PhotoDynamic Therapy
What is it?
Sometimes called a "Power Photofacial", photodynamic
therapy (PDT) involves the application of a light absorbing
agent, Levulan (5 aminolevulinic acid), which is taken up
preferentially by precancerous, malignant or fast growing
(e.g. sebaceous) cells and converted to protoporphyrin IX,
a potent photosensitizer. Exposure to intense light
of appropriate wavelength activates PPIX, forming cytotoxic
free radicals and singlet oxygen, leading to specific cell
death.
Levulan is a natural substance produced by the body in
the process of making hemoglobin.
Levulan is a "smart" solution. It is only absorbed
by abnormal cells such as those in acne conditions, pre-cancerous
actinic keratoses, and sun damage. It is the selectivity
of this solution in targeting only bad cells that allows
such quick success in restoring skin to a healthy normal
condition.
What is it used for?
- PDT is a great treatment for papulopustular acne, as
an alternative to Accutane. Shrinks sebaceous glands
and kills P.acnes bacteria
- Photodamage
- Actinic keratoses (pre-cancers). Left untreated,
5-20% of AKs will transform into squamous cell carcinoma
within 10-25 years
- Scleroderma
- Rosacea, including rhinophyma (large, red, "W.C.
Fields nose")
- It has also been show to lead to a reduction in future
tumors when treating non-melanoma skin cancers
- Diminishes the appearance of fine lines and wrinkles
- Reducing pore size
- Improving skin texture
- Improving pigmentation
- Treating sebaceous hyperplasia (overgrowth of oil glands)
How is the Treatment
Performed?
Depending on the patient's individual condition and motivation,
this treatment can be adjusted to be more or less aggressive,
as needed.
The process:
- You will be pretreated for 4 weeks
with the Obagi Condition and Enhance system, in order
to adequately prepare your skin for the treatment to
come and to enhance the skin's ability to heal more
quickly after treatment. The more active ingredients
are stopped 1 week prior.
- On the day of treatment your skin
will first be prepared with microdermabrasion and then
cleansed with acetone.
- The Levulan solution will be applied
to your face and you will then be able to "incubate"
either at home or in the office, depending on the time
Dr. Mashal deems necessary for your condition, while
the liquid is selectively absorbed by pimples, cysts,
overactive sebaceous glands, pre-cancers and other abnormal
cells, turning them into "targets" for the
next step - light.
- Your face will then be washed and
acetone reapplied.
- You will be treated with IPL (Intense
Pulsed Light) or Vbeam laser
- Lastly, your face will be exposed
to blue light for 5-8 minutes. The light is drawn
to the target cells that have absorbed the Levulan,
selectively destroying them without damaging normal
cells.
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What are the side effects?
- Depending on how aggressively you are
treated, your skin will be red and have some peeling (and
crusting if you have skin cancers) for several days after
the treatment. Usually, the first 1-2 days are the worst.
Five to six days is the average "downtime".
Mineral makeup can be used to hide redness once the peeling
has stopped.
- Your skin will be especially sensitive to sunlight for
24-36-48 hours after treatment. It is important
to limit sun exposure for the first day or two to minimize
the side effects of treatment.
How many treatments will I need?
Depending on how aggressive your treatment is and the condition
of your skin prior to treatment, you might need as few as
one, or as many as 3-5 treatments at 2-3 week intervals.
You will see the effect of treatment within 1-2 weeks.
Patients with actinic keratoses and acne often get excellent
results with just one treatment, though results may vary.
Consent
for Levulan Photodynamic Therapy - Photodynamic
Therapy Information - Photodynamic
Therapy Pre and Post Care Instructions |
