Photodynamic Therapy

Photodynamic Therapy is a relatively new technology that is revolutionizing the practice of Dermatology. We use photodynamic therapy (PDT) for two main conditions. The first is to treat rough scaly sun damaged skin and the associated precancerous patches known as actinic keratoses. The second is to treat severe acne.

PDT involves applying a solution called levulon, or levulinic acid, to the skin after cleansing the skin very well. Any part of the body can be treated but normally the face, arms, hands, back and chest are treated. After the levulon is allowed to soak into the skin for a certain period of time, usually an hour, patients are brought into the Blue Light Room and the skin area to be treated is exposed to the Dusa Blue-U Light for a usually 8-15 minutes.

The levulon, when allowed to soak into the skin, is taken up by abnormal cells that are turning over more rapidly than normal. When exposed to the special Dusa Blue-U Light, the abnormal cells are killed.  Normal healthy cells typically do not take up levulon and so are not affected.

PDT For Precancerous Skin

This process will kill precancerous cells, some true early cancerous cells and cells with significant sun damage. The roughness of the skin becomes smooth, the actinic keratoses (AKs) fade or go away, the tiny red vessels go away, and the abnormalities in color in general are normalized. PDT is therefore used to treat precancerous skin lesions and to prevent precancerous lesions from developing.

It is remarkable that PDT can so significantly prevent tiny early skin cancers from developing. Dermatologists are embracing PDT because it is so effective and, when used in a preventive way, can minimize and eliminate in many cases the need to freeze, burn and cut out rough precancerous lesions. Dr. Stover typically recommends a session once a month for 3 months then a session once a year.

PDT For Acne

Finally we are seeing a safe alternative to Accutane for difficult cystic acne. PDT, like Accutane, will downregulate the overactive oil or sebaceous glands which contribute to severe acne in adolescents as well as adults.

PDT, however, is essentially without side effects. PDT also kills the bacteria that cause acne and so often can eliminate the need for antibiotics. Depending upon the severity of the acne, we usually recommend a PDT session once a month for 3-4 months.

Hormone changes seen in adolescence cause oil glands to become overactive. PDT kills overactive skin cells. Excess oil tends to clog pores causing raised pimples. Dead skin cells do not exfoliate as they normally do because they become stuck on the oily skin surface. The bacteria associated with acne, P. acnes, flourishes and overgrows in the presence of the excess oil in the clogged pore. The pimple then can become quite large and cyst-like. PDT is an important component of acne therapy in that it shrinks overactive oil glands. Pores are less clogged and the bacteria do not flourish. The DUSA Blue-U Light also is of the exact nanometer wavelength the specifically kills the bacteria P. acnes.

Dr. Stover will also recommend other treatment steps to effectively deal with acne such a strong salicylic acid wash to help clear away dead skin cells stuck on the oily skin surface contributing to the clogged pores. Benzoyl peroxide is used to help clear away dead skin cells and kill bacteria. Antibiotics given either topically or by mouth will kill bacteria as well and may be recommended. With antibiotic resistance such a troubling issue today, PDT is recommended to minimize or eliminate the need for antibiotics.

PDT For Other Skin Lesions

PDT is also used in our office to treat rosacea, difficult rashes such as dermatitis or psoriasis that do no respond to traditional therapy as well as warts. PDT will destroy the fine pattern of vessels that make rosacea visible and troubling. Any skin condition that involves cells that are rapidly reproducing may be improved with PDT. Dr. Stover usually recommends PDT as a component to an overall treatment program for many skin problems, often not the only treatment approach.

For more information about PDT, go to www.dusapharma.com.