Photodynamic Therapy/Levulan

What is Photodynamic Therapy (PDT)?
Photodynamic acne therapy involves the application of Levulan (5-Aminolevulinic acid), a photosensitizing solution, which is then applied prior to using a light treatment. Levulan is a “smart” solution for it is only absorbed by abnormal cells such as those in acne conditions, pre-cancerous actinic keratoses, and sun damage. Subsequent exposure to photoactivation ie Intense Pulse Light (IPL) or Blu Light, destroys specifically these abnormal cells ultimately destroying the lesions. It is the selectivity of this solution in targeting only bad cells that allows such quick success in restoring skin back to a healthy normal condition.

Who would benefit from PDT? 
Currently, it is FDA approved to treat a pre-cancerous skin condition called actinic keratosis. However, dermatologists are finding even remarkable results in treating cystic acne and sun damaged skin.

In acne patients, Levulan treatment inactivates the bacteria that trigger acne, exfoliates the skin to unclog pores, and it shuts down the production of sebaceous glands in the skin. The ability to decrease oil gland production from the sebaceous glands, which is the main cause of acne, is vital in treating and preventing acne formation. It is ideal for patients who have failed other conservative treatments such as topical or oral antibiotics, patients who do not want to take accutane, or are looking to improve concomitantly skin texture, tone, lines and wrinkles.

In patients with sun damage, Levulan intensifies the power of the IPL. It is believed that for every IPL with levulan treatment is equivalent to 3 treatments. This is ideal for patients who want to shorten the number of treatment sessions.

Who should NOT use PDT/Levulan?
Anyone who has cutaneous photosensitivity at wavelengths at 400-450 nm, porphyria, or known allergies to porphyrins, and in patients with known sensitivity to any of the components of the Levulan Kerastick for Topical Solution. Anyone who is pregnant or nursing.

What precautions should be taken?
Patients should avoid exposure of the photosensitive treatment sites to sunlight or bright indoor light prior to and at least 48 hours after IPL Levulan treatment. Exposure may result in a stinging and/or burning sensation and may cause erythema or edema of the lesions. Sunscreens will not protect against photosensitivity reactions caused by visible light.

What should I expect during the treatment?
When you arrive, you will need to fill out some consent forms. Next, the face will be cleaned. The Levulan will be applied and it will be left on for 1-2 hours depending on the patient and problem. A topical anesthetic cream will then be applied for 30 minutes. You will be given special goggles to wear to protect your eyes during the treatment. During the IPL treatment, you may feel a stinging, pricking sensation. Your skin will feel warm like you were out in the sun for2-3 hours. Specific post procedure instructions and skin agents are discussed. Patients are instructed to go home immediately and stay indoors at least 24 hours, preferably 48 hours. Is it vital to avoid sun exposure during this time for it may cause severe blisters, resulting in hyperpigmentation. When following the instructions properly, your skin will turn red and swollen only for 2-5 days. Some crusting may be noted. There should be only mild discomfort but not pain. The following week, some patients may have some faint residual redness which usually disappears shortly thereafter. Patients should be able to return to normal activities within 2-7 days. Usually after the 2nd day, make up can be applied.