Photodynamic Therapy PDT Treatment
Photodynamic therapy (PDT) is a three-step treatment used to treat mild or serious conditions of the skin through the use of a photosensitizing drug and a light source to activate it. PDT destroys abnormal cells that cause actinic keratosis, a precancerous condition, and can also minimize pores and reduce oil glands to treat acne, rosacea, and some scarring.
During the PDT procedure, a topical photo sensitizer called Levulan is applied to the skin and left for an incubation period of several minutes to several days. Levulan is made of aminolevulinic acid (ALA), a natural substance found in the body. After incubation, the Levulan is activated with a wavelength light source.
Patients may experience sensations of warmth, tingling, heat, or burning during this part of the treatment. After light activation, the treated area is washed, and patients can return home, and most return to work within one to two days after the procedure.
For optimal results, patients may need up to five treatment sessions, depending on the severity of their condition and the aggressiveness of their treatment. Sessions are spaced two to five weeks apart and can be continued afterward to help maintain the initial results of the treatment.
Although PDT is considered a safe treatment option, there are certain risks and side effects associated with any cosmetic medical procedure. These risks and side effects may include redness, pigmentation, bruising, infection, and scarring. These side effects are usually mild and go away within a few weeks.
What to Expect Before and After Photodynamic Therapy (PDT) Treatment
Before Treatment & Preparation
- Notify our office if you have a history of recurrent cold sores or take medications that make you more sensitive to sunlight.
- If you have a history of recurring cold sores (Herpes simplex virus), we will prescribe you prophylactic Valtrex or another oral antiviral to begin the morning of your treatment.
- If you are having your face or scalp treated, please be sure to bring a wide-brimmed hat and sunglasses to help block the sun on your trip home following treatment.
- If possible, try to arrive without make-up.
- Notify our office if you are on blood thinners, as these may result in a more exuberant response (increased swelling, crusting, bleeding).
- Please notify our office if you have a history of porphyria.
- Men should shave their faces the morning of the procedure and have their hair trimmed short in all treatment areas.
After your Photodynamic Therapy (PDT) treatment, your skin will feel warm to the touch and sting, similar to a sunburn. You may also experience redness, skin tenderness, dark spots, and swelling. This is a normal reaction. The stinging sensation begins during the treatment and may last up to 24 – 48 hours.
Your skin will then feel somewhat dry and rough and may appear a bit darker over the next 7 days. The remaining skin changes typically resolve over a 7 to 10-day period.
Please plan on spending one to two hours at our office for your treatment: degreasing of the treatment area, application of medicine, the incubation period (30 minutes -2 hours), treatment time depending on physician’s orders, and sunscreen application post-treatment.
Home Care on the Day of Treatment
If you have a history of recurring cold sores (Herpes simplex virus), be sure to take the prophylactic antiviral medication on the morning of your treatment and to complete the course as prescribed
- It is expected that your skin will become pink to markedly red. *Always pat dry your skin and avoid rubbing and picking your skin.
- Additionally, you may begin applying ice packs to the treated areas. This will help keep the area cool, alleviate any discomfort and minimize swelling. Swelling will be most evident around the eyes and is usually more prominent in the morning.
- To help soothe your skin, Aquaphor healing ointment may be applied throughout the day.
- Remain indoors if possible and avoid direct and indirect sunlight and direct bright indoor light for 48 hours.
- Elevate your head on two pillows when sleeping to reduce swelling.
- You may take analgesics such as Tylenol®, Advil®, Motrin® as directed, if necessary.
Home Care on Day 2
Continue to apply ice packs as needed to alleviate discomfort and swelling. You may take a shower. You may take analgesics. Any discomfort usually subsides by Day 3.
- You should avoid sunlight and try to remain indoors on Day 2. The photosensitivity to sunlight is usually gone 24 hours after treatment, but may last as long as 48 hours. *Always pat dry your skin and please avoid rubbing and picking your skin.
- Continue to moisturize your skin with Aquaphor or a Post-Procedure Moisturizer (i.e.: IDI Hydrate). Home Care on Days 3 – 7
- Many patients may start peeling on day 4. Please avoid peeling off loose tissue, let it come off naturally.
- The area may be pink to red for 4-6 weeks, but ultimately often looks rejuvenated.
- The skin will feel dry and tightened. A good moisturizer with broad-spectrum sunscreen should be used daily (i.e.: Post Procedure Face Moisturizer with Sunscreen: EltaMD UV Clear SPF 46).
- Try to avoid direct sunlight for two weeks. Use a broad-spectrum sunscreen with a minimum SPF 30 (i.e.: EltaMD UV Clear SPF 46) for four months and going forward. • Continue to moisturize your skin. At this time you may prefer to use a less greasy moisturizer (in place of Aquaphor) such as a Post-Procedure Moisturizer (i.e.: IDI Hydrate or IDI Ultralight Hydrator) or other facial creams or lotions (i.e.: Cetaphil or CeraVe).
- You may use makeup, once all crusting is resolved and no open sores are present. • Men may typically shave with an electric razor after day three, or use a standard razor blade after day 5.
- Upon completion of your healing, we recommend you begin a daily skin care regimen with a facial moisturizer with sunscreen that fits your lifestyle.
- If you have any problems or concerns or experience severe pain or a fever over 100.5º, please do not hesitate to call our office. We want to assist you!