Photodynamic Therapy (PDT)





Photodynamic therapy (PDT) is a special treatment performed with a topical photosensitizing agent called Levulan(5-aminolevelinic acid or ALA), which is activated by specific wavelengths of light.  These treatments remove sun damaged, pre-cancerous spots called actinic keratosis.  Sun damage, fine lines, and blotchy pigmentation are also improved.  PDT treatment also has the unique ability to minimize pores and reduce oil glands, helping to treat stubborn acne vulgaris and acne rosacea.  In addition, it can improve the appearance of some superficial acne scars.



Patients with severe sun damaged skin manifested by actinic keratoses, texture, and skin tone changes including mottled pigmentation and skin laxity may see excellent results.  You may also see improvement of large pores and pitted acne scars.  Active acne can improve dramatically.



To achieve maximum improvement of pre-cancerous sun damage (actinic keratosis), skin tone and texture, a series of 2-3 treatments about 4 weeks apart is most effective.  Some patients with just actinic keratoses are happy with one treatment.  More treatments can be done at periodic intervals in the future to maintain the rejuvenated appearance of the skin.



Following PDT, the treated areas can appear red with some peeling for 2-7 days.  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.  Darker pigmented patches called liver spots can become temporarily darker and then peel off leaving normal skin. (This usually occurs over seven to ten days).  Repeat treatments may be necessary.




  1. Easier for patients than repeated topical liquid nitrogen, Efudex (5-FU), or Aldara   because the side effects are minimal, there is rapid healing, and only 1-3 treatments are required.
  2. The ALA/PDT treatment is less painful when compared to liquid nitrogen, 5-FU and Aldara.  It is non-invasive and requires no needles or surgery.
  3. Reduced scarring and improved cosmetic outcome compared with cautery, surgery and Efudex.  Liquid nitrogen can leave white spots on your skin.
  4. Levulan improves the whole facial area treated, creating one color, texture, and tone rather than just spot treating with liquid nitrogen, cautery and surgery.




  1. Be sure to tell your physician if you are taking any oral medications or using any topical prescription or non-prescription products on your skin.
  2. If you have a history of cold sores, please inform your physician prior to the day of your appointment so that preventative medications can be prescribed.
  3. Bring adequate sun-protective items with you to your appointment, such as a wide-brimmed hat, long sleeve shirt, gloves and/or an umbrella.

After Care Instructions Following Photodynamic Therapy—PDT Blue Light with ALA

Day of Treatment: (If redness and/or swelling occur)

  1. Begin applying ice packs to the treated areas.  This will help keep the area cool and alleviate any discomfort, as well as help keep down any swelling.  Swelling will be most evident around the eyes and is usually more prominent in the morning.
  2. YOU MUST remain indoors and avoid directed sunlight for the first 40 hours.  You must also avoid bright indoor lights, including non-florescent lights, computer screens and sitting by windows with direct sunlight.  Use sunscreen daily, even if you are indoors, and wear a wide-brimmed hat when outside.
  3. You can mist your face with a fine water spray or hydrating mist as often as you like for comfort.
  4. Apply a soothing moisturizer or over the counter Hydrocortisone ointment 1% twice daily.
  5. Take analgesics such as Advil or Tylenol if necessary.
  6. You may begin taking a shower the day of treatment.  Wash face using very mild cleansers such as Cetaphil and apply these gently with your fingertips.  Avoid scrubbing your face and use cool water to rinse with.

Day 2-7

  1. Continue to take pain medication and apply ice packs as needed to help alleviate discomfort and swelling.  The discomfort usually subsides between 48-72 hours following treatment.
  2. If blisters form, you should soak the treated areas with a solution of 1 tsp. white vinegar in 1 Cup of cold water.  Ice should be applied directly over the vinegar soaks.  After soaking and applying ice for approximately 20 minutes, the area should be patted dry and Aquaphor or Hydrocortisone 1% ointment, reapplies.  Follow this procedure every 4-6 hours during your waking hours until blisters heal.
  3. Re-apply aquaphor, as needed to relieve dry, tight-feeling skin.  Other non-fragranced lotions (e.g. Cetaphil, Vanicream) can be used as well provided they do not cause stinging when applied to the face.  Make sure you don’t use retinoids or other anti-aging creams or topical prescriptions for acne and rosacea until complete healing has occurred.

Day 7

  1. You may begin applying make-up once any crusting has healed.  This usually occurs at 5-10 days following the treatment.
  2. Avoid getting any excessive sun on the treated area for two weeks post treatment.  The treated area will be very susceptible to sun exposure and skin discoloration may occur.  You may go out with a sun block of 30 SPF or greater.  This must be used for approximately four months following the treatment.  Think seriously about purchasing a brimmed hat!!
  3. Once the crusting has subsided, the treated area may be red.  This will gradually subside over a period of 4-8 weeks.  A green based cover up make-up can be purchased from most cosmetic lines that can be work under your own make-up to help conceal the redness from the laser treatment.


Note: If you have problems, please call our office 24-hours a day.

PDT is a medical procedure that requires medical orders in order for precertification to be completed through insurance.


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