapy, also called PDT, is used to treat various skin conditions including actinic keratoses (pre-cancerous skin spots), sun damage, acne, and enlarged oil glands.  This treatment is performed with a topical photosensitizing agent called Levulan® (5-aminolevulinic acid or ALA).  Levulan® is a natural substance in the body.  The Levulan® Kerastick is applied to the skin to be treated and is absorbed selectively by damaged and abnormal skin cells.  The medication is typically left on the skin to be absorbed by these cells for 1-2 hours.  The treated area is then exposed to a blue light for 16 minutes and 40 seconds (1000 seconds).  Patients often experience a tingling and burning sensation while sitting under the light.  Together the light and the medication cause a sun-burn like reaction that selectively peels the damaged skin cells that have taken up the photosensitizer, typically leading to more rejuvenated skin, fewer precancerous areas, improved texture, and more even pigmention.  The treated skin normally takes approximately 7 days to heal.

 Some patients require additional treatments (usually 4 weeks apart) for maximum improvement.  If the appropriate redness is not achieved with a 1-2-hour "incubation" with the photosensitizer, a second treatment allowing 2-3 hours for the agent to be absorbed will usually yield the desired temporary redness.  More treatments may be necessary periodically in the future to maintain the renewed appearance of the skin.

Following PDT, the treated areas will appear red, peaking usually at about 8-10 hours following light treatment.  Occasionally, patients have an exuberant response and may experience intense redness and crusting of their skin.  Temporary swelling of the lips and around the eyes is possible.  Darker patches often called “age spots” may become temporarily darker.

It is critical to avoid sun exposure, including sunlight through glass, for 24-48 hours following treatment .  Failure to avoid the sun may lead to uncontrolled activation of the photosensitizer, and to a reaction similar to a second degree burn.  You must wear a high-number sunblock containing zinc oxide or titanium dioxide, protective clothing and a wide-brimmed hat if you must be outdoors or even in very close proximity to fluorescent light (e.g. desk lamp).  Chemical sunscreens alone will not work.  Beware also of reflected sunlight, even through window glass.

The intensity of the reaction varies from mild to pronounced redness.  Redness, peeling and crusting are normal and desirable.  You should keep the skin soft with a moisturizer or Vaseline.  Over the counter 1% hydrocortisone, cold creams and chilled aloe may help make the skin more comfortable during the healing phase.  Please notify our office if you have any swelling, blistering, or develop a fever.  If you have a history of cold sores, you should take an oral antiviral medication (such as Valtrex, Famvir, or generic acyclovir) twice daily for the first three days after treatment for prevention.

To find out if Photodynamic Therapy is right for you, call (402) 330-4555 or click here to request an appointment.