P D T - F. A .Q.

Photodynamic therapy may also be known as: "ALA PDT or ALA BLU-U treatment".

These treatments remove sun damaged pre-cancerous areas and spots called
actinic keratoses. Sun damage, fine lines, and blotchy pigmentation are also
improved because of the positive effect of Levulan and the light treatment. ALA
BLU-U treatment also has the unique ability to minimize pores and reduce oil
glands, effectively treating stubborn Acne, Rosacea, and improve the appearance of
some acne scars.

How much improvement can I expect?

Patients with severe sun damaged skin manifested by actinic keratoses, texture,
and tone changes including mottled pigmentation and skin laxity may see excellent
results. You may also see improvement of large pores and pitted acne scars. Active
acne can improve dramatically. This treatment may eliminate the requirement for
oral antibiotics or Accutane.

How many treatments will I need to see the best results?

To achieve maximum improvement of pre-cancerous (actinic keratoses) areas, a
series of three treatments 2-4 weeks apart is the most effective. Some patients with
only actinic keratoses are happy with just one treatment. To achieve excellent
photorejuvenation results (reduced sun damage, improved skin tone, colour, and
texture), patients may require 4-6 treatments. More treatments can be done at
periodic intervals in the future to maintain the rejuvenated appearance of the skin.
Acne patients improve with two to four treatments, performed at three week intervals.

What are the advantages of Photodynamic Therapy?

1. Easier for patients than repeated topical liquid nitrogen, Efudex (5FU), or Aldara
cream. The side effects of PDT are minimal, the skin heals rapidly, and only 1-3
PDT treatments usually required.

2. The ALA PDT treatment at our clinic is painless verses liquid nitrogen, 5-FU, and

3. Reduced scarring risk and improved cosmetic outcome compared with
electrocautery, surgery, and Efudex. Liquid nitrogen may leave white spots on your

4. PDT improves the whole area treated creating a more uniform colour, texture, and
tone, rather than just spot treating with liquid nitrogen, electrocautery, or surgery.

In summary, PDT matches the "Ideal treatment" for photodamaged skin:
- well tolerated (essentially painless).
- easily performed by our specialty clinic environment.
- non-invasive (no needles or surgery required).
- excellent cosmetic outcome (particularly in cosmetic sensitive areas like the face
Are there any disadvantages?

Following PDT, the treated areas may appear red with some peeling for 2-7 days.
Some patients have an exuberant response to PDT, and experience marked redness
of their skin. Temporary swelling of the lips and around your eyes can occur for
several days. Darker pigmented patches called "liver spots" or "lentigines" can
become temporarily darker and then peel off leaving normal skin. This usually occurs
over 7-10 days. Photodynamic therapy is not an exact science. Repeat treatments
beyond the estimates outlined above may be necessary to achieve best results.

Treatment steps
1. Patients who have a history of recurring cold sores (Herpes simplex type I) should start oral Valtrex or other similar antiviral treatment. This prescription should be started the day before or the morning of your PDT treatment. The prescription for this product will be ordered for you.
2. Make sure your skin is clean and free of all makeup, moisturizers, and sunscreens. Bring a hat, sunglasses, and scarf when appropriate to the clinic.
3. Photography will be done by the staff before your procedure.
4. You must sign a consent form prior to the treatment.
5. An acetone scrub is performed. This will enhance a more even absorption of Levulan and will produce a better result.
6. Levulan is applied topically to the whole area to be treated (such as the whole face, back of the hands, extensor part of the forearms). This is done by Dr. Weksberg and/or his staff.
7. The Levulan is left on for 30-60 minutes before any light treatment.
8. The BLU-U light is applied to the treatment area for 8 minutes. This light activates the Levulan on the skin.
9. Post-treatment instructions will be given to you to care for your improved skin.
Before and after pictures.