Photodynamic therapy (PDT) is a unique treatment that is commonly used to treat acne, skin cancers, and pre-cancerous skin lesions. The treatment involves applying a photosensitizing drug (a drug that increases sensitivity to light) to the targeted lesion and then using light therapy to treat the area.
Physicians have recognized the power of photosensitizing drugs for thousands of years. Records from ancient Egyptian and Indian civilizations document the use of photosensitizing substances and a light source to treat certain skin lesions. It is likely that the use of PDT was discovered accidentally and that ancient physicians did not fully understand its mechanism of action.
A renewed interested in photodynamic therapy1 began in the 1960s with the development of safe and effective photosensitizing drugs. Researchers and scientists documented success in using PDT in treating actinic keratosis and certain forms of cancer. Today PDT is commonly used to treat pre-skin cancers and acne lesions. This highly effective treatment causes minimal discomfort to patients and does not leave lasting scars, making it a treatment of choice for certain skin lesions on visible areas of the body.
When Dr. Rokhsar meets with patients who are troubled by moderate to severe acne that does not respond to other treatments, he may recommend photodynamic therapy2. PDT can stop acne activity, diminish older acne scars, and leave the skin looking and feeling much smoother.
When using PDT to treat acne, Dr. Rokhsar first cleanses the skin and then applies Levulan, a unique photosensitizing drug that is very effective in the treatment of acne. After the drug has penetrated the skin (15 – 45 minutes), he turns on a special light that is calibrated to emit blue or red light, depending on the type of acne being treated. Levulan makes certain cells and the acne sebaceous glands more sensitive to light. PDT3 is such an effective acne treatment thanks to the combined use of Levulan and light therapy.
PDT is also a very effective and safe way of treating certain types of skin cancers and pre-cancerous lesions, including:
Dr. Rokhsar preps the targeted area by thoroughly cleansing the lesion and surrounding skin. If necessary, he will remove some of the crust from the lesion so the photosensitizing drug can absorb into the skin more easily. Next, he applies the drug and allows it to soak into the skin for up to 6 hours. In certain instances, he may inject the drug into the targeted area. Once the drug has thoroughly penetrated the skin, light therapy begins. PDT may successfully eliminate the lesion on the first round or multiple treatments may be required, spaced at monthly intervals.
PDT is a safe and effective treatment, but it’s normal to experience certain mild side effects after treatment, which are collectively referred to as the “PDT effect.” The treated area may appear red and swollen and may feel tender or sensitive. A scab or crust usually forms after several days and many people experience discomfort during this phase. After several weeks, the scab will fall off and the skin below may appear pinker or lighter than surrounding skin. Over time, the new skin will take on its normal tone and texture as the body creates healthy new skin cells.
During the treatment, the skin became extremely sensitive to light. This sensitivity remains for the first 48 hours, so it is extremely important that patients protect the treated area from the sun during this time. This may require the use of strong sunscreen, hats, scarves, gloves, and other protective clothing. Once the first 2 days have passed, patients still need to protect their skin to prevent permanent color changes in the treated area.
In comparison to other skin treatments, PDT offers many advantages. These include:
PDT for acne is a two-step procedure that has amazing results in controlling cystic acne and preventing scar formation. First, a light absorbing agent is applied to the skin and left to penetrate for about an hour. Next, any residual substance that did not absorb into the skin is removed, and the skin is exposed to a special light. The light is attracted to the areas where the light-absorbing agent penetrated and kills the bacteria in those areas.
Treatment with PDT light therapy at our NYC office is as comfortable as possible. A slight stinging may be felt when the light is shone on the skin, but this discomfort passes quickly.
PDT for acne generally requires a series of two to three treatments for best results. NYC dermatologist and laser specialist, Dr. Rokhsar spaces each session three weeks apart.
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1 Photodynamic Therapy. Available: https://www.webmd.com/melanoma-skin-cancer/skin-cancer-guide/photodynamic-therapy-nonmelanoma.
2 Photodynamic Therapy. Available: https://www.healthline.com/health/photodynamic-therapy.
3 Photodynamic Therapy (PDT): PDT Mechanisms. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3572346/.