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Photodynamic therapy (PDT), also known as photo rejuvenation, combines the power of light energy with a drug known as a photosensitizer. When absorbed by the target area, a light source activates the photosensitizer to destroy damaged tissues and abnormal cells. This in turn causes new, healthy cells to form. Over time, the treated area becomes smoother, more even, well-toned, and younger-looking.
Are you considering a non-invasive method of skin rejuvenation with minimal downtime? Consider a visit with Nurse Kelly at Cayman Doctors to achieve even, radiant, and rejuvenated skin.
Call our clinic at 1 (345) 943-6363 to know more about photodynamic therapy or book an . We are located at West Shore Center (Pink Plaza), 508 West Bay Road, PO Box 32078, Grand Cayman KY1-1208, Cayman Islands, B.W.I.
Schedule a consultation with one of our highly trained and experienced practitioners at Cayman Doctors now to gain more understanding about photodynamic therapy.
Fast Facts
Who’s it for?
Photodynamic therapy is indicated for patients with fine lines, wrinkles, hyperpigmentation, acne scars, rosacea, sun-damaged skin, and warts.
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IPL (Intense Pulsed Light)
Celebs who swear by it:
Kelly Rowland, Emma Stone, and Chrissy Teigen
What is Photodynamic Therapy (PDT)/ Photo Rejuvenation?
Photodynamic therapy (PDT), also known as photo rejuvenation, combines the power of light energy with a drug known as a photosensitizer. The photosensitizer may be taken by mouth, applied on the skin, or administered through the vein. A light source (e.g. laser, blue light, or light-emitting diode) will be then used to activate the components of the photosensitizer. This process destroys damaged tissues and abnormal cells.
How Photodynamic Therapy Works
During the procedure, the photosensitizer will be administered to the skin. Once absorbed by the target area, a light source will be used to activate the components of the photosensitizer. The photosensitizer is usually non-toxic. However, once activated by the light source, the photosensitizer becomes toxic to the damaged tissues and abnormal cells.
Advantages of Photodynamic Therapy
Photo Rejuvenation has the following advantages:
- Shorter recovery time: The procedure is minimally invasive and does not require surgery, allowing you to return to your normal routine afterwards.
- Minimal discomfort: The treatment time is short to help minimise discomfort.
- Quick procedure: Depending on the condition being treated, the entire process usually takes 15 to 90 minutes to complete.
- Numerous indications: The procedure can treat various cosmetic and health concerns such as fine lines, wrinkles, hyperpigmentation, acne scars, rosacea, sun-damaged skin, and warts.
- High level of safety: Upon light activation, the photosensitizer selectively destroys the damaged tissues and abnormal cells without affecting the healthy cells.
Risks and Complications of Photodynamic Therapy
This minimally invasive procedure also has risks and complications such as:
- Infection
- Itching
- Light sensitivity
- Scales, crusts, or blisters
- Skin discoloration
- Stinging or burning
- Swelling
Dr. Christoffersen will conduct a detailed assessment of the overall health and expectations of all the potential candidates to significantly lower the risk of complications and achieve the best clinical outcomes. Nurse Kelly works to ensure that the treatment has a high level of safety and efficacy.
What to Expect before Photodynamic Therapy
Before the treatment, Nurse Kelly will provide specific instructions to achieve optimal results. These include the following:
- Shave excess hair.
- Avoid prolonged sun exposure or sun tanning.
- Avoid waxing or depilatories.
- Avoid taking blood-thinning medications, supplements, or herbs.
- Avoid smoking.
- Avoid caffeine and alcohol.
What to Expect during Photodynamic Therapy
During the procedure, the photosensitizer will be administered to your skin. Once absorbed by the target area, a light source will be used to activate the components of the photosensitizer. You will need to wear protective goggles during the process. You may feel a stinging sensation once the photosensitizer is activated by the light source. Depending on the condition being treated, the procedure only takes a few minutes to complete.
Photodynamic Therapy Recovery Time
You may go home following the treatment. However, you will need to avoid strenuous exercise and heavy lifting as sweat can irritate the treated area. Depending on the body area, you will need to wait about 2-6 weeks to fully heal after photodynamic therapy. You will also need to wear protective clothing and high-quality sunblock because you will likely experience skin sensitivity after the treatment. Any discomfort you may feel can be relieved with ice application and taking over-the-counter pain medications. Most importantly, you will need to follow up with Dr. Christoffersen and Nurse Kelly to monitor your progress and determine if additional treatment is necessary.
