Photo Dynamic Therapy (PDT)
- Photodynamic therapy (PDT) combines a drug (called a photosensitizer or photosensitizing agent) with a specific type of light to kill cancer cells.
- The U.S. Food and Drug Administration has approved the photosensitizing agent called Aminolevulinic acid (ALA or Levulan®), for use in PDT to treat or relieve the symptoms of Actinic Keratosis (AK).
- Patients treated with PDT should avoid direct sunlight and bright indoor light for at least 4 days after treatment.
- Researchers continue to study ways to improve the effectiveness of PDT and expand its use to other cancers.
Photodynamic Therapy (PDT) is a breakthrough dermatologic treatment that has been highly successful in the treatment of Actinic Keratoses (AK), mild to resistant Acne, Hidradenitis Suppurativa and other skin conditions. Whether you have tried other treatments in the past with limited success or are treating your condition for the first time, photodynamic therapy may be just the right treatment for you.
This innovative therapy is a two-step process. First, the affected areas are treated with a topical solution called Aminolevulinic Acid (ALA). ALA is a “natural” product found in all humans throughout the body. It is a precursor for hemoglobin synthesis. This medication is left on for approximately 15 minutes. Then, the patient is exposed to a light known as the Blue-U for 6 minutes. The Blue-U uses a specific non-damaging wavelength that when combined with ALA destroys certain precancerous lesions and the bacteria associated with acne.
This therapy requires multiple treatments which are performed every 2-4 weeks. The only reported side effects are minor stinging, burning, redness, swelling and/or itching which should subside within 24 hours.
Pros and Cons of PDT
Studies have shown that PDT can work as well as surgery or radiation therapy in treating certain kinds of cancers and pre-cancers. It has some advantages, such as:
- No long-term side effects when used properly.
- Less invasive than surgery.
- Usually takes only a short time and is most often done as an outpatient.
- Can be targeted very precisely.
- Unlike radiation, PDT can be repeated many times at the same site if needed.
- There’s little or no scarring after the site heals.
- It often costs less than other cancer treatments.
However, PDT has limits too. It can only treat areas where light can reach. This means it’s mainly used to treat problems on or just under the skin, or in the lining of organs that can be reached with the light source. While some of the drugs can travel throughout the body, the treatment only works where the light shines. This is why PDT can’t be used to treat cancers that have spread too many places. Also, the drugs that are currently used leave people very sensitive to light for some time, so special precautions must be taken after the drugs are put in or on the body.
PDT patients must avoid exposure to direct sunlight or bright indoor light for a period of 48 hours after treatment. All patients treated with the Blue-U must wear sunscreen with an SPF 30 or above on the treated areas for at least 48 hours post-treatment. It is also recommended that you cover the treatment areas with protective clothing (e.g. a hat or scarf) and stay in the shade if possible.
This procedure provides a non-invasive method for targeting inflammatory and pre-cancerous lesions on the face. Recent studies show between 68-86% improvements using Photodynamic Therapy with a high patient satisfaction rating.
Photo Dynamic for Acne
If you have acne that is not responding to medications, or if you are unable to tolerate oral or topical medications for acne, photodynamic therapy with Levulan ALA may be right for you. Combined with a light source, Levulan ALA kills the acnes bacteria in your skin, decreases sebum (oil) production and provides long term improvement of acne.
About the Procedure
The procedure is called Photodynamic Therapy (PDT). Whether treating acne or sun damage, the process is very similar. The treatment utilizes a drug, called Levulan ALA, and a light source that can kill the acnes bacteria in your skin. Levulan has been used in the skin for decades to treat severe sun damage and skin cancers in adults.
The product, called Kerastick, is applied topically (directly on the skin) and allowed to incubate painlessly for approximately 1 hour. A light or laser source is then used to “photo-activate” the Levulan ALA and thus directly affect the hair follicle and sebaceous glands.
Prior to the procedure, your skin will be prepped, ensuring skin is clean and free of all makeup, moisturizers and sunscreens. During the procedure, the Blue-U light source is used. It is important to note that there are no ultraviolet rays in this light source.
The treatment itself takes approximately 10 minutes. You may feel mild stinging or burning when the skin is exposed to the light or laser source. Afterwards there is no, or minimal pain. You should expect mild to moderate redness and scaling that can persist from 0-5 days, like a mild sunburn.
Patients usually require at least 3 treatments spaced at 3 week intervals to see significant improvement (80% or greater) for months at a time. Depending on the severity of the condition, the number and strength of the required treatments will vary. After achieving long term reduction in acne lesions, infrequent treatments can be done to maintain long term efficacy. Unfortunately, as of now medical insurances do not cover this form of acne treatment.