Photodynamic therapy — PDT — is one of the most underknown treatments at medAge and one of the most effective we offer for sun-damaged skin. If you’ve spent decades in the Asheville sun, this page is worth your time.

Most patients come to us asking about lasers, microneedling, or fillers. PDT rarely comes up — not because it doesn’t work, but because it’s a less-advertised treatment. That’s a missed opportunity, especially for patients in Western North Carolina where sun exposure accumulates through decades of outdoor living.

What PDT treats

PDT’s FDA-approved indication is actinic keratoses — precancerous sun-damaged lesions that, left untreated, can progress to squamous cell carcinoma. That’s the clinical justification. But PDT has a well-documented secondary benefit that aesthetic patients love: significant photorejuvenation of sun-damaged skin beyond the lesions themselves.

Patients who undergo PDT for actinic keratoses routinely report improved skin tone, reduction in age spots and hyperpigmentation, finer texture, reduced pore size, and a visible reduction in the mottled, uneven quality that decades of UV exposure create. These cosmetic benefits are real and documented — they’re just secondary to the primary clinical purpose.

What PDT treats (by indication)

• Actinic keratoses (FDA-approved primary indication)
• Sun damage, age spots, and solar lentigines
• Uneven skin tone and texture from UV exposure
• Active acne and sebaceous gland overactivity
• Skin quality improvement in chronically sun-exposed areas

How PDT works at medAge

We use Levulan Kerastick (aminolevulinic acid, ALA) — the FDA-approved photosensitizing agent for PDT. After application to the skin, ALA is selectively absorbed by abnormal and highly active cells (damaged keratinocytes, acne-causing bacteria, sebaceous glands). After an incubation period, the treated area is activated with blue light — which causes a photochemical reaction that selectively destroys those targeted cells while leaving surrounding normal tissue intact.

The entire process takes a few hours including incubation time. Downtime is real: expect redness and peeling for 5 to 7 days after treatment. This is not a “lunchtime procedure.” It’s a clinical treatment with meaningful results and a recovery period to match. Plan accordingly.

When is the right time of year for PDT?

Spring — right now — is ideal. You need to avoid sun exposure following PDT for at least 48 hours, and you’ll be photosensitive for longer. Treating in April or May means your recovery happens before peak summer sun exposure. We generally discourage PDT in the height of summer in Asheville for this reason.

What to expect after treatment

Days 1–2: Redness, swelling, and photosensitivity. Strict sun avoidance is essential. Day 3–5: Peeling and crusting on treated lesions. This is expected and a sign the treatment is working. Days 5–7: Skin begins to settle. Most patients are presentable by day 7–10. Weeks 3–8: The photorejuvenation benefits emerge as new skin develops — the improvement in tone, texture, and spot reduction becomes progressively visible.

Ultherapy is one of a kind in Asheville. As far as we can confirm, medAge is one of very few practices in the area offering the only FDA-approved ultrasound device for non-surgical skin lifting. Here’s what that actually means for patients.

We hear variations of the same question often: “I’ve seen Ultherapy mentioned but I don’t really know what it does — or whether the results are real.” Fair question. Let’s walk through it clearly.

What Ultherapy actually does

Ultherapy uses focused ultrasound energy to reach the SMAS layer — the superficial musculoaponeurotic system. That’s the same structural layer surgeons address during a facelift. It’s the foundational scaffolding beneath the skin and fat, and it’s what holds facial tissue in position over time.

As the SMAS weakens with age, skin descends. Volume shifts downward. The jawline loses definition. The brow drops. These aren’t superficial texture issues — they’re structural changes that surface-level treatments can’t meaningfully address.

Ultherapy reaches that deeper layer non-surgically. The focused ultrasound creates precise thermal coagulation points that trigger the body’s own collagen-building response in the SMAS and deep dermis. Over three to six months, that collagen production translates into a visible, measurable lift.

Key things to know before your appointment

What does Ultherapy feel like?

