Photodynamic Therapy (PDT)

Photodynamic Therapy (PDT)
Acne, Photo Rejuvenation, Precancerous Spot Treatment in the San Diego Area

Dr. Palm is the co-author of a book chapter on photodynamic therapy in the treatment of actinic keratoses and photorejuvenation as well as the first author on a published study on the use of Metvixia™ cream (methyl-aminolevulinic acid) in the treatment of precancerous spots and sun-damaged skin. She is a laser authority and frequent lecturer at national dermatology and laser meetings regarding best practices and patient safety with light and laser technology. Her offices are located in Solana Beach, CA just north of San Diego.

What is Photodynamic Therapy (PDT)?

Photodynamic therapy (PDT) describes a procedure in which a topical solution called aminolevulinic acid (Levulan® Kerastick) is applied to the skin and is later activated by a light source in the presence of oxygen to preferentially target abnormal cells. PDT is FDA-approved for the treatment of precancerous lesions called actinic keratoses (AKs). An alternative solution, methyl-aminolevulinic acid (Metvixia) is approved in the U.S. but is not currently commercially available for PDT.

Light Sources used in PDT

Although the PDT reaction is most often activated by a blue light source or Blu-U, other laser and light therapy such as Intense Pulsed Light (IPL), pulsed dye lasers, and red light sources can be used as well. Dr. Palm most commonly combines a blue light source with an IPL to activate Levulan® with multiple lights sources. She believes, and clinical studies suggest, that using multiple light sources allows better clearance of precancerous spots and superior photorejuvenation – meaning better improvement of sun damage, brown spots, broken blood vessels, oil gland shrinkage, and improvements in skin texture.

Treatment of Precancerous Lesions, Sun Damage, Rosacea, and Acne with PDT

Although PDT is FDA-approved for the clearance of AKs, photodynamic therapy can be used to effectively treat other skin conditions as well. PDT not only targets precancerous cells, but also melanin (brown spots), blood vessels (telangiectasias), and oil glands. Medical literature supports the role of PDT in treating photodamage, rosaceaacne, sebaceous hyperplasia (enlarged oil glands), and sun spots.

Recovery Time After and Comfort During PDT

Photodynamic therapy has associated downtime. Patients must remain indoors away from sun exposure and bright light sources for 48 hours following the procedure. The skin may peel or be red for approximately 7-10 days, especially when multiple light sources are used during treatment. To maximize patient comfort, Dr. Palm uses topical numbing cream as well as cooling devices during the procedure.

Photodynamic Therapy on the Face and Body

PDT can be used to treat precancerous spots and sun damage on many areas of the body. The face, scalp, chest, arms, and legs are amenable to treatment. Although a single PDT treatment may yield excellent results, photodynamic therapy is best completed as a series of treatments. On non-facial areas, longer incubation times (the time between topical Levulan treatment and light activation) over several hours or overnight may be utilized to improve clearance of AKs and enhance photorejuvenation.

Cost of Photodynamic Therapy

PDT is an FDA-approved treatment for precancerous lesions and insurance plans accepted at Art of Skin MD can be billed for a portion of PDT including the Levulan and blue light activation. If IPL is used as a part of the treatment plan of PDT, this portion is not billable to insurance and the associated cost varies depending on the area of treatment.

Patient Comfort during Photodynamic Therapy

Alleviating pain and discomfort during PDT is a high priority at Art of Skin MD. Patients undergoing photodynamic therapy in conjunction with IPL photofacial light activation are provided with topical numbing.   All patients are offered additional comfort measures including forced air cooling and aerosolized mineral water spray during blue light activation.

If you are interested in PDT as a non-surgical alternative treatment for sunspots, acne, precancerous lesions, and other skin conditions in the San Diego area, call Dr. Melanie Palm at 858.792.SKIN (7546) to schedule your appointment.