Written by: Jeffrey Sassmannshausen, MD
With age comes wisdom, but also the telltale signs of years spent in the sun. This can take the form of fine lines, deeper wrinkles, pigmentation, precancerous spots, and skin cancer. As the number of precancerous spots have risen over the years, so has the need for treatment. Photodynamic Therapy (PDT) is an innovative, non-invasive treatment option that combines medication therapy and light therapy to treat the damaged and precancerous cells in the skin.
When the skin has only a few spots to treat, I will use liquid nitrogen to freeze the lesion causing it to crust up and die. In individuals with wide-spread damage or many spots, treating the entire face is needed. This can be accomplished using a topical chemotherapy drug or PDT. Both have the same outcome, clearing at least 85% of the damaged cells. Which one to use will depend on insurance and patient preference. Typically, most patients prefer PDT due to faster healing times. Recently, I have started PDT treatments for my face and scalp.
Photodynamic therapy is done in the office. The medication, aminolevulinic acid, is applied to the face or scalp and will sit on the skin for at least one hour. During this time, I have a quiet lounge where you can relax, read a book, or take a nap. After this incubation, you will be seated under a visible blue light. We have two different lights so the treatment will last either 4 minutes or 16 minutes. During the treatment the skin may feel warm and prickly. When I had the treatment, it felt very warm and like I was getting many small bee stings.
After the treatment, the skin becomes quite red and sore. The aminolevulinic acid remains active in the skin for 48 hours, so care must be taken to avoid the sun. When the treatment is finished, just go home and kick back. With my treatment, the soreness lasted two days and then became very itchy. The itchiness lasted an additional two days before the skin started to peel. By one week, my skin was back to normal, minus the rough damaged cells and pigmentation.
A course of PDT includes three treatments that are spaced about one month apart. In the end, the face is smoother, less pigmented and “as soft as a baby’s bottom”.
Most insurances will cover PDT. If needed, we will get a prior authorization from your insurance plan. Often, any out of pocket expenses will be discovered before having a treatment; so ideally, there will be no unexpected bills. Medicare will cover PDT without any prior authorization.
Having your skin checked every year is just like having your car serviced for routine maintenance. The better care you give it, the longer your skin will function properly and look good. Clearing up damaged cells and precancerous areas are very important for that long-term health of the skin. Photodynamic therapy is an easy and effective treatment which can last for years.