BLU-Light or photodynamic therapy involves the use of specific light or laser sources to treat a variety of common skin conditions. This treatment may be combined with a topical medication or used alone. Drexel Dermatology offers blue light therapy, which is a type of photodynamic therapy approved to treat premalignant skin lesions and some superficial skin cancers.
Photodynamic therapy is also effective in treating acne, improving fine wrinkles around the eyes, and rejuvenating the skin. The use of photodynamic therapy for conditions other than actinic keratosis is considered off-label.
What is photodynamic therapy (blue light therapy)?
Photodynamic therapy (PDT) is a medical treatment that uses a photosensitizing drug (a drug that becomes activated by light exposure) and a light source to activate the applied drug. The result is an activated oxygen molecule that can destroy nearby cells. Precancerous cells and certain types of cancer cells can be treated this way. The basic premise of PDT is selective tissue destruction. Although the photosensitizer may be absorbed all over by many cells, atypical or cancerous cells take up more of the drug and retain the drug for a longer duration than normal tissues.
Although PDT's use in skin was first investigated in 1990s for actinic keratosis, it was not as popular or widely used because of the required long incubation times (usually 18-24 hours) and limited indications. Since approximately 2001, PDT has become more widespread in use primarily because of advances including shorter incubation times (30-60 minutes) and more applications, including acne and cosmetic skin rejuvenation.
Before and After Photos: Photodynamic therapy
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BEFORE PDT
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2 MONTHS AFTER PDT
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How is photodynamic therapy performed?
The procedure is easily performed in the office. PDT essentially has three steps. First, a light-sensitizing liquid (photosensitizer) is applied to the skin. Second, there is an incubation period ranging from 30 minutes to 4 hours. Finally, the target tissue is then exposed to a specific wavelength of light that then activates the photosensitizing medication.
How is photodynamic therapy used to treat the skin?
PDT using Levulan and a proprietary blue light is currently FDA approved for the treatment of skin precancers called actinic keratosis (rough scaly spots generally on sun-exposed skin). PDT is also known as "ALA/PDT treatment" or "BLU-Light." It has been referred to as a "super photo facial" when the photosensitizer is used with a pulsed dye laser. These treatments may help remove sun-damaged precancerous skin. Sun damage, fine lines, and blotchy pigmentation may also be improved because of the positive effect of PDT. PDT also has been shown to help decrease the appearance of pores and reduce oil glands, effectively treating some stubborn acne, rosacea, and improving the appearance of some small superficial acne scars.
What are the side effects of photodynamic therapy?
Anticipated side effects of photodynamic therapy with Levulan include discomfort, burning, swelling, redness, skin peeling, lightening or darkening of skin tone, and possible hair removal. All of these are more likely in areas of sun damage or within pre-cancerous lesions. The peeling may last many days and the redness for a few weeks. If you are just being treated with the BLU light without Levulan, you are unlikely to experience any of these side effects.
Is photodynamic therapy painful?
The application of the levulan is not painful. Exposure to the BLU-light can be uncomfortable, but is usually tolerable. The first 1 to 3 minutes after light exposure there is usually a tingling sensation. The 3rd through 7th minute is typically the most uncomfortable, but is usually helped by a cool air blower. After the 8th minute the pain subsides and the last 8 minutes are usually well tolerated. If Levulan is not used, the BLU-light session is pain free.
How long does a session last?
A BLU-light session alone (without Levulan) takes about 20 minutes. If your doctor uses Levulan, the incubation time depends on the area treated and could be anywhere from one to two hours followed by light exposure that lasts 16 minutes.
How many treatments will I need?
Depending on the extent and size of the area involved you may need several treatments spaced about 4 weeks apart. For limited disease a single session is often sufficient.
How much will photodynamic therapy cost and is it covered by insurance?
Photodynamic therapy sessions FOR ACTINIC KERATOSES (pre-cancerous lesions) are covered by most insurances. However, some insurances do require a prior-authorization. Other off-label uses for PDT, including acne, are considered cosmetic, and are therefore NOT covered by insurance. You will be given an estimate of the cost if this is being considered for you.
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