Photodynamic therapy (PDT) is a procedure involving the application of a light-sensitizing medication (Levulan®), followed by exposure to a light source, which “activates” the medication. The medication is more selectively absorbed by structures such as precancerous cells and oil glands. When the area is then exposed to the light source, the sensitized structures react more intensely, causing destruction of precancerous cells and shrinkage of oil glands. This treatment can be used to treat various indications including: acne, actinic keratoses, Hidradenitis Suppurativa, warts and other conditions.
What equipment is used?
PhotoMedex Omnilux (Blue LED) best for treating acne and near hair-bearing areas (beards, eyebrows, scalp, etc)
Alma® Harmony Intense Pulsed Light (IPL) (540 nm-950 nm) improves photodamaged skin while treating actinic keratoses
Cutera® LimeLight™ (IPL) (520-1100 nm) improves photodamaged skin while treating actinic keratoses
What will the procedure feel like?
With the procedure, a thin layer of a light sensitizing solution is applied. Depending on the condition being treated, the medication is allowed to absorb in the skin from 30 minutes to 2 hours. During this time you may bring work, a book, or something to keep you occupied. Following the absorption period, the entire area is treated with a light source. Blue LED treatment is performed using a large panel of lights that targets the entire area at once. The area may feel warm and sting during the treatment. IPL treatments consist of multiple pulses delivered with the laser. Each pulse feels like a brief hot stinging or snapping sensation. A device that blows cold air is used during the treatment to keep the skin cool and decrease discomfort. Some patients choose to take ibuprofen prior to treatment to help with discomfort.
Do I have to do anything to prepare in advance?
Tanned skin cannot be safely treated, so we ask that you avoid sun exposure for 4 weeks prior to your treatment and self-tanning products should not be applied to the treatment area 2 weeks prior. If you have a history of cold sores, be sure to notify your provider prior to your appointment and he or she will prescribe a medication to take the night before that will reduce the likelihood of a breakout.
What will I look like afterwards?
Immediate redness, discomfort, and swelling are expected and will intensify in the 24-48 hours following treatment. The overall downtime of the treatment varies based on the treated indication. The downtime may last anywhere from 2-10 days and may involve mild redness and flaking to moderate or severe redness, swelling and peeling. During this time, Tylenol or Ibuprofen may be helpful, and ice packs intermittently applied to reduce discomfort. Sun exposure after a treatment must be carefully avoided as it may result in a more severe burn with redness.
The medication applied remains active in the skin for 48 hours after the treatment. Patients must remain indoors and wear sunblock during this time. Increased side effects will develop with sun exposure.
How many treatments are necessary?
The number of treatments required to reach the desired or optimal result varies based on the treated indication and severity of the condition. Some conditions may only require one treatment while others may require multiple treatments. Maintenance treatments are then recommended as needed.
When will I see results?
Results are seen in the month following each treatment. Your provider will evaluate you to see if the condition has improved or if more treatments are needed.
Who cannot have the treatment?
Photodynamic therapy is not safe in darker skin types or tan skin. Patients who have taken isotretinoin (Accutane) within the previous 12 months or are currently pregnant cannot have the treatment.