Photodynamic Therapy

Photodynamic therapy (PDT) at Dermatologist Medical Group is performed with Levulon activated by the V Beam laser.  PDT is an exciting technology incorporating the application of a natural photosensitizing substance (Levulon, see below) to the skin, followed by activation with light. When the Vbeam® Laser is used to activate the levulon, the combination produces powerful results against sun damage, acne and photoaging.

What to expect during treatment

Levulon Kerastick is a solution of 5-aminolevulinic acid (ALA), which is applied by your practitioner in our office. ALA is a substance which occurs naturally in the body. The Levulon is swabbed onto freshly cleaned skin, and allowed to absorb for 30 minutes to a few hours, while you wait in our office. During this time, the ALA is penetrating into the skin, specifically into areas of damage, precancers, and oil glands.  In the skin cells, the ALA is converted into protoporphyrin IX, which can be activated with light. When the incubation time is over, the area is treated with the Vbeam® Laser. The laser light activates the protoporphyrin IX, which then destroys the unwanted cells. During the laser portion of the treatment, your eyes will be protected with special goggles. You will feel multiple “zaps” which may feel like rubber band snaps. A cooling mist may also be sprayed onto the skin. There will be some burning. Most of our patients tolerate this without any problems. Depending upon the size of the target area, the laser treatment time can take between 10 to 40 minutes.

What to expect after treatment

After the PDT session, you should expect redness, swelling, and peeling for 48 to 72 hours (like a sunburn). In some patients, this post-op redness is minimal. Other patients may experience more swelling, burning, some crusting, and tightness. If you do not experience redness after the first session, your practitioner will likely increase the strength of subsequent treatments, until you develop the post-op reaction. After the PDT session, it is important for you to protect from sunlight and bright indoor light exposure for 48 hours, since remaining light-sensitizing ALA will still be in your skin. You may feel burning with exposure to any type of light, during this post-op time. You will need to use titanium dioxide or zinc oxide based sunblocks, wear a hat and sunglasses, and stay indoors. Please bring a wide brimmed hat with you to your appointment, so you can wear it as you leave the office after the session. After the treatment, you can wash your skin with soap and water, and apply moisturizer. If there is a lot of crusting or blistering, you can apply Aquaphor ointment a few times a day. You can apply ice packs, and take Tylenol, aspirin, or Advil, if necessary. Makeup and topical medications (such as topical acne medications) can be resumed after crusting has healed. Applying makeup prior to this will not damage the treatment, but may just feel irritating. If you are having PDT to treat acne, your acne may initially flare after treatments. Brown spots in the treated area may initially become darker, before they peel off. Oil gland growths may be crusted after treatment. You should avoid the sun for two weeks, and use a sunscreen with SPF of 30 or more, for at least four months after treatment. Post-op redness will gradually subside over four to eight weeks.  Optimal PDT results are achieved with several treatment sessions, one to a few months apart.

What risks are involved?

Risks from PDT with Vbeam® Laser are minimal, but can include the possibility of light or dark discoloration, or scarring. The redness after treatment may be prolonged, if there is exuberant response to treatment. If eyes are not shielded properly, there is a risk for damage to the eyes. Self-tanning products should be removed before treatment. Patients receiving Accutane treatment for acne should wait at least six months after completion, before treatment. Tattoos should not be lasered. Let your practitioner know if you have a history of Herpes Simplex virus (cold sores) in the target area, so that prophylactic treatment can be started before laser. Patients on blood thinning medications can develop more bruising from the treatment. Topical medications should be stopped a few days before and after the appointment. Darkly pigmented skin may not be appropriate for laser treatment. Pregnant women should wait to have PDT treatment. PDT may cause permanent hair removal, thus men should be cautious in treating beard and moustache areas. As with any cosmetic procedure, there is the possibility that you may not achieve your anticipated result.

We are looking forwards to treating you with this powerful combination photodynamic therapy and laser treatment.