Photodynamic Rejuvenation treatment is the use of intense pulse light to treat a variety of skin conditions including the signs of aging due to the sun, large pores, broken blood vessels, brown and red spots. It is a more aggressive intervention than standard laser/photofacial therapy in that it utilizes a topical photosensitizing agent called Levulan®. The treatment is also excellent to treat those with acne/acne scarring and to eliminate precancerous sun damage. Commonly treated areas are the face, neck, chest, arms, hands and legs. Furthermore, it significantly improves skin tone and texture.

Photodynamic rejuvenation treatment procedure
The Levulan®, which is a clear painless solution, is applied to your skin and left on for 15-60 minutes. It is then activated with a specific wavelength of light called BLU-U or Clear-Light. This takes about 8-10 minutes.

The Levulan® is absorbed by active cells, making the targeted acne cells more sensitive to the light. This combined interaction of the solution and the light is what gives rise to the term "photodynamic therapy." The Levulan® will also target sebaceous hyperplasia (which are those small, 1-3 mm, benign bumps under your skin) and the papules of acne rosacea. An important part of the treatment program is medical extraction of blackheads and acne pustules. This procedure will expedite the improvement in your skin condition by cleaning the pores of hardened sebum and infected debris. The treatment reduces skin oiliness and minimizes the appearance of pore size. The entire skin texture improves following a photodynamic acne treatment.

What are the advantages and downside of PDT?
The advantages of PDT are rapid treatment of acne lesions all over the face, no scarring, no surgical excisions and no systemic side effects. The skin appears refreshed and younger following these treatments. There is reduced scarring and improved cosmetic outcomes compared with cautery, surgery, and Efudex. Liquid Nitrogen can leave white shots of your skin. The procedure is easier for patients than repeated topical liquid nitrogen, Efudex (5fu), or Aldara because the side effects are minimal and rapid healing. Additionally, the ALA/PDT treatment at our clinic is less painful than liquid nitrogen, d-FU, and Aldara. Furthermore, Levulan® improves the whole facial area treated, creating all one color, texture, and tone rather than just spot treating with liquid nitrogen, cautery, and surgery. We advise 2-3 treatments at 2 to 3 week intervals to obtain optimal results.

The “downside” of Photodynamic treatment (PDT) is that your skin will be red and have some skin peeling (and crusting if you have skin cancers) for several days after the treatment. Usually, the first 1-2 days are the worst. Pressed mineral base powder (available in our office) will hide most of the redness. Some patients have an exuberant response to PDT, and experience marked redness of their skin. Temporary swelling of the lips and around your eyes can occur for a few days. Darker pigmented patches called liver spots can become temporarily darker and then peel off, leaving normal skin. This usually occurs over seven to ten days. Repeat treatments may be necessary as PDT medicine is not an exact science. You must remain indoors the day following your treatment to avoid sun exposure, as you are photosensitive for about 24 hours after PDT. Topical acne lotions can be used in between your Levulan® treatments once the redness has settled down over a period of a few days.

Photodynamic therapy with Levulan® is indicated for:
Removing pre-cancerous actininc keratoses
Preventing skin cancer
Improving wrinkles
Reducing pore size
Improving skin texture
Improving pigmentation
Treating moderate to severe cystic acne
Treating sebaceous hyperplasia

How much improvement can I expect?
Patients with severe sun damaged skin manifested by actinic keratosis, texture, and tone changes including mottled pigmentation and skin laxity may see excellent results. You may also see improvements of large pores and pitted acne scars. Active acne can improve dramatically.

How many treatments will it take to see the "best" results?
To achieve maximum improvement of pre-cancerous (actinic keratoses) sun damage, skin tone, and texture, a series of three treatments 2-4 weeks apart is the most effective. Some patients with only actinic keratoses are happy with just one treatment. More treatments can be done at periodic intervals in the future to maintain the rejuvenated appearance of the skin.

PDT matches the “ideal treatment” for photodamaged skin:
Well-tolerated
Easily performed in a specialty clinic environment
Non-invasive (no needles or surgery required)
Excellent cosmetic outcome
(particularly in cosmetically sensitive areas of the face)