OC Wellness

The most common treatment options for AKs have traditionally involved topical ointment 5-FU (Effudex), laser resurfacing, or chemical peels. To avoid the prolonged recovery period and possible scarring associated with these techniques, photodynamic therapy has been developed.

Photodynamic therapy (PDT) is the treatment of choice for the invisible deeper sun damage as well as the visible pre-cancerous AK lesions. PDT involves a two step process that has been proven effective in clinical testing. This treatment cleared 100% of the AKs in 2/3 of the patients after one treatment.

The first step is the application of a topical solution called Levulan. Abnormal cells have a much greater affinity for the solution and absorb it while the healthy cells do not. The solution is left on for an incubation period lasting anywhere from 15 minutes to 18 hours.

The second step of PDT is to apply a concentrated light source to activate the chemical reaction which destroys the abnormal cells. Since the solution is absorbed only in the damaged cells, the healthy cells are not affected. This process can cause a mild burning sensation during the treatment. Usually, this improves immediately after treatment and ends within 24 hours.

Following the treatment, most patients experience mild swelling, redness, and a peeling of the AK lesions and the surrounding tissue. Patients choosing a more aggressive treatment will experience more peeling and/or crusting of the damaged skin that resolves within in one or two weeks. The doctor can easily control the severity of these reactions by limiting the incubation period and the amount of exposure to the light source.

Patients not willing to experience a prolonged recovery time after the procedure may choose a more mild treatment and return to work after a day or two. The trade-off is that they will require more treatments to achieve the same clinical results.

In addition to eliminating AKs and the subsurface skin damage, PDT has also been effective in improving the appearance of the skin by greatly reducing moderate to severe acne (including cystic acne), reducing color splotches, lessening the fine lines, and decreasing pore size.

Anyone who currently has, has had, or wants to prevent AKs or pre-cancerous skin lesions should be evaluated and treated using photodynamic therapy (PDT). Once a person has been successfully treated using this approach, it is recommended they return for a yearly follow up to prevent future problems.