Photodynamic Therapy (PDT)
What Is Laser Assisted Photodynamic Therapy (PDT)?
PDT combines light energy with a special photosensitising solution to target and treat sun damage, precancerous cells, and certain skin conditions, leaving your skin healthier and rejuvenated.
What is Laser assisted photodynamic therapy?
Photodynamic therapy (PDT) is an effective and established non-surgical treatment for the treatment of pre-cancerous lesions (actinic keratosis or ‘sunspots’), superficial basal cell carcinoma and superficial squamous cell carcinoma.
It has also been shown to play a role in the management of solar (sun) damage and other signs of skin ageing such as dyspigmentation, solar lentigines, fines lines, skin roughness and skin texture changes.
PDT is the process whereby a photosensitising cream is applied to the skin and is left to incubate for a certain period of time. The cream is selectively absorbed into abnormal cells, and when exposed to light of a specific wavelength these cells are destroyed and spare normal surrounding healthy tissue.
PDT is a good option for people who want to avoid surgery for certain types of thin skin cancers, or for busy people wanting to avoid the prolonged downtime of traditional creams such as Efudix or Aldara. PDT can also be utilised to rejuvenate sun-damaged skin.
Red light PDT and Laser-assisted PDT is available at Hunter Coast Dermatology & Laser.
Laser-assisted photodynamic therapy (LA-PDT) involves the use of a laser to pre-treat the area to create tiny micro-channels in the skin to enhance the delivery of the cream to the target area. This treatment can be slightly more uncomfortable but can enhance clinical efficacy and outcomes.
What does Photodynamic therapy Treat?
Actinic keratoses (sun spots)
Photodynamic therapy (PDT) is a highly effective treatment for actinic keratoses (AKs), which are precancerous lesions caused by long-term sun exposure. PDT targets multiple lesions across sun-damaged areas such as the face, scalp, and arms, offering a field treatment rather than focusing on individual spots. It not only treats visible AKs but also subclinical ones, helping to reduce the overall burden of sun damage and assist in preventing progression to squamous cell carcinoma. One treatment is required.
Superficial Basal cell Carcinoma
PDT is an excellent non-surgical option for selected superficial BCCs, especially in cosmetically sensitive areas like the face, chest, or lower legs. It works by applying a photosensitising cream to the lesion, which is then activated by a specific wavelength of light, selectively destroying cancerous cells while sparing healthy tissue. PDT offers minimal scarring, good cosmetic results, and is particularly useful for patients who wish to avoid surgery or who have multiple lesions. Two treatments are needed, two weeks apart.
Bowens disease
Bowen’s disease is an early form of skin cancer that remains confined to the upper layers of the skin. PDT provides a targeted, non-invasive treatment that effectively destroys abnormal cells while preserving surrounding healthy skin. It is ideal for large, thin, or multiple patches and is often better tolerated than topical treatments or surgery. In addition to its efficacy, PDT typically leaves minimal scarring, making it a preferred option for visible or cosmetically sensitive areas. Two treatments are needed, two weeks apart.
Before & After Images: Real Patient results
What does treatment with PDT involve?
Skin Preparation with CO₂ Laser for Enhanced Penetration
The first stage of PDT involves careful preparation of the skin. In many cases, a low-density carbon dioxide (CO₂) laser is used to create micro-channels in the skin. This technique enhances the absorption of the photosensitising cream by allowing it to penetrate more deeply into the abnormal tissue.
Application and Incubation of the Cream
Following preparation, a specialised photosensitising cream is applied directly to the affected area. This cream selectively targets abnormal or damaged skin cells. The area is then covered with a light-blocking dressing and left to incubate for a set period, usually 1.5-2.5 hours, to allow the cream to fully absorb into the target tissue.
Light Activation to Destroy Abnormal Cells
Once the incubation time is complete, the dressing is removed and the area is gently cleansed. The treated skin is then exposed to a red light, which activates the photosensitising cream. This triggers a controlled reaction that destroys the abnormal or precancerous cells while leaving the surrounding healthy tissue intact. This final step is precise, non-invasive, and offers excellent cosmetic outcomes with approximately 5-7 days of downtime.
Frequently Asked Questions
How does it work?
The Laser Assisted component is achieved with a carbon dioxide laser to deliver energy to the skin creating microscopic columns of ablated tissue. This type of laser energy is broken up into tiny columns and delivered in a polka dot fashion across the skin and is called ‘fractionation’. This type of fractionated laser is much safer than older full resurfacing lasers and has significantly less downtime.
After these columns of energy are delivered to the upper layer of skin (epidermis), it peels away over the days following leaving a new layer of skin behind. The skin in between the ablated columns assists in regeneration and collagen remodelling resulting in improved skin quality and a reduction in fine lines and wrinkles.
It also allows for superior absorption of the photosensitising cream, allowing photodynamic therapy to occur much more efficiently and effectively.
Why should I have this treatment, instead of using Efudix or Aldara?
How many treatments are required?
One treatment is required for actinic keratosis and solar damaged skin. Studies show this results in approximately 85% response rates. Two treatments spaced one week apart are required for superficial skin cancers.