Photodynamic Therapy (PDT)
“Blue Light”, photodynamic therapy, or PDT is a treatment that helps remove premalignant or precancerous lesions on the body. These premalignant lesions are called actinic keratoses or solar keratoses. They typically appear on sun exposed areas of the skin and tend to be rough in texture; almost like sandpaper. The good news is these precancerous lesions can be treated so they do not turn into skin cancer; more specifically squamous cell carcinoma.
Most patients that are familiar with these actinic keratoses are also familiar with a cream called Efudex or fluorouracil. Efudex is a great medication that can rid your skin of precancerous cells, but most patients absolutely hate the process. Typically, you need to use the cream for 2-4 weeks twice a day; sometimes longer. Side effects are common and include redness, scabs, peeling skin and a long recovery period after stopping treatment. Efudex absolutely still has its place in dermatology, but for select patients there may be an alternative and that is PDT.
Photodynamic therapy or PDT is an in-office procedure that uses a special photosensitizing medication (makes your skin very sensitive to light) and a special wavelength of “blue light” to destroy precancerous cells. Typically, this procedure is well tolerated and the recovery is shorter when compared to Efudex. Sometimes more than one treatment is needed to get the full benefits. Also, these seems to be a cosmetic benefit, too. Most patients state that it helped remove some sun damage from their face.
Treatment tends to be quick and relatively easy. After arriving in the office, we will clean your face to remove any oil and makeup. After that we apply a photosensitizing medication to the affected area and let it absorb for a couple hours. Finally, we turn on the “blue light” which activates the treatment. The blue light stays on for about 16 minutes. During this time, you may notice a slight burning or tingling sensation. Every patient is different, but most say the first couple minutes it feels like a burning sensation and then it just feels warm for the remainder of treatment. You will be extremely sensitive to sunlight for 48 hours after treatment. Sunscreen helps, but you need to AVOID sunlight for 48 hours. That means wearing a wide brim hat after treatment and anytime you plan to be outside. If you happen to be in direct sunlight without a hat (even if you are wearing sunscreen) it may reactivate the chemical and the healing process will take much longer. We will provide a prescription medication to help calm down the redness afterwards. Most patients notice they are back to looking normal within 7 days, although some patients take longer to heal. Finally, we like to see you back in the office about 12 weeks later to see the results or possibly retreat the area a second time. Patients will a lot of actinic damage may require multiple treatments.
Data shows that PDT can kill precancerous cells and even help prevent skin cancer. PDT is not a cure all. It is still possible to develop new precancerous lesions even in the same area that was treated. This is why many patients come in once per year for this treatment when they notice new rough spots appear.
As always, sun precautions are a must. Wide brimmed hat, sunscreens, and sun protective clothing can all help prevent future rough spots.