Conditions Treated by Photodynamic Therapy
Photodynamic therapy has numerous indications. An overwhelming body of clinical evidence shows that this treatment can address various cosmetic and health concerns.
Fine Lines and Wrinkles
Photodynamic therapy stimulates the formation of healthy new skin. This in turn replaces the old and damaged skin cells causing the lines and wrinkles. As a result, the treated area becomes smoother and younger-looking.
A study evaluated the safety and efficacy of 2% 5-aminolevulinic acid (ALA) gel with hyaluronic acid (ALA-HA) and light-emitting diode-red light (LED-RL) for facial rejuvenation. [1] Before and after the treatment, the participants had undergone a digital skin analysis to evaluate skin wrinkling, pore size, and redness. Results showed that the treatment significantly improved the overall skin appearance with reductions in wrinkles, skin spots, pores, and uneven skin texture observed.
A review of studies was conducted to assess the effects of photodynamic therapy using light-emitting diodes in patients with facial wrinkles. [2] It was concluded that the treatment resulted in reduced fine lines and wrinkles and softer, smoother skin. In addition, it was also found that combining different LED wavelengths produced better outcomes.
A study reported that photodynamic therapy was associated with marked improvements in the signs of skin aging including fine lines and wrinkles. [3] It was also concluded that photodynamic therapy may offer increased efficacy when used together with the photosensitizers 5-aminolevulinic acid (ALA) and methyl aminolevulinate (MAL). This combination was also associated with higher patient tolerability.
Treatment Options
Photodynamic therapy reduces the appearance of fine lines and wrinkles by promoting the production of new healthy skin cells.
Hyperpigmentation
Hyperpigmentation is characterized by skin patches that are usually darker than the surrounding areas of the skin. This condition is caused by excessive production of melanin, the natural pigment that gives color to your skin. While this skin condition isn’t generally harmful, dark skin patches can be a cosmetic concern and can affect your self-esteem.
Photodynamic therapy can help reduce the appearance of abnormal skin discoloration due to hyperpigmentation. By inhibiting excessive melanin production, the treated area becomes smoother and achieves even skin color. This helps restore self-esteem and improves the overall quality of life.
A study evaluated the safety and efficacy of 2% 5-aminolevulinic acid (ALA) gel with hyaluronic acid (ALA-HA) and light-emitting diode-red light (LED-RL) for facial rejuvenation. [1] Before and after the treatment, a digital skin analysis was conducted to evaluate skin wrinkling, pore size, and redness. Overall, the treatment was associated with a significant improvement in skin discoloration.
An online review of studies that used light-emitting diodes as a light source for photodynamic therapy was conducted. [4] A total of 24 original articles were included. Results showed that the treatment was associated with significant improvements in the appearance of hyperpigmentation, scars, and signs of skin aging.
A study assessed the mechanism underlying the whitening effects of photodynamic therapy on melanin-producing cells (melanocytes) and in a patient with sun-damaged skin. [5] It was found that exposure of melanocytes to photodynamic therapy reduced their melanin content without affecting cell survival. In addition, the process of melanin production (melanogenesis) was also inhibited. Moreover, the authors observed that photodynamic therapy reduced mottled hyperpigmentation in a patient with sun-damaged skin.
Treatment Options
Photodynamic therapy addresses the root cause of hyperpigmentation which is excessive melanin production.
Acne Scars
Photodynamic therapy combines the power of light energy and a light-activated solution (photosensitizer) to completely destroy the acne-causing bacteria. In addition, this process also stimulates the growth of new healthy cells which in turn fill up sunken areas due to scarring. Over time, the treated area becomes smoother and scar-free.
Fifty-two patients with thick raised acne scars at the lower jawline were included in a study. [6] A group of patients received 5-aminolevulinic acid-based photodynamic therapy (ALA-PDT) and were evaluated by dermatologists. After three rounds of treatment, the appearance of acne scars was significantly reduced. Moreover, the treatment was also associated with a lower recurrence rate within 6 months of the follow-up period.
