Photodynamic therapy causes temporary sensitivity to light, including all natural light and even some indoor lighting in some cases. The intensity and duration of light sensitivity after a PDT treatment will depend upon the photosensitizing agent used and the amount of exposure to the activating light. In the case of topical application of the photosensitizing chemical, the most common form of photodynamic therapy, the skin will be highly sensitive to sunlight for up to 72 hours in the treated areas. When the photosensitizing drug is administered internally, as is the case in some PDT treatments for cancer, sensitivity of the skin and eyes to light may persist for six weeks or more. Regardless of the form of photodynamic therapy, there will be a period of light sensitivity and patients are advised to follow all PDT treatment post-care guidelines assiduously as complications are possible.³

Photodynamic therapy is used in cases related to excessive UV damage as well as some acneic conditions. A patient presenting severely sun-damaged skin with actinic keratosis, mottled pigmentation, dull or sallow skin and skin laxity is a good candidate for photodynamic therapy. In cases of persistent acne, photodynamic therapy may be used alone or in conjunction with other therapies such as oral isotretinoin. When photodynamic therapy is used alone to treat acne a series of 3-5 PDT treatments is the general recommendation.⁴

Patients may respond differently to a PDT treatment, but in general directly after receiving photodynamic therapy the skin appears red with some swelling as if the patient has a rather severe sunburn. Over the next few days after receiving photodynamic therapy the skin may begin to tingle and itch as the skin begins to peel, crust or even ooze. After the initial 48 hour period when patients must stay indoors and limit activity, these visible side effects may endure for an additional 2 weeks or more.⁵

Photodynamic therapy may be covered by insurance, depending on the application of the treatment. Blue light therapy for acne is generally not covered as it is considered “cosmetic.” However, forms of cancer or possible precancerous conditions such as actinic keratoses, are generally covered, at least in part, by insurance plans.

Photodynamic therapy is an effective treatment for the removal of brown spots such as pigmentation from sun damage as well as freckles. A PDT treatment for brown spots may use the V-Beam laser as the light source. The brown spots will initially become darker before naturally flaking off the skin. As photodynamic therapy is rather efficacious for the treatment of certain brown spots, patients may need just one or two PDT treatments to reach their desired effect. Some discoloration in the skin is better treated by other interventions, so consulting with an experienced physician is important. For overall improvement in signs of photoaging in the skin, photodynamic therapy used in conjunction with IPL shows promising results.⁶

Photodynamic blue light therapy may reduce the appearance of fine lines and wrinkles through destruction of old collagen fibers and stimulation of new collagen production. Although the improvement of fine lines, photodamage and other abnormal pigmentation may occur as a result of photodynamic therapy, it is an “off-book” application and currently there are no standardized guidelines for these specific conditions.⁷

Photodynamic therapy includes the use of a sensitizing agent that is then activated with an appropriate light source. The most common form of PDT treatment uses a blue fluorescent light, but some photodynamic therapy makes use of other light sources such as LED panels, lasers and even natural sunlight.⁸

The onset and duration of peeling in the skin after photodynamic therapy will vary depending upon the location, the sensitizing agent used and the duration of exposure to the light during the PDT treatment. In general, peeling will commence between 2-6 days after the photodynamic therapy and may endure for 2 weeks. It is very important to follow all post-procedural instructions including not picking or pulling the skin, allowing it to naturally slough off in response to the PDT treatment.

It’s important to consult with the practitioner administering the PDT treatment as recovery and care instructions may differ. In general, the skin will look and feel as if it has sustained a sunburn after a PDT treatment. The use of cold packs or cool compresses may be recommended on the day of treatment to cool the skin, and washing the skin may be prohibited until the day after receiving photodynamic therapy. Once cleansing is allowed after photodynamic therapy, the skin may be washed with a gentle, fragrance-free cleanser and a clean towel should be used to pat dry the skin. Rubbing the skin during the cleanse or drying of the skin after a PDT treatment is generally not recommended. Often, a simple emollient moisturizer, or white petrolatum, is recommended to keep the treated skin moist. For an additional cooling effect on the skin after a PDT treatment, the moisturizers or emollients may be stored in the refrigerator.