Photodynamic Therapy
Photodynamic therapy (PDT) is a treatment modality used in dermatology for various skin conditions, including pre-cancerous lesions like actinic keratoses, certain types of skin cancer, and severe cases of acne. This non-invasive procedure leverages the power of light-activated medications to target and destroy abnormal cells, offering an alternative and effective solution for patients.
PDT starts with applying a photosensitizing medicine (either a gel or solution) to the treatment area. These agents are selectively absorbed by rapidly growing cells, such as cancerous or pre-cancerous cells, making them highly effective for targeted treatment. The sebaceous glands are an important therapeutic target for acne treatment.
After a specified incubation period during which the patient waits in the office, the treated area is exposed to a specific wavelength of light. This light activates the photosensitizing medicine, leading to a reaction that destroys the abnormal cells and reduces sebaceous gland activity while sparing the surrounding healthy tissue.
Aminolevulinic acid (ALA) and methyl aminolevulinate (MAL) are the most commonly used photosensitizing agents in dermatology.
Various light sources can be used in PDT, including blue, red, and intense pulsed light (IPL). The choice of a light source depends on the specific condition being treated and the depth of the targeted cells. Each light source has a specific wavelength that activates the photosensitizing agent, triggering the therapeutic effect.
Actinic Keratoses
Actinic keratoses (AKs) are rough, scaly patches on the skin caused by prolonged sun exposure. They are considered pre-cancerous lesions that can develop into squamous cell carcinoma if left untreated. PDT is highly effective in treating AKs, as it preferentially targets and destroys abnormal skin cells.
Basal Cell Carcinoma
Basal cell carcinoma (BCC) is the most common form of skin cancer. PDT can treat superficial BCCs, providing an alternative to surgical excision. The targeted approach of PDT helps preserve the aesthetic appearance of the treated area, making it a preferred option for visible or cosmetically sensitive areas.
Acne
Severe acne, particularly cases resistant to conventional treatments, can be effectively managed with PDT. The therapy targets the overactive sebaceous glands and reduces the bacterial load on the skin, improving acne lesions and inflammation.
Minimally Invasive
PDT is a nonsurgical, minimally invasive procedure that requires no incisions or stitches. Compared to traditional surgical methods, this results in a quicker recovery time and less discomfort for patients.
Precision and Selectivity
The photosensitizing agents used in PDT are selectively absorbed by abnormal cells, allowing targeted treatments. This minimizes damage to surrounding healthy tissue, reduces the risk of side effects, and promotes faster healing.
Versatility
PDT can treat many dermatological conditions, from pre-cancerous lesions to severe acne. Its versatility makes it a valuable tool in the dermatologist’s arsenal, providing effective solutions for various skin issues.
Cosmetic Outcomes
Because PDT is a non-invasive procedure, it offers excellent cosmetic outcomes. The treatment is particularly beneficial for areas where cosmetic appearance is a concern, such as the face, neck, and hands.
Pre-Treatment Preparation
Before the procedure, patients should avoid sun exposure and discontinue using photosensitizing medications. The dermatologist will clean the treatment area and apply the photosensitizing agent, which needs to be absorbed by the skin for a specific period.
The Procedure
After incubation, the treated area is exposed to the chosen light source. The exposure time is typically between ten and sixteen minutes, depending on the light source. Patients experience a tingling or burning sensation during light exposure.
Post-Treatment Care
Following the procedure, patients should strictly avoid direct sunlight and protect the treated area with sunscreen and protective clothing for 48 hours. Mild redness, swelling, and peeling may occur but usually subside within a few days. The dermatologist will provide detailed aftercare instructions to ensure optimal healing and results.
Photodynamic therapy is a highly effective and versatile treatment option for various dermatological conditions. Its minimally invasive nature, precision, and excellent cosmetic outcomes make it an appealing choice for patients seeking advanced skin treatments. If you are considering PDT, consult a qualified dermatologist to determine if this innovative therapy suits you. At Vue Dermatology & Laser, we are committed to providing a range of treatment options, including PDT, to help you achieve healthy, beautiful skin.
Dr. Philip Eliades is a board-certified dermatologist seeing patients at Vue Dermatology & Laser in Norwood, Massachusetts.
At a Glance
Philip Eliades, MD, FAAD
- Board-Certified Dermatologist
- Served as Chief Resident at NewYork-Presbyterian Hospital/Weill Cornell Medical Center and Memorial Sloan Kettering Cancer Center
- Author of numerous peer-reviewed research articles in leading Dermatology journals
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