Photodynamic therapy, or PDT, is an innovative procedure that uses the Levulan chemical applied directly to treatment areas at Spectrum Dermatology. This chemical renders the skin sensitive to a special blue light that is used following the application of the Levulan chemical. PDT is approved by the Food and Drug Administration (FDA) to specifically treat actinic keratosis.
PDT is also an effective means of treating sun damage as well as hidradenitis suppurative (a rare, chronic skin condition). PDT can be considered a medical or cosmetic procedure. When it is considered medical, it is usually covered by insurance providers.
Photodynamic therapy is painless. The area to be treated is first cleansed, followed by the chemical application. However, the chemical must sit on the skin for 60 – 120 minutes in order to incubate. PDT appointment can be long, and patients are encouraged to bring something to occupy themselves.
After incubation, the blue light activates the chemical for about 15 minutes. Some mild heat and discomfort may be experienced, but overall the procedure is pain-free. Post-treatment, sunscreen is applied to the treated area. For the following 48 hours, it is important to avoid sunlight and wear ample sunscreen and protective clothing. Redness and peeling may occur for up to one week post-treatment. When treating actinic keratosis, the spot will “flake away” during the week to reveal healthy skin below.
When using photodynamic therapy to treat cancer, the process can be a little different. First, a photosensitizing product is injected into the bloodstream. This is naturally absorbed by the body, but lingers in cancer cells. Between two and three days later, a second appointment is scheduled to see if there is a cancerous tumor. If there is, the tumor still has the photosensitizer within it and can be treated with the blue light. Cancer cells are destroyed. This works by restricting the tumor’s ability to receive nutrients and by fostering an attack on tumor cells by the immune system.
PDT is almost always an outpatient treatment. There are no caps for how often it can be used, and for cancer patients it might be used in tandem with surgery, chemotherapy, and radiation therapy.
PDT is not effective for all types of cancer. It is currently approved by the Food and Drug Administration (FA) to treat esophageal cancer as well as non-small cell lung cancer. Most often, a porfimer sodium is injected when using PDT to treat cancer.
PDT has minimal side effects. However, some patients are sensitive to porfimer sodium, and mild side effects can last up to six weeks. Direct sunlight exacerbates side effects. Tissue damage is usually minimal, but in some cases, PDT causes swelling, burning, pain, and scarring. In very rare cases, trouble swallowing, stomach aches, shortness of breath, coughing, and painful breathing can occur. Spectrum Dermatology can treat tissue damage with a variety of treatments, but severe side effects require immediate medical attention.
Insurance will usually cover PDT for medical reasons, including actinic keratosis and cancer. Sometimes prior authorization is required. However, insurance rarely covers PDT for cosmetic reasons.
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