Photodynamic Therapy

What is Actinic Keratosis?

Actinic keratosis is a precancerous skin condition that develops in sun-exposed skin. The lesions occur in people of any skin type most often beginning at age 30 or 40 and becoming larger and more numerous with age. Actinic keratoses are small and noticeable red, brown, or skin-colored patches that don’t go away without treatment. They commonly occur on the head, neck, or hands but can be found on other areas of the body. Usually more than one is present. They may:

• Have a rough texture.
• Itch, burn, or sting.
• Range in size from 1 to 3 mm or larger (about the size of a small pea).
• Be numerous, with several patches close together.
• Be surrounded by red, irritated skin.

How is AK treated?

Early treatment of actinic keratosis is recommended to stop the possible progression to the types of skin cancer called squamous cell or basal cell carcinoma. The most exciting current treatment of AK is called Photodynamic Therapy, or PDT. PDT employs a photosensitizing medication called the Levulan® Kerastick® (aminolevulinic acid) and application of a light source, typically blue light.

The treatment is quick, easy and comfortable. Most patients report a mild, tolerable stinging or burning during the 10-15 minute light treatment. Only 1 to 3 treatments, several weeks apart are typically needed. After the treatments most patients will have some redness, swelling and peeling that may last up to 7 to 9 days and will be completely resolved in 3 to 4 weeks. Darker, pigmented patches called liver spots can become temporarily darker and then peel off leaving normal skin. Sun damage, fine lines and blotchy pigmentation are improved. Cosmetic results are excellent.

What are the advantages of using PDT?

• Easier for patients than repeated topical liquid nitrogen, Efudex or Aldara because the side effects are minimal, the healing is rapid and only 1-3 treatments are needed.
• PDT is painless verses liquid nitrogen, Efudex and Aldara.
• Reduced scarring and improved cosmetic outcome compared with cautery, surgery and Efudex.  Liquid nitrogen can leave white spots on your skin.
• PDT improves the whole facial area treated creating one color, texture and tone rather than just spot treating with liquid nitrogen, surgery and cautery.