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Photodynamic Therapy

What is Photodynamic Therapy?

Photodynamic therapy is used primarily in the treatment of precancerous lesions known as actinic keratoses. It is indicated for those who have numerous actinic keratoses over an extensive area, but it has also been used in the treatment of other skin conditions such as acne or photoaging. The procedure involves the application of a photosensitizing medication known as aminolevulinic acid over the affected skin. The medication is allowed to incubate for at least 1 hour and is preferentially absorbed by the abnormal cells of the skin. After the incubation period, the treated skin is then exposed to blue light in order to trigger an oxidizing reaction which ultimately leads to cell death. Patients may need more than one treatment in order to achieve desired results.

What should I expect after the treatment?

During the treatment session you may experience a sensation of warmth, stinging, or burning. Afterwards you will feel like you sustained a sunburn. The skin will be red and mildly tender, which indicates a good response to the treatment. Over the next 24-48 hours there may be swelling, bruising, blistering, and crusting. Skin reactions resolve over 1-6 weeks and post-inflammatory skin changes may occur.

Who should not receive the treatment?

Inform your physician if you have an autoimmune disease (i.e. lupus, Sjogrens), conditions known as porphyria or pseudoporphyria, or other conditions that make you sensitive to light. Also you should not receive the treatment if you are pregnant or breastfeeding. If you have a history of herpes simplex (cold sores), please inform your doctor as you will need prophylactic treatment.

Pre-Treatment Instructions

  • Bring a hat (preferably a wide-brimmed) if the face or scalp is being treated. A bandana or ski mask is also protective if receiving facial treatment. If the arms are being treated, please bring a long-sleeved shirt.
  • Wash the areas to be treated and DO NOT apply makeup, moisturizer, or sunscreen as this will interfere with the absorption of the medication.
  • Plan to be in the office for 2 hours on the day of your treatment.

Post-Treatment Instructions

  • Your skin will be light sensitive for next 48 hours. DO NOT plan any outdoor activities or you will burn.
  • Apply sunscreen daily (Vanicream 50+) for the next 48 hours over the treated areas.
  • Use gentle cleansers (Cetaphil) and moisturizers as Cetaphil (if acne-prone) or Aquaphor.
  • DO NOT pick at any scabs or flakes.
  • For relief of irritation you may use an ice pack, frozen bag of peas/corn, or cooled aloe vera gel. Some inflammation is needed to clear the skin, but if severe you may use hydrocortisone cream twice daily and take ibuprofen 400-600 mg every 8 hours for relief of pain.
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