TREATMENTS
Photodynamic therapy (PDT)
Treatment for people with multiple solar keratoses or skin cancers where surgery is not appropriate and a good cosmetic outcome is required.
- Skin cancer treatment with lowest scarring risk
- Treatment of individual skin cancers or larger areas of sun damage
- Skin rejuvenation effect
Photodynamic therapy uses light to activate an immune response in the skin. It is an effective treatment for people with multiple solar keratoses or skin cancers where surgery is not appropriate, and a good cosmetic outcome is required.
Photodynamic therapy (PDT) is a non-surgical treatment option for certain types of skin cancers and sun-damaged skin. It uses a combination of a photosensitising agent (a topical cream), and bright light to target and destroy abnormal cells.
The process begins with applying a photosensitising cream, such as aminolevulinic acid or methyl aminolevulinate, to the affected area. This cream is absorbed by the abnormal cells, and after a prescribed period, the area is exposed to a light source. The light activates the cream, causing a reaction that destroys the cancerous or damaged cells while sparing the surrounding healthy tissue.
PDT is primarily used to treat superficial non-melanoma skin cancers like basal cell carcinoma or squamous cell carcinoma, as well as solar keratoses, usually leading to an excellent cosmetic result.
MBBS, MA (Virtual Comm), Grad Cert Hlth Info, Grad Dip Comp Inf Sci
Before and after photodynamic therapy for basal cell carcinoma of the nose
Photodynamic therapy also used for the aesthetic treatment of sun-damaged skin and in some cases of acne and rosacea
The number of PDT sessions needed varies depending on the severity and type of skin concern; superficial cancers may require two treatments a few weeks apart, while cosmetic treatments for sun damage might only need one session.
Benefits of photodynamic therapy
For treating skin cancers, the cosmetic result is usually superior to any other treatment (i.e. surgery, cryotherapy, topical creams):
- Treats an area of sun-damaged skin (e.g. an entire face) rather than targeting individual spots.
- In most cases, treatment only requires a single visit to the clinic (although a follow-up visit is usually required to assess treatment results).
- No need to apply cream daily or twice daily for 4-6 weeks.
- For the treatment of skin cancers, there is only mild discomfort after treatment; skin irritation usually settles within days (if a large area is treated, there may be sores, crusts and redness for 2-3 weeks).
How to prepare
PDT works better and there are fewer side effects if you are well prepared.
The skin should be prepared for treatment by clearing any scale or crusts. Your doctor may prescribe or recommend a cream or ointment for this. If so, use it daily for 1-2 weeks.
Don’t apply fake tan to the treatment area.
Avoid skin irritants such as tretinoin and other retinoids, vitamin C and other acids.
If possible, do not take medications that increase skin sensitivity to light, such as doxycycline. (You should confirm with your prescribing doctor that this is safe.)
Clean the skin and don’t apply make-up to the treatment area.
How it’s done
- A nurse or therapist prepares the area to be treated by cleaning it with alcohol or acetone, and sometimes by microneedling (i.e. making many small punctures in the skin using an electronic device to allow the treatment cream to penetrate the skin better).
- They then apply a thick layer of aminolevulinic acid (ALA) cream to the area to be treated. The cream is covered with a dressing or plastic film and left on the skin for 1-3 hours.
- After this period, the ALA cream is cleaned off the skin’s surface.
- ALA which has penetrated into skin cancer or sun-damaged cells is then activated by light. A combination of red low level light for approximately 15 minutes and/or intense pulsed light may be used.
- Following this, the nurse or dermal therapist will apply sunscreen and/or a cooling gel to the treated area. They may also cover it with a dressing, which should be left in place for 2-3 days.
Related treatments
After your treatment
Return to the clinic after about 1 month so the doctor can examine the skin and determine whether PDT has successfully treated your solar keratoses or skin cancer. In some cases, further treatment may be required.
Learn more about photodynamic therapy aftercare.
Side effects and problems
Some people find PDT treatment painful. This can be treated with a cold compress or spray or medication administered at the time of treatment. It is unusual for strong pain to persist after treatment, but the skin may sting or itch and there is often redness or peeling for several days. Serious complications of PDT are rare.
Avoid known photosensitising drugs and chemicals before light-based treatments such as laser, IPL/BBL and LED light therapy. If you are taking these medications, be sun smart every day.
More infoDowntime varies according to the procedure. It’s important to keep treated skin out of water until it’s watertight (usually about 3 days, or up to 21 if there are stitches) and avoid stretching surgical wounds for up to a month. Anything that irritates the skin – including sunlight – should be minimised or avoided for 2-3 weeks.
More info
Level up your skin health
Interested in exploring photodynamic therapy for suspected skin cancer or sun damage? Book a skin assessment appointment with our doctor.
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