Eighty patients with facial moderate-to-severe acne vulgaris were included in a study. [7] The patients were randomized to receive 2-3 treatments with conventional PDT (C-PDT) or daylight PDT (DL-PDT) at two-week intervals. Photographs were taken before and after the treatment. Results showed that the group treated with DL-PDT had reduced acne scars and pain compared with the C-PDT-treated group.
An online review of studies that used photodynamic therapy in the treatment of keloid and thick raised scars (hypertrophic scars) was conducted. [8] In total, 538 articles were identified and reviewed. It was found that photodynamic therapy appears to play a promising role in reducing the appearance of keloid and hypertrophic scars.
Treatment Options
Photodynamic therapy destroys the acne-causing bacteria while stimulating the growth of new healthy skin cells.
Rosacea
Rosacea is characterized by blushing or flushing of the face. It may also cause visible blood vessels and small, pus-filled bumps. These unpleasant symptoms may occur for weeks to months and then disappear for a while.
Photodynamic therapy uses a specific wavelength of light to reduce the size of blood vessels in the face. This in turn reduces blood flow to the area, thus, eliminating blushing or flushing of the face. Also, the constricted blood vessels become less noticeable.
A study evaluated the efficacy and safety of topical photodynamic therapy in Chinese patients with rosacea. [9] Seventeen participants with rosacea were treated with 5-aminolevulinic acid (ALA)-PDT three times, 7-10 days apart. One month after the final treatment, facial redness was significantly reduced. In addition, the treatment was associated with a higher patient satisfaction rate.
Ten patients aged 18-65 years who have rosacea were enrolled in a study. [10] The patients were treated with 5-aminolevulinic acid photodynamic therapy (ALA-PDT) three times, 10 days apart, followed by three times intense pulsed light (IPL) at 3-4 weeks intervals. After all the treatments, the participants experienced significant improvement in the symptoms of rosacea with a higher tolerability profile.
Twenty patients with rosacea were treated with aminolevulinic acid-photodynamic therapy (ALA-PDT). [11] The treatment was administered four times at 10-day intervals. During the follow-up period, all patients reported that the inflammatory lesions completely disappeared after 24 weeks. In addition, other symptoms of rosacea such as flushing, itching, prickling, and burning also vanished.
Treatment Options
Photodynamic therapy treats the symptoms of rosacea by reducing the size of the blood vessels in the face.
Sun-Damaged Skin
Excessive sun exposure can significantly damage your skin by causing premature aging and even increasing your risk of skin cancer. Sun-damaged skin, also known as photoaging, photodamage, or solar damage, can lead to wrinkling, freckles, age spots, decreased elasticity, rough or uneven skin texture, spider veins, redness, and blotchiness. This in turn can make you look older than your real biological age.
Photodynamic therapy stimulates the formation of new skin cells. This in turn replaces the old damaged cells that cause photoaging and other skin concerns. As a result, the treated area becomes smoother, tighter, and rejuvenated.
A study reviewed photodynamic therapy for aesthetic-cosmetic indication. [3] It was concluded that photodynamic therapy may offer increased efficacy when used together with the photosensitizers 5-aminolevulinic acid (ALA) and methyl aminolevulinate (MAL) in the treatment of photodamaged skin. This combination was also associated with higher patient tolerability.
A study evaluated the long-term improvement effect of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) on photoaging. [12] Ten patients were treated with ALA-PDT and were evaluated by two dermatologists at baseline, 1 month, 6 months, and 24 months after the treatment. Results showed that the patients had significant improvements in the symptoms of photoaging such as fine lines and mottled pigmentation.
A study reported that photodynamic therapy has prominent use in the treatment of sun-damaged skin. [13] It was found that PDT can help improve the appearance of the treated area via several mechanisms. These include generating oxygen species that help modulate the immune system, suppressing microbial load, wound healing, and lightening of scars.
Treatment Options
Photodynamic therapy treats the signs and symptoms of sun-damaged skin by promoting the formation of new skin cells.
Warts
Warts are characterized by small, grainy skin growths and are caused by a virus. They usually have a rough texture and tiny black dots. While warts are harmless and go away on their own, they can cause widespread pain and can be a cosmetic concern. Most importantly, warts are contagious and can be transmitted via close physical contact.
Photodynamic therapy can help treat warts by modulating the activity of the immune system. When administered, this treatment increases the production of immune system cells that help fight infection. This in turn eradicates the virus that causes warts.
