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Copyright Medical Skin and Laser Australia 2016

Photodynamic Therapy (PDT)

How does Photodynamic Therapy work?

PDT is a simple, non-invasive treatment that consists of the application of 5-ALA, a photosensitizing activating solution to the lesion(s) followed by exposure to a particular light source (633nm red LED). The abnormal cells in the lesion absorb the active ingredient from the solution. When exposed to the red light, a chemical reaction occurs which destroys those cells, minimising side effects and the potential for scarring.

What does Photodynamic Therapy involve?

Prior to commencing this treatment, a biopsy will need to be performed to confirm the diagnosis. You may have more than one lesion treated at one time.
PDT treatment consists of the following steps.

  • Lesion preparation

  • Application of cream

  • Light Treatment

  • Moisturiser and SPF

 

Photodynamic Therapy Process:

 

  1. Before the activating cream is applied, the lesion(s) will be prepared by removing any scale/crust and roughening the skin surface. This preparation phase allows the ALA solution to be maximally absorbed by the abnormal cells that cause the lesions.

  2. The solution will then be applied to the lesion and the adjacent skin. It must remain in place for 1-3 hours. During this time you are free to relax inside the Clinic, or leave the Clinic, however you must ensure that the lesion is not exposed to very cold air or to direct sunlight.

  3. We use a 633nm red light source from the Healite II lamp for the activation phase. This “illumination” phase takes approximately 13-16 minutes. Due to the selective nature of the solution, healthy skin surrounding the lesion does not need to be protected during illumination. You will be given safety goggles to protect your eyes during the illumination as the light is very intense. The number of treatments that you will need depends upon the type of lesion that you have. Your doctor will discuss this with you and will also ask you to return for a check-up after 3 months.

  4. Application of a soothing moisturiser and SPF cream

 

Will Photodynamic Therapy be painful?

PDT is very well tolerated, however can be uncomfortable for some. You may experience a stinging or burning sensation during the illumination phase. Some people describe it as small "electric shocks" over the skin. The light can be paused anytime, for a short bursts, to relieve any discomfort. It is possible to use local anaesthetic and/or nerve blocks to alleviate any pain if PDT is being performed over large areas.

What should I expect after treatment?

After your treatment, we advise you to stay out of direct sunlight for 4 days. Please apply your silicone dressing twice daily to promote healing. Your healing cream with SPF should be applied as often as needed. Keeping your face well moisturised will aid in comfot and ease of recovery. Due to the sun-sensitivity of photodynamic therapy, many patients have a sunburn feeling for several days following treatment. This can be alleviated with the use of cool compresses, and simple pain relief. Local discomfort around the treatment site is the most common side effect with PDT. Mild to moderate redness, swelling and inflammation are normal after-treatment responses, which usually resolve rapidly. Large treatment areas such as the face or scalp usually heal within 4-6 days. If you have PDT to the lower limbs, you may need to restrict your activities for a few extra days to ensure that your skin heals.

How much does Photodynamic Therapy cost?

Costs of photodynamic therapy will depend on the area treated and the number of sessions you will require.
Actinic/solar keratoses (sunspots) will require only one treatment session, whilst skin cancers will require two sessions. Our doctor will assess the severity and area at the time of consultation.
Note: PDT is NOT covered under Medicare. Some health insurance companies do provide a partial rebate for this procedure. We advise patients to check with their cover prior to undertaking this procedure.

What makes Photodynamic Therapy different to other skin cancer treatments?

In general Photodynamic Therapy treatment has:

  • Potentially less scarring compared to surgery

  • Less down time

  • Quicker recovery (typically days, not weeks/months)

  • Photorejuvenation effects if used on sunspots or sun damaged skin

Recent studies have indicated that field treatment with PDT is the most effective of the current options available for treating actinic/solar keratoses when compared to cryotherapy (freezing) and topical prescription creams.

Note that not all lesions are suitable for PDT, and therefore it will only be offered in appropriate circumstances.

Photodynamic Therapy (PDT) is an effective treatment for;

  • Some non-melanoma skin cancers (superficial SCC and BCC)

  • Certain types of pre-cancerous lesions, such as actinic/solar keratoses.

  • Acne lesions (active and non-active)

Not all lesions are suitable for this treatment and therefore it will only be offered in particular circumstances, after a full skin check and skin biopsy.