Photodynamic Light Therapy.

What is Photodynamic Light Therapy?
Photodynamic therapy (PDT) is a special treatment performed with a topical photosensitizing agent called Levulan (5-aminolevulinic acid or ALA) activated with the correct wavelength of light.  This is also known as “ALA/PDT treatment”.  These treatments remove sun damaged pre-cancerous zones and spots called actinic keratoses. Sun damage, fine lines, and blotchy pigmentation are also improved because of the positive effect of Levulan and the light treatment.  ALA/PDT treatment also has the unique ability to minimize pores and reduce oil glands, effectively treating stubborn acne vulgaris, acne rosacea, and improve the appearance of some acne scars.

What type of results will I see?
Patients with severe sun damaged skin manifested by actinic keratosis, texture, and tone changes including mottled pigmentation and skin laxity may see excellent results.  You may also see improvement of large pores and pitted acne scars.  Active acne can improve dramatically.

How many treatments will it take to see the "best results"?
The recommended course of therapy is two treatments separated by eight weeks.

Are there any disadvantages to the therapy?
Following PDT, the treated areas can appear red with some peeling for 2-7 days.  Temporary swelling of the lips and around your eyes can occur for a few days. Most patients appear to be suffering from a very severe sunburn and there can be discomfort as with a severe sunburn. Darker pigmented patches called liver spots can become temporarily darker and then peel off leaving normal skin.  (This usually occurs over seven to ten days.)  Repeat treatments may be necessary as medicine is not an exact science. You will be photosensitive (very sun sensitive) for 24-40 hours after your treatment.  You must remain indoors avoiding sunlight for the first 24-48 hours after your treatment.

What are the advantages to the therapy?
Easier for patients than repeated topical liquid nitrogen, Efudex (5-FU), or Aldara because the side effects are minimal, rapid healing, and only 1-3 treatments required. Redness can be expected post-treatment.  Some patients may experience redness, swelling and crusting over of pre-cancerous lesions post-treatment.  This typically resolves in less than one week.

Reduced scarring and improved cosmetic outcome compared with cautery, surgery, cryosurgery and Efudex.  Liquid nitrogen can leave white spots on your skin.

Levulan improves the whole facial area treated evening color, texture, and tone rather than just spot treating as with liquid nitrogen, cautery and surgery. It can treat clinical actinic damage as well as subclinical damage and prevent the development of future actinic keratoses.

In summary, PDT matches the “ideal treatment” for actinic damage:
• Well tolerated
• Easily performed by a specialty clinic environment
• Non-invasive (no needles or surgery required)
• Excellent cosmetic outcome (particularly in cosmetic sensitive areas of the face)

What are the treatment steps?
1.  Patients who have a history of recurring cold sores (Herpes simplex type I) should start oral Valtrex 500 mg tablets, two tablets twice daily for three days  starting this prescription the morning of your PDT treatment.  The prescription for this product will be ordered for you. Please contact the office at (847)882-9300 at least 3 days prior to your treatment if you have any history of cold sores (Herpes Simplex Type I).
2.  Make sure your skin is clean and free of all make-up, moisturizers, and sunscreens.  Bring a hat, sunglasses, and scarf when appropriate to the clinic.
3.  Photography may be done by the staff before the Levulan is applied.
4.  You must sign a consent form.
5. An acetone scrub is performed.  This will enhance the absorption of the Levulan and give a much more even uptake.
6.  Levulan is applied topically to the whole area or whole zone to be treated. 
7.  The Levulan is left on for at least 30 minutes before any light treatment.
8.  The Levulan is activated with the BLU-U.  This unique spectrum of light activates the Levulan beginning with low energy levels.  This is can cause slight stinging or tingling, but requires about 16-17 minutes to complete.
9.  Post-treatment instructions will be given to you to care for your improved skin.

See our Home Care Instructions for Photodynamic Light Therapy.