Photodynamic Therapy Overview
At our San Diego cosmetic dermatology office, our dermatologists are well-experienced with photodynamic therapy (PDT) treatments. This treatment is also commonly referred to as “ALA or PDT treatment,” Levulan photofacial or photodynamic acne therapy. Prior to light treatment, we allow the topical photosensitizing agent to undergo an incubation time of one to three hours on the skin and only apply it after an acetone and/or microdermabrasion in order to provide the most effective results possible.
Our physicians have vast experience with PDT and have been involved in clinical research, published peer-reviewed journal articles and lectured on the topic worldwide. Furthermore, Dr. Goldman is the lead author and editor of the preeminent Photodynamic Therapy textbook, now in its second edition, which is used to teach physicians around the world about the advanced techniques we use to help our patients achieve maximum results.
Photodynamic therapy (PDT) delivers amazing results and can treat the following conditions with minimal downtime and risk.
- Sebaceous gland hyperplasia (ie excess oil production)
- Sun damage
- Pre-cancerous lesions (actinic keratosis AKs)
The treatment uses a specific wavelength of light to activate a topical photosensitizing agent called Levulan (5-aminolevulinic acid or ALA) or Metvixia (methyl aminolevulinate).
What to Expect
Photodynamic therapy (PDT) in San Diego is for the treatment of acne and other skin diseases involve the use of photochemical reactions to photosensitizing agents, light, and oxygen. It involves three steps.
First, microdermabrasion and an aceton scrub is done. Once the skin is prepped the photo-sensitizer medicationn is applied to the skin surface. It specifically targets fast growing cells, such as pre-cancerous lesions, oil glands, and p. acnes bacteria that causes acne. Then 4 specific wavelengths of lasers ( PDL, IPL, Blue Light and Red Light) are applied which activate the medication!
Because the photo-sensitizer is preferentially absorbed by the acne lesions and the light source is directly targeted on the lesional tissue, PDT achieves dual selectivity, minimizing damage to adjacent healthy structures. It is mediated by oxygen-dependent photochemical reactions, resulting in the destruction of the acne lesion.
The purpose of this treatment is to initiate photochemical reactions, and not to heat or mechanically change tissue as seen in other dermatologic uses. Ultimately, Photodynamic Therapy is a very safe procedure that can provide patients with outstanding results with minimal downtime and risk. ncbi.nlm.nih.gov has more information on what Photodynamic Therapy can do.
For acne patients, it can reduce or eliminate the need for oral antibiotics, thus eliminating concerns for antibiotic-resistant bacteria. This treatment can even help avoid the need for Accutane!
We also provide a variety of top professional skincare lines you can use daily at home to support the results of your treatment. Stop by our office any time for recommendations on the best home treatment program for you.
During your procedure:
- The area being treated will be prepped with Vibradermabrasion to exfoliate the skin,
and then wiped with an acetone solution to strip the skin’s barrier so that the Levulan
can penetrate more efficiently.
- Once the Levulan is applied you will incubate for 1 – 3 hours depending on your
- When your incubation period is over you will wash the Levulan off and your physician
will begin the laser portion of the procedure. You will be treated with 1 – 2 lasers
depending on your doctor’s recommendation.
- Your eyes will be protected.
- You will feel the sensation of heat (similar to grease “splattering” or rubber
band “snapping” against your skin).
- Cold air is applied directly to the skin as it is being treated to help decrease sensation
- After the laser(s) you will lay under a combination of a Red & Blue Light for 15 minutes
per area. You will feel the sensation of heat, similar to a sunburn, which may intensify
- Your skin will be cooled with cold air as well as a cool mist during your treatment
to minimize pain.
After your procedure:
- Moisturizer & a generous amount of sunscreen will be applied to treated area after
- When you leave our office you will need to be shielded from the daylight as much as
possible (hat, sunglasses, scarf, etc.) especially if you are driving yourself. If you have
someone to drive you then we suggest you sit in the back seat with something covering
- YOU MUST AVOID SUNLIGHT AND REMAIN INDOORS FOR THE REMAINDER OF
THE DAY OF TREATMENT AND THE ENTIRE FOLLOWING DAY. This includes avoid
sitting by a window, skylight, or even opening your front door.
- Sensation of heat/sunburn (will subside over the next few days). OK to take Tylenol or
- Redness & mild swelling will occur immediately after treatment. These symptoms
typically peak at 48 – 72 hours, with the redness lasting up to a week. To help minimize
swelling you can use ice packs and sleep with your head slightly elevated.
- Superficial peeling and/or crusting is normal & could last up to 1 week.
- If you are being treated for acne, you may experience purging which will resemble
pimples or a bad breakout. Do not try and extract or “pop” them, they will subside over
the next few days.
- NO RUBBING, PICKING OR WIPING THE TREATMENT AREA.
- Wash the treated area twice a day with a gentle cleanser. DO NOT use a washcloth or
the Clarisonic to cleanse for one week.
- Apply moisturizer as often as needed to help with dryness.
- When you are able to go outside apply a sunscreen with Zinc Oxide &/or Titanium
Dioxide. Protect the treated area from the sun both indoors & outdoors (hat, sunglasses,
- Medicine is not an exact science, and there can be no guarantees of
your results. It is always a possibility that you may not get the desired result after one
treatment. Additional treatments may be necessary to achieve optimal desired results.
- Follow any additional specific post treatment instructions from your physician.
- Follow up with your physician in ______ days/weeks.
Please contact our office if you have any questions or concerns at (858) 657-1002
Q: What is photodynamic therapy?
Q: Who is a good candidate for Photodynamic Therapy in San Diego?
Q: How many treatments will I need?
Q: Does PDT work for acne?
Q: How does it work for precancerous lesions?
Q: What are the advantages for treating skin pre-cancer?
Q: How much downtime should I expect after a treatment?
Q: What are the side effects?
Q: How much does it cost?
Q: What is Levulan?
In addition to photodynamic therapy, we offer a wide range of laser treatments that are a good alternative for many skin conditions that we treat at Cosmetic Laser Dermatology. Our sister practice West Dermatology next door can do more traditional treatments for pre-cancerous lesions such as topical Aldara or Efudex, cryotherapy (freezing lesions off), or surgical excision. For acne there are topical and oral prescription medications a medical dermatologist can prescribe.
Contact us today at for more information to schedule a PDT consultation. We are located in the UTC area of San Diego, minutes from La Jolla, Del Mar, and Downtown San Diego.
For more information about the monthly specials offered at Cosmetic Laser Dermatology, visit our Promotions page.
“If I could give this office 10 stars I would! I’ve never been to such an incredible office where everyone was so sweet, helpful, and professional!”- Jessica V.
“I love and appreciate the professionalism, knowledge, warmth, and extraordinary care from the team at Cosmetic Laser Dermatology.”- Alejandro S.
“I had such an awesome experience for my first visit and I am referring everyone I know to this office. From the super friendly staff to the state of the art procedures, they are the cream of the crop.”- Dinah M.