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Photodynamic therapy, or PDT, treats a field of sun-damaged skin in a single session by combining a light-activated cream with a medical light source. It is the standard treatment for widespread actinic keratosis, an option for superficial skin cancers, and an adjunct for resistant acne. Dr. Paul Kuzel, a board-certified dermatologist, selects the indication and performs the treatment in clinic.
PDT is selective by design. The cream is absorbed preferentially by abnormal, rapidly dividing cells, and only those cells are destroyed when the light is applied. Surrounding normal skin is largely spared, which is why an entire field can be treated at once.
PDT is a field treatment. It is chosen when the problem is spread across an area rather than confined to a single spot, or when surgery is undesirable on a cosmetically sensitive site.
Multiple or widespread actinic keratoses on the face, scalp, ears, hands and forearms. PDT treats the visible lesions and the subclinical damage between them, with clearance rates comparable to topical chemotherapy in a fraction of the time.
Thin, superficial basal cell carcinomas and squamous cell carcinoma in situ, where the lesion is large, on the lower leg or face, or where the patient is not a surgical candidate. Diagnosis is confirmed by biopsy first.
Moderate to severe acne that has not responded to topical or oral treatment, or in patients who cannot take isotretinoin. PDT reduces sebaceous gland activity and bacterial load.
In treating a field of actinic keratosis, PDT also improves the texture, mottled pigmentation and fine lines of chronically sun-damaged skin. Patients treated for medical reasons frequently note the cosmetic improvement.
Sun damagePDT is effective for the conditions it is indicated for and ineffective, or harmful, for those it is not. The decision to use it follows a diagnosis, and the protocol is chosen for the lesion.
A PDT session takes two to four hours in total, most of it waiting. The illumination itself is under twenty minutes.
The treated skin remains light sensitive for 48 hours. Strict avoidance of sun and bright indoor light in that period prevents a severe reaction. After that, the skin heals like a sunburn.
PDT for actinic keratosis or superficial skin cancer follows a medical assessment, which is generally covered by Alberta Health Care with a referral from your family physician. Referrals can be faxed to (403) 225-2914. Call (403) 286-6888 to confirm the cost of the photosensitiser under your drug plan.
PDT for acne or photodamage does not require a referral and can be booked directly.
For actinic keratosis, a single session clears most thin lesions in the treated field, and a second session at one to three months clears most of the remainder. Published complete response rates are in the range of seventy to ninety percent for the face and scalp, with a good cosmetic result. Because sun damage continues, new lesions arise over time and periodic retreatment is expected.
For superficial basal cell carcinoma and Bowen's disease, two sessions one week apart achieve clearance in the majority of appropriately selected lesions. Recurrence rates are higher than with surgical excision, so treated sites are followed at three, six and twelve months and annually thereafter.
For acne, a series of sessions reduces inflammatory lesions and oil production for several months. The effect is not permanent and is used alongside, not instead of, medical treatment.
During illumination most patients feel burning, stinging or prickling, which builds over the first few minutes and is managed with cooling air, cool compresses and short pauses. It stops when the light is switched off. Discomfort over the following day is similar to a sunburn and responds to plain analgesics. Daylight PDT, where appropriate, is considerably less uncomfortable.
Physician assessment and treatment of actinic keratosis and skin cancer is medical dermatology and is generally covered with a referral. The photosensitiser cream is a prescription product; its cost depends on your drug plan and is confirmed before treatment. PDT for acne or cosmetic photodamage is not covered.
For medical indications billed to Alberta Health Care, a referral from a physician is the normal route, and it can be faxed to (403) 225-2914. PDT for acne or photodamage can be booked directly. If you do not have a family doctor, call (403) 286-6888 and the team will advise.
Cryotherapy treats individual lesions one at a time and is best for a few thick spots. Topical chemotherapy creams treat a field but take two to four weeks of daily application with a prolonged reaction. PDT treats a field in one session with a reaction that resolves in a week, and gives the best cosmetic result on the face. Many patients receive a combination.
Plan for 48 hours indoors after the session, away from windows and bright light, and expect visible redness and peeling for about a week. Most patients treat on a Thursday or Friday and return to work the following week with some residual pinkness.
Yes, for specific types: superficial basal cell carcinoma and squamous cell carcinoma in situ, confirmed by biopsy. It is not used for nodular or infiltrative basal cell carcinoma, invasive squamous cell carcinoma or melanoma, which require surgery. Where PDT is used, the site is followed regularly because recurrence rates are higher than after excision.
One or two for actinic keratosis, spaced one to three months apart. Two, one week apart, for superficial skin cancers. Two to four for acne. Because sun damage is ongoing, patients with extensive actinic keratosis are typically retreated every one to two years.
A variant in which the photosensitiser is activated by natural daylight rather than a clinic lamp. The cream is applied in clinic and the patient spends two hours outdoors in indirect daylight on a suitable day. It is markedly less painful and well suited to large facial and scalp fields with thin lesions, and is used from late spring to early autumn in Calgary.
Temporary darkening or lightening of the treated skin occurs in a minority of patients and usually resolves over months. Infection and scarring are rare with correct aftercare. Patients with certain porphyrias, or taking photosensitising medications, may not be suitable, which is reviewed at consultation.
Dr. Paul Kuzel, MD FRCPC, a board-certified dermatologist and the founder and Medical Director of Rejuvenation Dermatology Calgary South, assesses every patient, sets the protocol and oversees the treatment. He sees patients in English and Czech.
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Book a consultation with Dr. Kuzel, or ask your family physician for a referral.
Rejuvenation Dermatology Calgary South
10201 Southport Rd SW #102
Calgary, AB T2W 4X9
Two blocks west of the Delta Hotel
(403) 286-6888
Referrals by fax: (403) 225-2914
Open seven days a week, with early mornings and evenings on weekdays.
Take the first step toward achieving healthy, radiant, and flawless skin. Contact Rejuvenation Medical Aesthetics today to schedule your personalized consultation and explore the advanced treatments tailored to your unique needs.