A study was conducted to confirm the effect of photodynamic therapy on genital warts. [14] Subjects with genital warts were treated with photodynamic therapy and their blood samples were examined afterwards. Four hours after photodynamic therapy, an increase in immune system cells such as CD4+, IFN-α, and IFN-ß was observed. All of these cells help fight infection.
A study investigated and assessed the efficacy of conventional photodynamic therapy (C-PDT) versus daylight photodynamic therapy (DL-PDT) in thirty patients with facial flat warts. [15] A group of patients underwent C-PDT while another group of patients was treated with DL-PDT three times at 1-month intervals. Results showed that DL-PDT was associated with a faster resolution of the symptoms of facial flat warts and a higher patient satisfaction rate compared with C-PDT.
Eighty patients with verrucae (common warts) were treated with photodynamic therapy (PDT) using intralesional methylene blue (MB) followed by intense pulsed light (IPL), IPL alone, or a placebo. [16] The response to the treatments was then assessed by a dermatologist. It was found that PDT using intralesional MB followed by IPL was associated with a higher cure rate compared with IPL treatment alone and placebo.
Treatment Options
Photodynamic therapy treats different types of warts by increasing the production of immune system cells.
Question & Answer
Are there discomforts associated with photodynamic therapy?
You may experience a stinging sensation during the procedure. Any discomfort that you may feel can be managed with ice application and over-the-counter pain medication.
How long does it take to see photodynamic therapy results?
You will notice the final results of the treatment after 4-8 weeks.
How many treatments will I need?
This will depend on the condition needing treatment. In general, 2-5 treatment sessions at 2-4 week intervals are recommended to achieve the best results.
Who are the ideal candidates for photodynamic therapy?
As long as you are in good overall physical and mental health, the treatment is right for you. However, it is not recommended if you have:
- An allergy to the photosensitizer or any of its components
- An autoimmune disorder
- Porphyria (a build-up of pigments called porphyrin in the body)
- Unrealistic expectations
How much does photodynamic therapy cost?
The total cost will depend on the following factors:
- The practitioner’s fee
- The fee of the clinic or medical facility
- The number of treatment sessions required
- The body area needing treatment
Are there limitations to photodynamic therapy?
Photodynamic therapy can only treat areas of your body where light can reach.
Are photodynamic therapy results permanent?
Results from photodynamic therapy are semi-permanent and last for several months.
References
- Huang, A., Nguyen, J. K., Austin, E., Mamalis, A., Cohen, M., Semkhayev, B., Ho, D., & Jagdeo, J. (2020). Facial rejuvenation using photodynamic therapy with a novel preparation of ALA and hyaluronic acid in young adults. Archives of dermatological research, 312(8), 567–573. https://doi.org/10.1007/s00403-020-02038-5. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32060617/.
- Ablon G. (2018). Phototherapy with Light Emitting Diodes: Treating a Broad Range of Medical and Aesthetic Conditions in Dermatology. The Journal of clinical and aesthetic dermatology, 11(2), 21–27. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5843358/.
- Philipp-Dormston W. G. (2018). Photodynamic therapy for aesthetic-cosmetic indications. Giornale italiano di dermatologia e venereologia : organo ufficiale, Societa italiana di dermatologia e sifilografia, 153(6), 817–826. https://doi.org/10.23736/S0392-0488.18.05982-5. Retrieved from https://pubmed.ncbi.nlm.nih.gov/29600693/.
- Huang, A., Nguyen, J. K., & Jagdeo, J. (2020). Light-Emitting Diode-Based Photodynamic Therapy for Photoaging, Scars, and Dyspigmentation: A Systematic Review. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 46(11), 1388–1394. https://doi.org/10.1097/DSS.0000000000002351. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32091415/.
- Kim, S. K., Oh, S. J., Park, S. Y., Kim, W. J., Kim, Y. S., & Kim, Y. C. (2018). Photodynamic therapy inhibits melanogenesis through paracrine effects by keratinocytes and fibroblasts. Pigment cell & melanoma research, 31(2), 277–286. https://doi.org/10.1111/pcmr.12658. Retrieved from https://pubmed.ncbi.nlm.nih.gov/29045012/.
