Levulan Photodynamic Therapy (PDT) is a combination of a topical photosensitizer and a special light source which destroys targeted cells. PDT was initially used to treat cancer cells and is now being used in the treatment of non-cancerous conditions such as acne and for facial rejuvenation. When used for these conditions, the photosensitizer is applied to the face and then the skin is exposed to a light source. Rapidly growing cells, oil glands, and other structures in the skin absorb the photosensitizer and are destroyed by a reaction caused by the light.

What is Photodynamic Therapy (PDT)?

When a laser is used upon the skin there are three possible effects that can occur. One of these, photochemical, which draws from photosensitive reactions, serves as the foundation for photodynamic therapy (PDT).

The general idea to PDT is that certain molecules are activated when exposed to specific wavelengths of light, if these molecules are distributed to certain tissues in the body and then exposed to different wavelengths of light the molecules will produce a reaction inside the tissue. The reaction destroys the unwanted tissue while leaving the surrounding tissue intact. In PDT the most common photosensitizer (light-reactant chemical) is topical aminolevulinic acid HCI (ALA), known as Levulan.

There are three different light sources that can be used in PDT, these are: blue light (BLU-U) and intense pulsed light (IPL).

A. Blue Light – The blue light photodynamic therapy illuminator is designed to send a steady flow of blue light on the skin for a thousand seconds, this light is used to activate the light-reactant chemical placed upon the skin. Exposure limits have been placed by the American Nationals Standards Institute (ANSI) to protect the skin from consequences caused by excessive exposure.

B. Intense Pulsed Light – Because of the nature in which IPL is used, it can be applied to the skin with less side effects and patient downtime. When used in photorejuvenation IPL produced excellent cosmetic results without pigment alterations or scarring.

PDT Uses

Acne - Patients who were treated with PDT also showed improvement in acne and a decrease in P acnes. Clinical improvements were seen up to six months after a single treatment of topical ALA on facial acne with exposure to a light source four hours later. When PDT is used to treat acne the topical ALA is applied broadly and evenly to the affected areas—unlike AK where the topical ALA is applied spot treatment style—and the patients are then exposed to the light source for a thousand seconds. During PDT on acne, patients commonly experience severe burning and pain; however, there are many treatment methods to help acne patients deal with the pain associated with the photodynamic therapy, these include, but are not limited to: pretreatment with topical anesthetics, cool compresses during therapy, systemic steroids, non-steroidal anti-inflammatory drugs, and even narcotics.

Actinic Keratosis - PDT is used commonly to treat actinic keratosis (AK) which are common lesions found most typically in lightly pigmented individuals, and since a large number of cancerous cells begin as AK, detection and treatment is critical. Pulse dye lasers (PDL) and intense pulse light (IPL) devices are used to treat AK easier, faster, and with less pain than the original blue light. Topical ALA is applied to the individual lesions and left for thirty to sixty minutes before being treated with IPL. The treatment is fast and virtually pain free.

Photorejuvenation – Visible skin damage can be distinguished by wrinkling, coarse skin texture, pigmentation alterations, and telangectasias. Photorejuvenation therapy with Levulan has been found to help improve and reduce each of the different characteristics of damaged skin, including: decreasing thickening and crusting of the skin, minimizing pore size, improving the texture of the skin, and subtle improvement in wrinkles.

Photodynamic Therapy Treatment

Before taking topical ALA (the medicine used during PDT) you should tell you health care provider if you have ever had porphyria or an allergic reaction to any medicine. Also, females who are pregnant or plan to become pregnant should notify their health care provider. You should not breast-feed while taking this medicine without your health care provider’s approval. After the physician has applied the medicine to your sores and before the treatment your skin will be sensitive to sunlight and bright indoor light. Shade the treated sores if you must be outside, sunscreens will not protect your skin after use of topical ALA. Continue to keep out of light for 24 hours after your treatment.

Side effects that can occur from photodynamic therapy treatment include: severe stinging or burning, scaling, crusting, itching, light or dark spots on the skin, wearing away of the skin, puss filled pimples, mild swelling for three to five days, and skin ulcers. These side effects are temporary and should be gone within four weeks after the treatment. After eight weeks your doctor will examine your sores and any that have not healed may be treated again. The number of treatments you need will depend on how your sores heal.


Will I feel any discomfort during the treatment with the Levulan® PDT system?

Probably. Although the Levulan® PDT system has been designed for less patient discomfort, many patients do report some:
• Stinging and burning
• Swelling and temporary reddening
This discomfort usually occurs immediately following treatment, rather than in the weeks following. Any swelling and redness will begin to subside soon after treatment and will be gone in a few weeks. In fact, some patients have reported that swelling is reduced even sooner.

How many PDT sessions will I need?

The number of photodynamic therapy treatments that have been used has ranged from one to three (over a period of three months).

How long after a PDT before I can return to normal activities?

This treatment will make you extremely photosensitive and you will be required to avoid sun exposure for 24 hours after photosensitizer has been applied.

LEVULAN PDT CONSENT FORM