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.

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

See day by day a typical healing process from a Levulan Photodynamic Therapy (PDT) procedure.

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.  Many times we actually recommend a full treatment with our Medical Aesthetician Farzaneh to do a professional microdermabrasion of the skin. Once the skin is prepped the photo-sensitizer medication 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!

Read our full pre/post treatment guidelines for photodynamic therapy.

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.

Photodynamic therapy and Clear+Brilliant laser to treat active acne by Dr. Wu. After treatment, skin is visibly smoother and clearer.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.

Treatment Guidelines

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
    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. 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
    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:
  • Moisturizer & a generous amount of sunscreen will be applied to treated 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.
  • 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
    Ibuprofen.
  • 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,
    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 in ______ days/weeks.

Please contact our office if you have any questions or concerns at (858) 657-1002

Photos

Actual un-retouched patient before and after Fraxel laser and photodynamic therapy to treat acne by Dr. Fabi. Disclaimer: Results may vary from patient to patient. Results are not guaranteed. Before and after Fraxel laser and photodynamic therapy for acne by Dr. Fabi
Actual un-retouched patient before and after photodynamic therapy for pre-cancerous lesions and facial redness by Dr. Butterwick. Disclaimer: Results may vary from patient to patient. Results are not guaranteed Before and after photodynamic therapy for pre-cancerous lesions and facial redness by Dr. Butterwick
Actual un-retouched patient before and after photodynamic therapy for pre-cancerous lesions and facial redness. Disclaimer: Results may vary from patient to patient. Results are not guaranteed Before and after photodynamic therapy for pre-cancerous lesions and facial redness by Dr. Butterwick
Actual un-retouched patient before and after photodynamic  therapy (PDT) to reduce pimples and breakouts by Dr. Fabi. Disclaimer: Results may vary from patient to patient. Results are not guaranteed. Before and after photodynamic therapy (PDT) to reduce pimples and breakouts by Dr. Fabi
PDT and Fraxel to treat acne scars by Dr. Boen Photodynamic Therapy and Fraxel to treat acne scars by Dr. Boen
Photodynamic therapy and Clear+Brilliant laser to treat active acne by Dr. Wu. Disclaimer: Results may vary from patient to patient. Results are not guaranteed. Photodynamic therapy and Clear + Brilliant laser to treat active acne by Dr. Wu
Photodynamic therapy and Clear+Brilliant laser to treat active acne by Dr. Wu. Disclaimer: Results may vary from patient to patient. Results are not guaranteed. Photodynamic therapy and Clear + Brilliant laser to treat active acne by Dr. Wu
Photodynamic therapy to treat active acne by Dr. Fabi.  Disclaimer: Results may vary from patient to patient. Results are not guaranteed. Photodynamic Therapy to treat active acne by Dr. Fabi
Photodynamic therapy to treat active acne by Dr. Fabi.  Disclaimer: Results may vary from patient to patient. Results are not guaranteed. Photodynamic Therapy to treat active acne by Dr. Fabi
Photodynamic therapy to treat active acne by Dr. Fabi.  Disclaimer: Results may vary from patient to patient. Results are not guaranteed. Photodynamic Therapy to treat active acne by Dr. Fabi
Photodynamic therapy to treat active acne by Dr. Fabi.  Disclaimer: Results may vary from patient to patient. Results are not guaranteed. Photodynamic Therapy to treat active acne by Dr. Fabi
Photodynamic therapy to treat active acne by Dr. Fabi.  Disclaimer: Results may vary from patient to patient. Results are not guaranteed. Photodynamic Therapy to treat active acne by Dr. Fabi
Fraxel laser and photodynamic therapy to treat acne for a male patient by Dr. Fabi. Disclaimer: Results may vary from patient to patient. Results are not guaranteed. Fraxel Laser and Photodynamic Therapy to Treat Acne by Dr. Fabi
Fraxel laser and photodynamic therapy to treat acne for a male patient by Dr. Fabi. Disclaimer: Results may vary from patient to patient. Results are not guaranteed. Fraxel Laser and Photodynamic Therapy to Treat Acne by Dr. Fabi
Fraxel laser and photodynamic therapy to treat acne for a male patient by Dr. Fabi. Disclaimer: Results may vary from patient to patient. Results are not guaranteed. Fraxel Laser and Photodynamic Therapy to Treat Acne by Dr. Fabi
Fraxel laser and photodynamic therapy to treat acne for a male patient by Dr. Fabi. Disclaimer: Results may vary from patient to patient. Results are not guaranteed. Fraxel Laser and Photodynamic Therapy to Treat Acne by Dr. Fabi
Fraxel laser and photodynamic therapy to treat acne for a male patient by Dr. Fabi. Disclaimer: Results may vary from patient to patient. Results are not guaranteed. Fraxel Laser and Photodynamic Therapy to Treat Acne by Dr. Fabi
Photodynamic therapy to address breakouts and rejuvenate the skin by Dr. Groff. Disclaimer: Results may vary from patient to patient. Results are not guaranteed. Photodynamic Therapy to Clear and Rejuvenate the Skin by Dr. Groff
