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Aesthetic Procedures >> Photo Dynamictherapy
 
Photodynamic Therapy
(P.D.T)
Light Based Technology

How does Photodynamic Therapy (PDT) work?

In photodynamic therapy a photosensitizer is applied to the skin. This is absorbed preferentially by certain structures in the skin, such as hair follicles, oil glands, bacteria, or rapidly growing cells. Illumination with a high-intensity light or lasers causes a reaction in the skin, resulting in destruction of the targeted tissue. Skin oiliness is decreased, the appearance of pores is greatly minimized, collagen is stimulated, and pre-cancerous cells are destroyed.

What types of conditions can be treated with PDT?

Photodynamic therapy has been effective in the treatment of actinic keratosis (pre-cancerous spots), sun-damaged skin, acne, warts, and many other diseases. At present time it is only FDA approved in treating Actinic Keratosis, but is being used frequently off-label for the treatment of other skin disorders as mentioned above. Levulan is in the second stage of clinical trials for other applications and should be officially FDA approved for other uses soon.

Is PDT uncomfortable?

During PDT the skin is washed several times and the activated substance is applied. Either of these may cause stinging. Following treatment there may be some transient itching and a mild sunburn sensation.

Photosensitivity

After PDT, a small amount of activated substance remains in the skin for 24 to 48 hours. Sunlight and even indoor light may affect this and cause redness and itching. Use of sunscreen with zinc oxide and wearing a hat may diminish these undesired effects.

Itching/Burning

Most people experience mild burning or itching for about one hour after the procedure, although this may last a day or two. Mild to moderate redness may be experienced for 24 to 48 hours. Only gentle emollients should be applied to the skin.

Swelling

Areas most likely to swell are around the eyes. This will subside within several hours. Application of ice or cold packs may help.

Peeling

Peeling of treated skin may occur several days after the procedure and can be alleviated by gentle washing and application of a slightly thicker moisturizer.

How much improvement can I expect?

Patients with severe sun damage 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.

How many treatments will it take to see the "best results?"

To achieve maximum improvement of pre-cancerous (actinic keratosis) sun damage, skin tone and texture, acne, and rosacea, a series of three treatments scheduled 2-3 weeks apart is the most effective. (Some patients with just actinic keratosis are happy with one treatment and a "touch up" on stubborn areas four weeks later.)

What are the advantages?

  • Easier for patients than repeated topical liquid nitrogen, Efudex (5FU), or Aldara.

  • Reduced scarring and improved cosmetic outcome compared with cautery, surgery, and Efudex.

  • In contrast with systemic photo sensitizers, persistent sun sensitivity is not a problem past the first 48 hours with this new topical approach.

  • Improvement will be noticed in the whole area treated (such as the full face) creating all one color, texture, and tone rather than just spot treating with liquid nitrogen, cautery, and surgery.

  • Levulan - Photo rejuvenation matches the "ideal treatment" for actinic keratosis.

  • Well tolerated (essentially painless).

  • 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 disadvantages?

  • Sunburn confined to the treated areas with redness and peeling for a few days to one week.

  • Temporary swelling of the lips and around your eyes if these areas are included in treatment. This usually lasts a few days.

  • Darker pigmented patches called liver spots that are actually lentigos will become darker and then peel off leaving normal skin. (This usually occurs over seven to ten days.)

  • Repeat treatments may be necessary, as this is not an exact science.

  • Those on a "financial budget" may have to plan for this treatment.

What is the Procedure?

  • First your skin is prepped with medical-grade Acetone and a Microdermabrasion. (This allows the Levulan to penetrate better and more evenly.)

  • A physician or nurse will apply the Levulan solution.

  • The Levulan will remain on between 1-3 hours.

  • The Levulan is removed with cleanser.

  • You will be given special goggles to wear to protect your eyes during the laser treatment.

  • During the treatment you may feel stinging, tingling, prickling, or burning of the lesions, but this should go away after the treatment.

  • Cooling packs will be applied to your face to decrease swelling.

  • After the treatment you will have sunblock applied and you will need to bring a hat to wear home.

  • You should stay out of the sun and bright light (even florescent) as much as possible for the next 48 hours.

  • The skin may turn red and swollen in the following 3-7 days.

  • Some crusting may be noted.

  • There may be some discomfort, but no significant pain.

  • After 1 week, there might be some residual redness that will subside after a few days and can be covered with makeup such as Jane Iredale Minerals that we retail in our office.
 
 
 
 

 
 
 
 
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