- Yan, D., Zhao, H., Li, C., Xia, A., Zhang, J., Zhang, S., Yun, Q., Li, X., Huang, F., & Tian, Y. (2022). A clinical study of carbon dioxide lattice laser-assisted or microneedle-assisted 5-aminolevulinic acid-based photodynamic therapy for the treatment of hypertrophic acne scars. Photodermatology, photoimmunology & photomedicine, 38(1), 53–59. https://doi.org/10.1111/phpp.12716. Retrieved from https://pubmed.ncbi.nlm.nih.gov/34273202/.
- Zhang, L., Zhang, Y., Liu, X., Shi, L., Wang, P., Zhang, H., Zhou, Z., Zhao, Y., Zhang, G., & Wang, X. (2020). Conventional versus daylight photodynamic therapy for acne vulgaris: A randomized and prospective clinical study in China. Photodiagnosis and photodynamic therapy, 31, 101796. https://doi.org/10.1016/j.pdpdt.2020.101796. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32454087/.
- Tosa, M., & Ogawa, R. (2020). Photodynamic therapy for keloids and hypertrophic scars: a review. Scars, burns & healing, 6, 2059513120932059. https://doi.org/10.1177/2059513120932059. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7328485/.
- Sun, Y., Chen, L., Zhang, Y., Gao, X., Wu, Y., & Chen, H. (2019). Topical photodynamic therapy with 5-aminolevulinic acid in Chinese patients with Rosacea. Journal of cosmetic and laser therapy : official publication of the European Society for Laser Dermatology, 21(4), 196–200. https://doi.org/10.1080/14764172.2018.1502455. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30040517/.
- Bao, N., Gu, T., Zeng, J., Wu, Y., Sun, Y., Gao, X., & Chen, H. (2022). Combined therapy of 5-aminolevulinic acid photodynamic therapy and intense pulsed light for rosacea. Lasers in medical science, 38(1), 17. https://doi.org/10.1007/s10103-022-03685-y. Retrieved from https://pubmed.ncbi.nlm.nih.gov/36562857/.
- Fan, L., Yin, R., Lan, T., & Hamblin, M. R. (2018). Photodynamic therapy for rosacea in Chinese patients. Photodiagnosis and photodynamic therapy, 24, 82–87. https://doi.org/10.1016/j.pdpdt.2018.08.005. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30118905/.
- Zhang, L., Zhao, Z., Wang, P., Zhang, G., Wang, B., Shi, L., Liu, X., Zhou, Z., & Wang, X. (2021). Long-term improvement on photoaging after ALA photodynamic therapy for actinic keratosis: A retrospective study. Photodiagnosis and photodynamic therapy, 33, 102181. https://doi.org/10.1016/j.pdpdt.2021.102181. Retrieved from https://pubmed.ncbi.nlm.nih.gov/33429100/.
- Dey, A., Singhvi, G., Puri, A., Kesharwani, P., & Dubey, S. K. (2022). An insight into photodynamic therapy towards treating major dermatological conditions. Journal of drug delivery science and technology, 76, 103751. https://doi.org/10.1016/j.jddst.2022.103751. Retrieved from https://pubmed.ncbi.nlm.nih.gov/36159728/.
- Xie, F., Yu, H. S., Wang, R., Wang, D., Li, Y. M., Wen, H. Y., Du, J. B., Ba, W., Meng, X. F., Yang, J., Lin, B. W., Li, H. J., Li, C. X., Zhang, L. G., Fang, X. D., & Zhao, H. (2019). Photodynamic Therapy for Genital Warts Causes Activation of Local Immunity. Journal of cutaneous medicine and surgery, 23(4), 370–379. https://doi.org/10.1177/1203475419838548. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31010295/.
- Borgia, F., Giuffrida, R., Coppola, M., Princiotta, R., Vaccaro, M., Guarneri, F., & Cannavò, S. P. (2020). Efficacy and safety of conventional versus daylight photodynamic therapy in children affected by multiple facial flat warts. Photodiagnosis and photodynamic therapy, 31, 101819. https://doi.org/10.1016/j.pdpdt.2020.101819. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32464266/.
- Hassan, S. N. E., Hussein, T. M., & Eldeeb, M. E. (2021). Photodynamic therapy using methylene blue and intense pulsed light versus intense pulsed light alone in treatment of verruca: A randomized controlled study. Photodiagnosis and photodynamic therapy, 36, 102541. https://doi.org/10.1016/j.pdpdt.2021.102541. Retrieved from https://pubmed.ncbi.nlm.nih.gov/34547471/.
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