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Photodynamic therapy (ALA/PDT) for sun damaged skin and Rosacea

Photodynamic therapy (PDT) is a special treatment performed with a topical photosensitizing agent called Levulan (Aminolevulinic acid (ALA) that is applied to the skin and then activated with activated with the correct wavelength of light. Known as “ALA/PDT this procedure treats sun damaged skin, rosacea, acne and can remove some pre-cancerous lesions.


What types of issues can be treated with ALA/Photodynamic Therapy (PDT)?

This procedure is used to reverse signs of sun damage such as fine lines, sun spots and irregular skin texture. ALA/PDT also treats stubborn acne vulgaris, rosacea and can reduce pore size. The FDA has approved this procedure for the treatment of pre-cancerous lesions named actinic keratoses. The treatments are performed as a series, typically three treatments spaced 2-4 weeks apart.



In summary, photodynamic therapy may treat:

• pre-cancerous actininc keratoses (ak’s)

• fine lines

• enlarged pores

• irregular skin texture

• sun and age spots

• inflammatory and cystic acne

• sebaceous hyperplasia (enlarged oil glands)


What are the advantages of ALA/PDT for the treatment of sun damaged skin?

Treatment is well tolerated and non invasive
In addition to the cosmetic benefit, it can remove pre-cancerous lesions and treat acne as well.
Can treat issues of color, tone and texture on the face and chest


What does the Photodynamic therapy treatment consist of?

The treatment begins with cleansing the face followed by either a microdermabrasion, sapphire abrasion treatment or an acetone scrub. These serve to remove certain substances on the surface of the skin to enable the Levulan substance which is applied next to penetrate deeply into the skin.

Once applied, the Levulan remains on the skin for 30-60 minutes, sometimes longer. During this time you may read, watch TV or take a nap.

The next step is to wash the Levulan off with soap and water. The Levulan byproducts are now activated by exposing your skin to specific wavelengths of light. The Blue light is the most well know light source used here, but other sources such as Intense Pulsed Light, Pulsed dye laser, LED light, etc may be utilized, depending on the goals of therapy.

For the treatment of sun damaged and aging skin, the IPL represents the best way to stimulate the Levulan and sometimes we use Blue light in addition.
The skin is washed once again, sun block applied and you leave to go home, wearing a hat, looking to avoid bright light or sun exposure for the next 48 hours.


What will I look like afterwards and is downtime required?

Following PDT, the face can appear red, followed by some flaking and peeling for several days. Rarely some patients have an exuberant response to PDT, and experience marked redness of their skin. Temporary swelling of the lips and around your eyes can occur for a few days as well. Darker pigmented patches or sun spots can become temporarily darker and then peel off over a week or so, leaving normal skin.