Photodynamic Therapy Overview
Photodynamic therapy, commonly called ALA or PDT treatment, Levulan photofacial, or photodynamic acne therapy, is a light-based treatment that targets active acne, redness, and other skin conditions. 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).
Our board-certified San Diego dermatologists have vast experience with PDT and have been involved in clinical research, published peer-reviewed journal articles and lectured on the topic worldwide. Dr. Goldman is also the lead author and editor of the Procedures in Cosmetic Dermatology Series: Photodynamic Therapy textbook, now in its second edition, which teaches physicians around the world about the advanced techniques we use to help our patients achieve maximum results.
What to Expect
Photodynamic therapy (PDT) in San Diego involves three steps:
- Medical Aesthetician Farzaneh will exfoliate your skin with Vibradermabrasion.
- Next, we wipe it with an acetone solution to strip the skin’s barrier. This helps the Levulan penetrate more efficiently.
- Once the Levulan is applied you will incubate for 1 – 3 hours depending on your doctor’s recommendation.
- When your incubation period is over you will wash the Levulan off and your physician will begin the laser portion of the procedure.
- Finally, we use 4 specific wavelengths of lasers (PDL, IPL, Blue Light and Red Light) to activate the medication.
- You will typically be treated with 1 – 2 lasers depending on your dermatologist’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 of heat.
- 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 during treatment.
- Your skin will be cooled with cold air as well as a cool mist during your treatment to minimize pain.
After your procedure:
- Your dermatologist will apply moisturizer & a generous amount of sunscreen to the treatment area after your procedure.
- 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 your face.
- Avoid sunlight and remain indoors for the rest of the day and the following day. This includes sitting by a window, skylight, or opening your front door.
- 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.
- Take Tylenol or Ibuprofen to minimize pain and swelling.
- Superficial peeling and/or crusting is normal and can 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.
- Don’t pick, rub, or wipe 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 and outdoors (hat, sunglasses, sunscreen).
- 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 as instructed.
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.
Photodynamic therapy is a very safe procedure that can provide patients with outstanding results with minimal downtime and risk.
For acne patients, it can reduce or eliminate the need for oral antibiotics, eliminating concerns for antibiotic-resistant bacteria. This treatment can even help avoid the need for Accutane.
We also provide a variety of medical-grade 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.
Please contact our office if you have any questions or concerns at (858) 943-2113.
Q: What is photodynamic therapy?
PDT is used to treat sun damage, pre-cancerous regions on the skin (actinic keratosis), acne, and rosacea. It is performed by placing the topical photosensitizing agent Levulan on the treatment area, which is activated with a specific wavelength of light. This treatment corrects the damaged skin.
Q: Who is a good candidate for Photodynamic Therapy in San Diego?
People of all ages who are struggling with problematic skin related to skin cancer, acne, rosacea, sun damage, or the natural aging process may benefit from Photodynamic Therapy. PDT also targets and destroys pre-cancerous cells without causing any damage to normal skin.
Q: How many treatments will I need?
Although every patient is unique, it is common for patients to undergo between 1-3 treatments to achieve optimal results. After undergoing your first Photodynamic Therapy treatment, our dermatologists will be able to determine how your skin is responding and will have a greater insight into the number of treatments that will provide you with the best outcomes.
Q: Does PDT work for acne?
Photodynamic therapy is often the number one choice to improve the overall look of skin with acne when oral medications and topical treatments have been exhausted.
Q: How does it work for precancerous lesions?
PDT kills cancer cells by combining a light sensitive drug with light from a laser. The treatment allows our doctors to target and destroy cancer cells without damaging the surrounding healthy skin.
Q: What are the advantages for treating skin pre-cancer?
The benefit of PDT for treating skin pre-cancerous lesions is its ability to target specific areas. It also decreases the risk of skin discoloration that is often caused by routine freezing with liquid nitrogen. Additionally, there is minimal downtime after a treatment. As one of the few treatments available today that can successfully eliminate pre-cancerous growths on the skin, PDT helps reduce the risk of developing skin cancer. This is a great pro-active treatment for patients who have had skin cancer and want to prevent additional occurrences.
Q: How much downtime should I expect after a treatment?
Immediately following treatment, most patients feel up to continuing with their normal daily activities without interruption, as PDT requires minimal to no down time. For more aggressive treatments, there can be up to 7 days of downtime. However, it is important to avoid all sun exposure for the following 1-2 days after your treatment, so you must stay 100% indoors.
Q: What are the side effects?
The most common side effects include a sunburn like reaction including mild redness, swelling, and tenderness in the treated area. The degree of redness is proportional to the degree of damage. Over the course of the next several days, all side effects will diminish noticeably, with final results from your treatment becoming visible as time continues to pass.
Q: How much does it cost?
The cost varies from patient to patient depending on the goals of the treatment. To find out how much your PDT treatment will cost, schedule a consultation with one of our dermatologists.
Q: What is Levulan?
Levulan (aminolevulinic acid ACL) is a photosensitizing substance that has been approved by the FDA for the treatment of actinic keratosis. Levulan is activated by light to treat skin pre-cancers, sun damage, acne and rosacea. Most practices apply Levulan and activate it with one light source (either blue light or IPL). At Cosmetic Laser Dermatology, we use 4 light sources which is a much more effective treatment.
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.
We offer many topical and oral treatments for acne and Accure laser therapy, which targets the skin’s sebaceous glands to address acne’s root cause.
Our sister practice West Dermatology next door also offers more traditional treatments for pre-cancerous lesions, such as topical Aldara or Efudex, cryotherapy (freezing lesions off), or surgical excision.
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.
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