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Photodynamic Therapy

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Actinic keratosis (AK) is a UV light–induced lesion of the skin that may progress to invasive.


Photodynamic Therapy

Actinic keratosis (AK) is a UV light–induced lesion of the skin that may progress to invasive squamous cell carcinoma. It is by far the most common lesion with malignant potential to arise on the skin. Actinic keratosis is seen in fair-skinned persons on skin areas that have had long-term sun exposure.

In Australia, the country with the highest skin cancer rate in the world, the prevalence of actinic keratosis among adults older than 40 years has been reported to range from 40-60%. The premalignant nature of actinic keratosis was recognized almost 100 years ago, and the name literally means thickened scaly growth (keratosis) caused by sunlight (actinic). In Australia, actinic keratosis represents the second most frequent reason for patients to visit dermatologists / skin clinics. An actinic keratosis may follow 1 of 3 paths; it may regress, it may persist unchanged, or it may progress to invasive squamous cell carcinoma. The actual percentage that progress to invasive squamous cell carcinoma remains unknown, and estimates have varied from as low as 0.1% to as high as 20%.

WHAT DO AK's LOOK LIKE?

By using a special topical solution called 5-ALA that's activated by light or laser, abnormal cells are targeted and killed. 5-ALA is a "smart" solution. It is only absorbed by abnormal cells such as those in pre-cancerous actinic keratosis, sun damaged skin and acne conditions. It is the selectivity of this solution in targeting only the abnormal cells that allows such quick success in restoring your skin to a healthy normal condition. As opposed to "spot" treatments for removing AK's, Photodynamic Therapy improves the entire area treated creating one color, texture, and tone. In addition to treatment of AKs, PDT is often used for improving skin tone and texture and also Resistant Acne. Overall sun damage accumulates over the years and we are usually not aware of it (with the exception of an obvious sunburn).

What does photodynamic therapy involve?
Photodynamic therapy involves;

  • Pre treating the skin for 2 weeks with ALLMEDIC products to help remove the top layer of skin cells and allow the process to work more effectively.
  • The skin is then degreased with special solution.
  • 20% ALA is then placed on the face from 90 minutes to 7 hours.  Some cases even overnight.
  • The skin is then exposed to a LED light both blue and red LED light to activate the ALA.
  • Strict sun avoidance for 48 hours

What can be achieved with photodynamic therapy?

The number of dystrophic or sun-damaged cells are decreased leading to an improvement in the texture of the skin and a reduction in the probability that these cells will become cancerous. Studies have shown that skin cancers both on face and scalp after PDT are decreased in numbers and severity. It also is very effective in helping to reduce the number of sebaceous glands along with the bacteria, propionobacterium acnes, that causes acne. Hence, dramatic improvements in the number of active acne lesions are seen. Particular improvements are seen in those people who have cystic or inflammatory type acne Benefits are gained not only from the activation of ALA by the LED light, but also from the light itself rejuvenating the skin. Photodynamic therapy can also be combined with laser treatment for brown spots or facial capillaries.


Who suitable candidate for photodynamic therapy?


those with;

  • Active, cystic, or inflammatory acne are suitable for the treatment. It is especially suitable for people who want to avoid Roaccutane use and its side effects.
  • Those who have solar keratosis (pre-cancerous skin lesions)/squamous cell carcinoma/basal cell carcinoma removed with minimal effect on normal skin and the least chance of scarring in comparison to other treatments such as cryotherapy (liquid nitrogen) therapy which tends to leave white areas on the skin, or surgery which tends to leave scars
  • Those with psoriasis and resistant psoriatic plaques that have not responded well to other treatments.

It is not suitable for people who;

  • are breast feeding or pregnant
  • have a history of keloid scarring
  • have had Roaccutane in the past 6 months.
  • have a history of porphyria

How many sessions are needed?

Best results are achieved by two to four sessions at intervals between 14 and 30 days for the treatment of acne. Treatment of solar keratosis, basal cell carcinomas, psoriasis and skin rejuvenation generally requires less treatments (one to two) at intervals of 2 to 6 weeks.

What are the side effects of photodynamic therapy?

Immediately post treatment, the skin appears red and sun-burnt. This can persist for up to one week. The skin may flake, crust or peel during this time. You may also experience approximately 2 days of mild swelling in the face if this is the treated area. Strict sun avoidance is required for 48 hours. There also may be some heat, discomfort, and itch felt in the treated areas for a couple of days.