What Is Photodynamic Therapy

Photodynamic therapy, or PDT, is a two-stage light treatment for acne, psoriasis, actinic keratosis (AK), early-stage skin cancers, and some other dermatological conditions. The FDA-approved treatment combines light energy with photosensitizer drugs to destroy harmful cells, including cancer cells, with minimal downtown.

If you’re struggling with actinic keratoses, active acne breakouts, or another skin condition that has not responded well to treatments, PDT skin treatment may be right for you.

How Does Photodynamic Light Therapy Work?

PDT is performed as an outpatient procedure, which means you will not need to stay in the hospital.

A photosensitizing medication will be applied to the treatment area to make it sensitive to light, and you’ll need to wait a certain amount of time for the drug to be fully absorbed, depending on the specific medication used.

Your provider will shine blue or red light onto the treatment area. The light used in PDT skin treatment comes from light-emitting diodes (LEDs) or certain kinds of lasers and reacts with the photosensitizing agent to destroy harmful cells.

PDT might also help by destroying blood vessels feeding cancer cells and by triggering the immune system to attack the harmful cells.

What Is PDT Skin Treatment Used For?

Photodynamic therapy (PDT) is a treatment for a wide range of skin problems, including both cancerous and noncancerous conditions. Currently, the only FDA-approved indication for photodynamic therapy in dermatology is the precancerous condition actinic keratosis, but the procedure is commonly used for many other dermatological conditions.

Photodynamic Therapy for Actinic Keratosis

The most common use for PDT is for the treatment of skin lesions called actinic keratosis. Actinic keratoses are early skin cancers caused by chronic sun exposure or UV radiation from tanning beds. Without treatment, actinic keratosis can evolve into squamous cell carcinoma. Photodynamic therapy for actinic keratosis is a great option because it can treat multiple lesions at once and potentially treat early lesions not yet visible on the skin’s surface.

PDT Treatment for Skin Cancer

In addition to being an effective treatment for actinic keratosis, photodynamic therapy is also used to treat some basal cell cancers (BCCs) and Bowen’s disease, or squamous cell carcinoma in situ. PDT treatment for skin cancer may be suggested if your cancer is located in a place where surgery is not aesthetically appropriate, such as on your face, or for large but shallow skin cancers. Photodynamic light therapy cannot deeply penetrate the skin and is therefore not a suitable treatment for deep BCCs or squamous cell skin cancers.

Light Therapy for Acne

Moderate to severe acne, including cystic acne, which has failed to respond to other treatment methods may benefit from photodynamic therapy. Light therapy for acne typically requires repeated treatments and tends to be more effective at removing red bumps and cysts than at removing whiteheads and blackheads. Improvement may take several months to become noticeable. The procedure works by killing bacteria that multiply in clogged pores and cause pimples and cysts.

Other Dermatological Uses for PDT

Other off-label uses of photodynamic therapy in dermatology include the treatment of rosacea, psoriasis, vitiligo, flat warts, photoaging, sebaceous hyperplasia, and genital warts. PDT may also be recommended for facial rejuvenation, to improve the texture and tone of sun-damaged skin, to improve blotchy or uneven skin tone, and to minimize pore size.

Pros and Cons of Photodynamic Therapy

Photodynamic therapy offers many benefits compared to surgery or other medical treatments. The procedure:

• Has no known long-term side effects when administered properly.
• Is less invasive and more precise than surgery
• Is usually performed as an outpatient procedure
• Can be repeated as often as necessary
• Causes minimal scarring

However, the treatment does have some limits. The treatment:

• Is only effective on areas where light can reach
• Cannot be used for deep skin cancers
• Cannot be used for people with certain blood diseases
• Leaves people sensitive to light for a period of time, requiring special precautions

What to Expect from Photodynamic Therapy

Preparing for Your PDT Treatment

Tell your healthcare provider if you take any medications or supplements and if you have any allergies. Also inform your provider if you have a history of cold sores, oral or genital herpes, shingles, or porphyria, or if you’re pregnant or plan to become pregnant. If you’re allergic to 5-aminolevulinic acid (ALA) or sensitive to light or sun, your provider may recommend a different treatment option.

The Day of Your Treatment

On the day of your appointment, don’t apply any lotions, creams, or makeup on the treatment area, and don’t shave the area being treated. Wear or bring something to protect the treatment area from the sun, such as a hat or umbrella. If you have a history of herpes, take your medication before your appointment as instructed by your provider.

In most cases, a PDT treatment session last from 15 to 90 minutes, but treatment time depends on your condition and the size of the area being treated.

Photodynamic Therapy Recovery

Most people return to their normal daily activities immediately following a treatment session. It is important to protect your skin and keep the treatment area covered. You may do this by making temporary lifestyle changes, such as:

• Staying indoors
• Avoiding bright or direct indoor lights, such as reading lamps
• Wearing protective clothing and wide-brimmed hats to protect against natural sunlight
• Staying away from certain environments where light may be reflected, like lakes, beaches, and snow

Side Effects of Photodynamic Therapy

Not everyone undergoing photodynamic therapy will experience the same type or severity of side effects. Although everyone responds differently, it is normal to experience some or all of the following for 1 to 2 weeks after your treatment:

• Photosensitivity of eyes and skin
• Swelling at or near the treatment site
• Redness that may feel like a sunburn
• Peeling
• Itching
• Scaling
• Crusting
• Tingling

Your dermatology healthcare team will provide you with a list of homecare tips, such as using cool compresses and taking over-the-counter medications, to help manage your side effects.

Call Our Office if You:

• Have a fever of 100.4 °F or higher with or without chills
• Experience redness, swelling, peeling, blistering, drainage, or other skin changes that become unbearable or last for more than 2 weeks
• Develop mild flu-like symptoms that get worse or don’t go away
• Experience worsening pain or pain that won’t go away
• Develop open sores or signs of infection on the treated area
• Have any questions or unexpected problems

Schedule Your Photodynamic Therapy Consultation

To learn more detailed information about photodynamic therapy or any of our other medical dermatology treatments—or to schedule an appointment with one of our board-certified dermatologists–contact us through our website or by calling one of our offices directly.