Photodynamic Therapy for Pre-Cancers

Photodynamic Therapy treats Actinic Keratoses (AKs), which are considered to be the first step in the development of skin cancer. They have the potential to progress to squamous cell carcinoma (SCC).

Fortunately, we offer a therapy designed to fit your busy lifestyle. our photodynamic therapy sessions offer a short, 2-part treatment course, low downtime (although you should avoid exposure of treated areas to sunlight or intense lighting). Flexible treatment options coupled with good results make this a perfect solution for our busy Southern Californian lifestyles. Additionally, the procedure offers excellent cosmetic response, with no scarring reported to date.

Photodynamic Therapy for AKs involves a direct application of aminolevulinic acid to the AK spots, followed by Blu-U light treatment.

The Blu-U light is of low intensity and will not heat the skin. However, during the light treatment, you may experience sensations of burning, tingling, stinging, or prickling of the treated AKs. These feelings of discomfort should improve at the end of the Blu-U treatment and should subside as early as 1 minute after the treatment, but may take up to 24 hours to subside. Following the treatment, the AKs and some degree of the surrounding skin may redden, and swelling and/or scaling may also occur. However, these effects are temporary and should completely resolve by 4 weeks after treatment.

Frequently Asked Questions and Full Procedure Description:

What are Actinic Keratoses?

Actinic Keratoses (AKs) are rough-textured, dry, scaly patches on the skin that are caused by excessive exposure to ultraviolet light (UV) such as sunlight. More than 10 million Americans have AKs.

• AKs are often called "sun spots."
• They occur most often on the face, scalp, ears, neck, hands, and arms.
• They can range in color from skin toned to reddish brown.
• They can be as small as a pinhead or larger than a quarter.

  Who Gets AKs?

AKs develop as the result of years of sun exposure. Because the effect of sun exposure is cumulative, it is your lifetime exposure that increases your risk. Even if you didn't suntan much, years of just doing simple tasks outside can add up to a significant amount of sun exposure. For example:

• Going outside to the mailbox.
• Playing an outdoor sport.
• Walking the dog.

Because AKs take a long time to develop, they generally appear after the age of 40. YOur risk of developing AKs increases if you have one or more of the risk factors:

• A history of cumulative sun exposure.
• Fair skin.
• Blonde or red hair, in particular if combined with blue, hazel, or green eyes.
• A tendency to freckle or burn after sun exposure.
• A weakened immune system.

Actinic Keratoses is the Most Common Precancer

AKs are considered to be the first step in the development of skin cancer. They have the potential to progress to squamous cell carcinoma (SCC). While most AKs remain benign, a study has shown that approximately 10 percent develop into SCC within an average of 2 years. Since there is no way to know ahead of time which AKs will develop into SCC, it is very important for individuals with AKs to be under a dermatologist's care. Frequent skin examinations are the key to early detection and prevention.

Why is Photodynamic Therapy a Good Choice for You?

• Short, 2-part treatment course.
• Low downtime (although patients must avoid exposure ofphotosensitized lesions to sunlight or prolonged or intense light for at least 40 hours)
• It is easy because:

1. A qualified healthcare professional will administer the treatment.
2. No prescription to fill
3. No daily medication to remember

• Flexible treatment.

1. Appropriate for a few AKs
2. Appropriate for multiple AKs

• Compatible with your daily routine.
• Good results:

1. Recovery begins right after your blue light treatment ends.
2. Excellent cosmetic response.
3. No scarring reported to date.

How does Photodynamic Therapy Work?

Aminolevulinic Acid solution is applied to the AK; patients will wait in our lobby for 30-60 minutes to allow the solution to penetrate into the AK. The solution is then absorbed by the AK cells where it is converted to a chemical that makes the cells extremely sensitive to light. When the AK cells are exposed to the blue light, a reaction occurs which destroys the AK cells.

Two-Step Treatment: In Depth

Step 1:
Aminolevulinic Acid will be applied to your AK lesions. Patients will wait in our lobby for 30-60 minutes to allow the solution to penetrate into the targeted cells. Avoid exposing the treated lesions to sunlight and other forms of bright light for at least 48 hours. Examples include household lights at close range or playing a sport such as golf. Sunscreens will not protect against photosensitivity reactions caused by visible light during this time.

Step 2:
Before your BLU-U light treatment, the AKs to be treated should be gently rinsed and patted dry. Your treatment with the BLU-U will be determined by your provider on a case-by-case basis. Protective eyewear should be worn during your BLU-U treatment.

During BLU-U Treatment:

The BLU-U blue light is of low intensity and will not heat the skin. However, during the light treatment, you may experience sensations of burning, tingling, stinging, or prickling of the treated AKs. These feelings of discomfort should improve at the end of the BLU-U treatment and should subside as early as 1 minute after BLU-U treatment, but may take up to 24 hours after your treatment has ended. Following the treatment, the AKs and to some degree the surrounding skin may redden, and swelling and scaling may occur.

Before and After Your Treatment...

Before your treatment, be sure to tell your physician if you are taking any oral medications or using any topical prescription or non-prescription products on your face or scalp. Bring adequate sun-protective items with you to your appointment, such as a wide-brimmed hat or umbrella.

After your treatment, avoid exposure of your aminolevulinic acid treated face or scalp to sunlight or bright indoor lighting prior to and for at least 48 hours after the application of aminolevulinic acid. Sunscreens will not protect against photosensitivity reactions caused by visible light. Moisturizers may be applied as needed.

Who Should Not use Aminolevulinic Acid?

Aminolevulinic Acid should not be used by patients who have cutaneous photosensitivity at wavelengths at 400-450 nm, porphyria, or known allergies to porphyrins, and in patients with known sensitivity to any of the components of aminolevulinic acid. The solution has not been tested on patients with inherited or acquired coagulation defects. It is possible that concomitant use of other known photosensitizing agents might increase the photosensitivity reaction of AKs treated with aminolevulinic acid. It is important to tell your physician if you are taking any oral medications or using any topical prescription or non-prescription products on your face or scalp. Tell your doctor if you are pregnant or nursing.

What are the Possible Side Effects?

The most common side effects include scaling/crusting, skin discoloration, itching, stinging, and/or burning, redness, and swelling. Severe stinging and/or burning at one or more lesions being treated was reported by at least 50% of patients at some time during the treatment.

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