Photodynamic Therapy

This information will help you prepare for photodynamic therapy (PDT).

PDT is an effective treatment for skin lesions called actinic keratoses, which are early skin cancers. PDT is also effective for some skin cancers on the surface of the skin.

PDT is a 2-step process. First, a medication will be put on the treatment area to make it very sensitive to light. You must wait while the medication is being absorbed. This takes 2 to 3 hours. Then, a red or blue light will be shined on the area. The light reacts with the medication and destroys the actinic keratoses or skin cancer.

Preparing for Your Treatment

Tell your doctor or nurse if you:

  • Take any medications; you may have to stop. Some medications may change the way PDT works. Include the following:
    • Medications that require a prescription
    • Medications that do not require a prescription
    • Herbal remedies
    • Vitamins
    • Dietary supplements
  • Have porphyria, a rare disorder that makes your skin sensitive to the sun.
  • Have an allergy to:
    • Peanut oil
    • Almond oil
    • 5-aminolevulinic acid (ALA)
  • Are pregnant or plan to become pregnant. This medication has not been used with pregnant women, so we do not know if it is safe.
  • Are sensitive to light or the sun.
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The Day of Your Treatment

  • Do not use creams, lotions, or make-up on the area to be treated.
  • Bring something to protect the treatment area from the weather. If the treatment was done on your face, bring a wide-brimmed hat or umbrella. If it is not on your face, wear clothing that covers the area.
  • Plan to be at your appointment for 2 to 3 hours.
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During Your Treatment

  • Before your treatment starts, you will wash your face with soap and water.
  • Your nurse will apply acetone or alcohol to remove any oils or debris left on your face.
  • Up to 2 coats of a medication that makes the skin sensitive to sunlight will be applied to the treatment area. Your doctor will tell you how long it will take for the medication to be absorbed, which could be up to 3 hours.
  • The treatment area will be placed in front of a light source, which will activate the medication.
  • During the light treatment, you may have some discomfort. People describe it as stinging, prickling, or burning sensations. This usually goes away after treatment, but may take up to 24 hours.
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After Your Treatment

Everyone responds differently to this treatment. For a few days, you may have the following:

  • Redness that feels like a sunburn
  • Slight swelling
  • Peeling
  • Itching
  • Scaling
  • Crusting
  • Tingling
  • Oozing
  • Mild flu-like symptoms

Follow the guidelines below at home to help you manage those symptoms:

  • Apply a cool compress to the treated area a few times a day for the first 24 hours. This will help reduce discomfort. To do this, take a clean washcloth, dip it into room temperature or cool water, ring it out, and gently apply it to the treated area. When the cool sensation goes away, soak the cloth again and repeat.
  • Starting the day after your treatment, use a gentle, fragrance-free cleanser to clean the treated area. Examples are Cetaphil®, Dove®, Basis®, and Eucerin®. Then, apply a moisturizer, such as Cetaphil, Lubriderm®, Aquaphor®, or petroleum to the area to keep your skin moist.
  • If you have discomfort after your treatment, take an over-the-counter medication such as acetaminophen (Tylenol®), ibuprofen (Advil®, Motrin®), or aspirin. If you are allergic to these medications, or if you cannot take them due to a medical condition, talk with your healthcare provider about which medication to take instead.
  • For 48 hours after your treatment, do not expose the treated area to bright light. This includes:
    • Direct sunlight
    • Indirect sunlight
    • Very bright indoor lights, such as spotlights, photocopy machines, and medical exam lights.
  • Normal house lighting is okay. If you must be outside after your treatment, protect the treated area from the sun. If you can’t cover the treated area, use a broad-spectrum sunscreen with an SPF of at least 30 directly on the area. Broad spectrum means it protects against both UVA and UVB rays. If the area is on your face, wear a wide brimmed hat.
  • After 48 hours, use a broad-spectrum sunscreen with an SPF of at least 30 on the treated area.
  • Starting the day after your treatment, use a gentle, fragrance-free cleanser to clean the treated area. Examples are Cetaphil, Dove, Basis, and Eucerin. Then, apply a moisturizer, such as Cetaphil, Lubriderm, Aquaphor, or petroleum to the area to keep your skin moist.
  • If a scab forms on the treated area, do not remove or pick at it. Apply a moisturizer.
  • Return to the office for your follow-up appointment according to your doctor’s instructions.
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Call Your Doctor’s Office if You:

  • Develop a temperature of 100.4 or higher with or without chills
  • Have redness, swelling, peeling, scaling, cracking, crusting, tingling, oozing, or drainage that becomes unbearable or lasts for more than a week
  • Have mild flu-like symptoms that get worse or do not go away
  • Have pain
  • Develop blisters, open sores, and/or blackened skin
  • Have any questions or unexpected problems
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