Photodynamic therapy to address breakouts and rejuvenate the skin by Dr. Groff. Disclaimer: Results may vary from patient to patient. Results are not guaranteed. Photodynamic Therapy to Clear and Rejuvenate the Skin by Dr. Groff
Fraxel and photodynamic therapy to treat acne on a female patient by Dr. Fabi. Disclaimer: Results may vary from patient to patient. Results are not guaranteed. Fraxel and Photodynamic Therapy to Treat Acne by Dr. Fabi
Fraxel and photodynamic therapy to treat acne on a female patient by Dr. Fabi. Disclaimer: Results may vary from patient to patient. Results are not guaranteed. Fraxel and Photodynamic Therapy to Treat Acne by Dr. Fabi
Fraxel and photodynamic therapy to treat acne on a female patient by Dr. Fabi. Disclaimer: Results may vary from patient to patient. Results are not guaranteed. Fraxel and Photodynamic Therapy to Treat Acne by Dr. Fabi
Fraxel and photodynamic therapy to treat acne on a female patient by Dr. Fabi. Disclaimer: Results may vary from patient to patient. Results are not guaranteed. Fraxel and Photodynamic Therapy to Treat Acne by Dr. Fabi
Fraxel and photodynamic therapy to treat acne on a female patient by Dr. Fabi. Disclaimer: Results may vary from patient to patient. Results are not guaranteed. Fraxel and Photodynamic Therapy to Treat Acne by Dr. Fabi
Actual unretouched patient before and after photodynamic therapy (PDT) to treat acne by Dr. Goldman. Disclaimer: Results may vary from patient to patient. Results are not guaranteed. Before and after photodynamic therapy (PDT) to treat acne by Dr. Goldman
Actual unretouched patient before and after photodynamic therapy for skin rejuvenation by Dr. Wu. Disclaimer: Results may vary from patient to patient. Results are not guaranteed. Before and after photodynamic therapy for skin rejuvenation by Dr. Wu
Actual un-retouched patient before and after of photodynamic therapy to treat sun damage by Dr. Wu. Disclaimer: Results may vary from patient to patient. Results are not guaranteed. Before and after photodynamic therapy for sun damage by Dr. Wu
Actual un-retouched patient before and after of photodynamic therapy for sun damage by Dr. Wu. Disclaimer: Results may vary from patient to patient. Results are not guaranteed. Before and after photodynamic therapy for sun damage by Dr. Wu
Actual un-retouched patient before and after PDT therapy to treat acne by Dr. Fabi. Disclaimer: Results may vary from patient to patient. Results are not guaranteed. Before and after photodynamic therapy (PDT) to treat acne by Dr. Fabi
Actual un-retouched patient before and after photodynamic therapy (PDT) for acne scars by Dr. Groff. Disclaimer: Results may vary from patient to patient. Results are not guaranteed. Before and after photodynamic therapy (PDT) to reduce acne scarring by Dr. Groff
Actual un-retouched patient before and after photodynamic therapy (PDT) for acne by Dr. Fabi. Disclaimer: Results may vary from patient to patient. Results are not guaranteed. Before and after photodynamic therapy (PDT) for acne by Dr. Fabi
Actual un-retouched patient before and after photodynamic therapy (PDT) for acne by Dr. Fabi. Disclaimer: Results may vary from patient to patient. Results are not guaranteed. Before and after photodynamic therapy (PDT) to treat acne by Dr. Fabi
Actual un-retouched patient before and after photodynamic therapy (PDT) for acne by Dr. Wu. Disclaimer: Results may vary from patient to patient. Results are not guaranteed. Before and after photodynamic therapy (PDT) for acne by Dr. Wu

Videos

Patient Testimonial: Photodynamic Therapy with Dr. Fabi (1:39)
Photodynamic Therapy with Dr. Fabi (2:14)
Eliminate Acne and Acne Scarring Once and For All
Renowned Dermatologist Discusses The Impact of Skin Health on Perceived Age & Attractiveness

FAQs

Q: What is photodynamic therapy?

A: 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?

A: 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?

A: 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?

A: 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?

A: 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?

A: 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?

A: 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?

A: After undergoing PDT treatment, 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?

A: 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?

A: 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!

Other Options

Goldman PDT Laser San Diego

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.

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The information available on this website is provided for informational purposes only. This information is not intended to replace a medical consultation where a physician’s judgment may advise you about specific disorders, conditions and/or treatment options. We hope the information will be useful for you to become more educated about your health care decisions.

*Please note: Free in-person consultations are available with Leysin Fletcher, PA-C, while all consultations with Drs. Goldman, Butterwick, Groff, Fabi, Wu, Boen, Loyal, and medical aesthetician Farzaneh Momeni-Salami are subject to a $250 fee that will be applied towards your treatment. Promotions are not available with Dr. Goldman. We do not accept insurance for any of our procedures. Any questions – feel free to call us at 858.943.2113.