Photodynamic therapy (PDT)
PDT is a relatively new treatment which can be used for:
- Removing pre-cancerous lesions
- Preventing skin cancer
- Improving fine lines and wrinkles
- Improving pores and skin texture
- Improving pigmentation
- Treating acne
PDT for Actinic keratoses: pre-cancerous skin lesions
If you have sun-damaged skin with scaly pink areas, pigmentation or rough patches then it is likely you have pre-cancerous changes.
The whole area will be affected and this is referred to as “field cancerization”.
Traditionally creams like Efudix and Aldara have been used and are very effective but have the disadvantage of needing 3-4 weeks of application and 1-2 weeks healing. During treatment, you have to avoid bright sunlight which can be inconvenient if you enjoy outdoor sports such as surfing, golf, tennis and bowls.
PDT is performed in one session and the reaction is settled within 4-7 days.
For many people one session will produce the desired effect but if enhanced cosmetic benefits are desired or if you have particularly damaged skin, further treatments can be performed to maximise the results.
PDT for Acne
PDT is a very effective therapy for acne and can produce long lasting acne clearance without the potential side effects of antibiotics and Roaccutane.
It is indicated for inflammatory lesions (red with small pustules) and a series of 3 sessions is suggested. The first 1-2 sessions may cause a temporary flare up for a few days but the improvement in acne is fairly rapid for most patients. Often the results are long-lasting but extra sessions can be scheduled a few months later if needed.
PDT for skin cancers
Low risk skin cancers in low risk areas may be suitable for PDT treatment. Superficial Basal cell carcinomas and Squamous cell carcinoma in-situ (IEC or Bowen’s disease) can be treated using a photosensitiser and intense red light.
Prior to treatment you will need a biopsy (or results from a previous biopsy) and should have had a full skin check by an accredited skin cancer doctor or dermatologist.
For carefully selected lesions the complete response rate is up to 97% after 12 months and 81.8% after 4 years follow up. This compares with 95% long term cure rates with surgery.