Photodynamic Therapy (PDT)

Photodynamic therapy is most often used to treat actinic keratoses and areas of extensive sun damage. It may also be recommended for selected superficial basal cell carcinomas and squamous cell carcinoma in situ, as well as acne, enlarged oil glands, oily skin, certain cases of rosacea, and uneven skin texture or discoloration caused by years of sun exposure.

The treatment is most commonly performed on areas that receive the greatest amount of sunlight throughout life, including the face, scalp, ears, chest, forearms, and backs of the hands.

The treatment begins with the application of a light-sensitive medication to the skin. This medication is absorbed primarily by damaged or abnormal cells while healthy skin absorbs much less.

After the medication has had time to penetrate the skin, the treatment area is exposed to a specialized blue or red light. The light activates the medication, creating a reaction that destroys the damaged cells while preserving most surrounding healthy tissue. Over the following days, your body naturally removes the treated cells and replaces them with healthier skin.

Your consultation begins with a thorough skin examination to determine whether PDT is the right treatment for your condition. Your dermatologist will review your medical history, current medications, previous skin cancers, and any prior treatments you have received. You will also discuss your treatment goals and what results you hope to achieve.

Before your appointment ends, your provider will explain how to prepare for treatment, what you can expect during the procedure, and how to care for your skin afterward.

Your skin is first cleansed to remove makeup, sunscreen, oils, and other debris. If thicker areas of sun damage are present, your dermatologist may gently prepare the skin to improve absorption of the medication.

The light-sensitive solution is then applied to the treatment area and allowed to absorb into the skin for a prescribed period. Once the medication is ready, the treatment area is exposed to a specialized blue or red light for several minutes.

During the light treatment, you may notice warmth, tingling, or a mild burning sensation. These feelings are temporary and usually improve shortly after the light is turned off. Cooling fans or short treatment breaks can be used to make the procedure more comfortable if needed.

Recovery is generally straightforward, although your skin will need time to heal. It is normal to experience redness, mild swelling, tenderness, dryness, peeling, or crusting over the next several days. Many patients describe the sensation as feeling similar to a sunburn. These temporary changes are an expected part of the healing process as damaged skin cells are replaced with healthy new skin.

The most important part of recovery is avoiding direct sunlight and bright indoor lighting for at least 24 to 48 hours after treatment. During this time, the medication remains active in the skin and can still react to light. Your dermatologist will also recommend moisturizing the treated area, avoiding picking or scratching the skin, and protecting your skin with sunscreen and protective clothing once you return outdoors. Most patients resume normal daily activities within a day or two while the skin continues to heal.

Photodynamic therapy is one of the most effective treatments for widespread actinic keratoses and sun-damaged skin. As the treated skin heals, patients often notice fewer rough, scaly lesions, smoother texture, a more even skin tone, and an overall healthier appearance.

When used to treat acne, improvements typically develop gradually over several weeks as inflammation decreases and oil production is reduced.

Some patients achieve excellent results after a single treatment, while others benefit from a series of treatments or occasional maintenance sessions, depending on the amount of sun damage and their individual skin care needs.

Photodynamic therapy offers both medical and cosmetic benefits. It treats large areas of damaged skin during a single office visit without surgery or stitches while preserving the surrounding healthy tissue. In addition to removing many precancerous lesions, PDT often improves skin texture, reduces discoloration, and leaves the skin looking healthier and more refreshed. Patients treated for acne may also experience fewer breakouts and less oil production over time.