PDT/Levulan
What is PDT?
 Photodynamic (PDT) skin rejuvenation utilizes a
medication called Levulan (20% aminolevulinic
acid) and specific wavelengths of light that
photoactivate the medication.
Levulan comes as a clear liquid that is painted on
the face and allowed to
"incubate" for a set time. The light then activates the aminolevulinic acid
which is
converted into oxygen radicals which then diminish or eliminate precancerous
facial lesions (AK's).
We are also using PDT to treat acne with great success. PDT can be combined
with intense pulsed light (IPL) therapy to achieve an even better result
particularly if brown pigment and small capillaries and redness are a concern.
Additionally PDT treatment provides a form of skin rejuvenation that gives an
overall benefit to the skin in terms of skin texture and fine lines.
What are AK's and how are they treated?
A.K. or actinic keratosis, are potentially pre-cancerous lesions on the face that
appear as discolored or crusting lesions that will not heal. They are usually the
result of many years of sun damage to the skin. Individuals with fair skin are
more susceptible to AK's. Approximately 20% of AK's will become cancerous
over time. Not all AK's are clearly visible on the skin. Typical areas for them to
appear are on the face, ears, neck, hands, and arms but they can occur on
virtually any sun exposed area of the body.
How are AK's treated?
The traditional treatments for AK's include spot treating with liquid nitrogen or
application of one of several topical agents such as 5 Fluorouracil (Efudex) or
Imiquimod (Aldara) creams. These agents work by causing necrosis (cell death)
of the tissues onto which they are applied. All are effective but all have potential
problems.
Why PDT?
Liquid nitrogen is still considered the "gold standard" treatment of
AK's since it
is fast, cheap and usually effective. Liquid nitrogen can, however, leave
hypopigmented (white) spots where applied since it can also kill the
melanocytes (pigment dells) as well as the AK's. Liquid nitrogen is not practical
for treating a larger surface area and the blistering and scabbing associated with
treatment may not be tolerated by some patients. Topical creams such as
Efudex or Aldara require application for 3-4 weeks and induce considerable
redness and irritation where applied. Many patients cannot tolerate these
creams. They also have potentially severe systemic toxicities.
PDT/Levulan for treating precancerous skin lesions
Before | After
Photodynamic therapy is a viable alternative to these treatments for
these reasons:
- Can treat the entire face in one sitting thereby eliminating
AK's that are
both seen and unseen
- Is associated with only a few days of redness that is well
tolerated
- Does not cause hypopigmentation or scarring
- Reduces surface irregularities, sebaceous hyperplasia
(enlarged oil
glands) and acne lesions on the skin
- Provides an overall cosmetic benefit to the skin like a
chemical peel
Photodynamic therapy illustration
Please also see: www.pdtherapy.com
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