What You Should Know About:

PHOTODYNAMIC THERAPY

What is it?

Photodynamic therapy (PDT) is the combination of a light source—either a laser or intense pulsed light in combination with a topical drug known as aminolevulinic acid ( ALA ). We use Intense Pulsed Light for facial rejuvenation which effectively eliminates red and brown spots, shrinks pores, and improves skin texture. Adding topical ALA dramatically enhances the Intense Pulsed Light. The ALA also targets atypical cells in the skim such as actinic keratoses which are precancers.

What is it for?

Photodynamic therapy is for either facial rejuvenation and/or the elimination of precancers and improving sun damaged skin. You can think of PDT as a “turbocharged” version of intense pulsed light, but with the added benefit of eliminating atypical skin cells.

How many treatments?

Usually, it will require two treatments, but may require a third in some patients. These treatments are performed once per month.

How to prepare?

Photodynamic therapy is very photosensitizing meaning that most patients will become very red like a sunburn. Therefore you must not be on any medications (oral or topical e.g. Retin A; Doxycycline) that make you sensitive to the sun. If you are, you must stop one week before the treatment, and may not begin until 5 days after the treatment. Since this treatment can bring out cold sores, we will prescribe an anti-viral medication that you must start the day before the treatment and continue for two days following the treatment for a total of four days. Because this treatment can make you very sensitive to the sun, you must bring a broad brimmed hat to the treatment so that you can wear it immediately following the procedure. You may wish to take three days off from work. Or if you are having the procedure performed on Thursday afternoon, you will need to take Friday off.

What to expect on the day of the procedure?

You will need to arrive one hour before your appointment time. When you arrive, we will photograph you, and ask you to wash your face with a mild cleanser. Then we will apply the ALA. This is a topical medication and does not hurt. Ten minutes later, we will apply a topical anesthetic. After 30-45 minutes, we will have you again wash your face, and then begin the procedure. You will have protective goggles on, and should keep your eyes closed. We will be performing the intense pulsed light on your face. It requires 20-30 minutes to perform. Occasionally, you may feel heat.

What to expect the following the procedure?

While this is a very effective procedure, there is downtime compared to the regular intense pulsed light. You will need to wear a broad brimmed hat and sun block we will apply it directly after the procedure. It is very important to avoid the sun for at least the first 72 hours. Most patients will become very red—as red as a tomato—for 3-5days. You will also have minor swelling and some flaking of the skin. This may last for up to one week. If you are very fair, and have moderate to severe damage, then the redness, flaking and swelling could be quite extensive for the first 5 days. Most patients can go back to work in 3 days; though their cheeks may be red.

Post Procedure Care

1. Avoid the sun —for the first 3 days. Stay away from windows as the sun penetrates glass
2. Continue taking the anti-viral medication for two days after the procedure
3. Wear a broad-brimmed hat
4. Wear sun block with either titanium dioxide or zinc oxide. It will be necessary to reapply during the day.
5. Apply either Aquaphor or Vaseline Intensive Care three times per day for the first 5 days
6. If you have discomfort immediately after the procedure, Tylenol should be adequate.
7. Beginning the night after the procedure, taking 400 mg of Advil/Ibuprofen three times per day with food for five days may decrease the redness and swelling.
8. If you have concerns during the post procedure period, please call our office at 650-725-5272.