We won’t sugarcoat it: Ultherapy involves sensation. Patients describe it as a deep warmth or intermittent intensity that pulses through treatment areas. The sensation is brief and punctuated — not continuous. Most patients tolerate it well, especially with the comfort protocols we use at medAge. If you have low pain tolerance, discuss this at your consultation and we’ll prepare accordingly.

Who is a good candidate?

Ultherapy works best for patients who have mild-to-moderate laxity and are not ready — or simply don’t want — surgical intervention. Ideal candidates are typically in their mid-30s through 60s with skin that retains reasonable quality and elasticity. For patients with significant tissue descent, Ultherapy alone may be part of a combination approach rather than a standalone solution.

How long do results last?

Most patients see results that last 12 to 18 months or longer. Because Ultherapy stimulates your body’s own collagen production rather than delivering a foreign substance, results build gradually and are durable. Many patients return annually for a maintenance treatment once results have peaked.

What makes medAge a different Ultherapy experience

Ultherapy outcomes are highly technique-dependent. The positioning of transducer lines, the depth settings selected for each anatomical area, and the clinical judgment of your provider all affect what you see at month six. At medAge, Ultherapy treatments are physician-supervised — not delegated without oversight — and performed by providers trained specifically in the Merz Ultherapy protocol.

We’re a Merz Aesthetics partner clinic, which gives us access to ongoing training and protocol updates that independent practices don’t receive.

If you’ve been researching skin treatments in Asheville, you’ve probably encountered both terms. They sound similar. They share some overlap. But the results — and the patients who are right for each — are meaningfully different.

At medAge, we offer both standard microneedling and Morpheus8 RF microneedling. Understanding the difference helps you make a better decision for your skin — and stops you from underinvesting in a treatment that could do more.

What is microneedling?

Microneedling, also called collagen induction therapy, uses a device with fine needles to create controlled micro-channels in the skin. Those tiny punctures trigger your body’s healing response, stimulating collagen and elastin production over several weeks.

The results are real. Microneedling improves skin texture, reduces the appearance of fine lines, shrinks pore size, and can help with superficial acne scarring. It’s a trusted, well-studied procedure with decades of clinical use behind it.

It’s also one of the most accessible ways to start investing in your skin. Lower price point than device-based treatments, minimal downtime, and it can be combined with PRP (platelet-rich plasma) for enhanced results.

What is Morpheus8?

Morpheus8 is a different category of treatment. It combines microneedling with radiofrequency (RF) energy — delivered at precise depth into the dermis and underlying tissue. The RF energy causes controlled thermal injury that triggers a much more substantial collagen remodeling response than needles alone can achieve.

The depth differentiation matters. Standard microneedling works primarily in the superficial dermis. Morpheus8 can reach the deeper dermal and subdermal layers — the same tissue layers that contribute to skin laxity, volume loss, and the kind of structural changes that come with aging.

The results from a properly executed Morpheus8 treatment are in a different class. Patients see improvements in skin tightening, jawline definition, texture, acne scarring, and fine lines — effects that build over three to six months as collagen production peaks and remodels. One or two sessions can produce outcomes that multiple standard microneedling sessions cannot replicate.

The honest comparison

Which one should you choose?

If you’re new to aesthetic treatments, microneedling is an excellent entry point. It’s appropriate for younger patients focused on preventive skin quality — texture, pore size, early lines. It can be combined with PRP at medAge for a meaningful boost in the growth factor response.

If you’re seeing skin laxity, deeper acne scarring, or changes in facial volume and definition — or if you’ve had microneedling before and feel ready for a more significant result — Morpheus8 is almost certainly the more appropriate conversation. The investment is higher, but so is the return.

At medAge, we don’t default patients to the higher-priced treatment. We match the treatment to the skin. Our providers will tell you honestly which one makes sense for what you’re trying to accomplish.

Morpheus8 at medAge Asheville

Morpheus8 at medAge is performed by our aesthetic nurses using the InMode platform — the original manufacturer of the device. We offer Morpheus8 for face, neck, and body for patients seeking a more comprehensive non-surgical approach.

If you’re weighing microneedling vs. Morpheus8 and want a professional opinion on which is right for your skin, we offer complimentary consultations to discuss your goals before you commit to anything.