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PDT for skin cancers and sunspots

PDT or PhotoDynamic Therapy is an excellent treatment modality for sunspots, sun damage and superficial skin cancers. Treatments are quick, convenient, with a shorter recovery time compared to surgery and other creams. Sunspots only require one treatment, whilst Basal Cell Cancers and IECs require two treatments.

Important facts on Photodynamic Therapy- PDT

  • PDT uses a cream that is concentrated in abnormal cells
  • The cream is then ‘activated’ using a low-level- laser light
  • This results in destruction of abnormal cells
  • Recovery from PDT is quick, usually within a period of days
  • Treatments are convenient, as only one treatment need to be performed for solar damage, or sunspots
  • Skin cancers such as thin BCCs or thin IECs can be treated by PDT
  • Skin cancers require two treatments of PDT
  • PDT has less chance of scarring compared to surgical removal of skin cancers and is ideal for skin cancers on the face or lower limbs
  • Correct selection of skin cancers and application results in higher cure rates

What is Photodynamic therapy?

pdt sun-spots curePhotodynamic Therapy (PDT) is a proven method of treatment for both sunspots and certain forms of skin cancer. This treatment is PHOTOCHEMICAL in nature, and uses a cream that kills abnormal cells. This cream is activated by red light several hours after application.

How does PDT cure skin cancer and treat sun spots?

pdtforbowensPhotodynamic therapy is a non-surgical and well tolerated treatment that combines the use of a special photosensitizing agent (ALA). This chemical is activated with a specific wavelength and intensity of light. It is a two-part treatment. First, the drug is administered to the skin via cream. An incubation period (wait time) of 90-180 minutes is need for absorption of the cream. This is followed by exposure under a specific light source for several minutes. Once the skin is exposed to the light treatment, the photosensitive drug starts to react by destroying damaged and cancerous cells leaving normal skin tissue unaffected.

What types of skin cancer can be treated by PDT?

bcc pdt treatmentPDT can only treat superficial or thin skin cancers, including superficial BCCs or Basal Cell cancers and IECs or Bowen’s disease.

 

PDT is also an excellent method of treating pre-cancerous areas or solar keratosis.

 

Read more about treating sun-damage

Is the treatment painful?

bcc-pdt treatmentIn general PDT is well tolerated and in many cases an anaesthetic is not required.

 

For treating skin cancers, a slight stinging or burning is commonly felt in the treated area when the laser light activates the cream.

 

For large areas of PDT, such as the face, or scalp we often provide pain relief with either a cooler or analgesia. The larger the area treated, the more the pain. Your skin cancer specialist and nursing staff will ensure that you are comfortable throughout the treatment process.

What can I expect in the following days after PDT?

pdt brisbaneDue to the sunsensitivity of photodynamic therapy, many patients have a sunburn feeling for several days following treatment. This can be alleviated with the use of cool compresses, and of course, sun protection.

 

Large treatment areas such as the face or scalp usually heal within 4-6 days.

 

If you have PDT to the lower limbs, you may need to restrict your activities for a few extra days to ensure that your skin heals.

What is involved in the PDT procedure?

Preparation of the area for PDT typically takes 10 to 15 minutes.

 

Step one: Cleaning skin, degreasing with applicator and microdermabrasion if needed. Areas to be treated marked out. Skin cancer location photographed and documented.

 

Step two: Application of cream. Cover with light proof dressing.

 

Step three: Incubation for three hours. The wait time allows for the chemical to be concentrated in the area of sun damage and cancerous skin cells.

 

Step four: illumination with specific low-level laser light. This takes 7 to 8 minutes to perform

 

Step five: Application of healing balm post PDT.

 

pdt specialistArea is cleaned prior to PDT.

 

 

 

 

 

 

 

 

 

photodynamic treatment brisbaneCream PDT METVIX is then placed on the targeted areas

 

 

 

 

 

 

 

 

 

pdt sun-spots cureChemical of METVIX is activated with light

 

 

 

 

 

 

 

 

 

pdt recoveryThis is what you look like at day 3. Skin heals up by day 6-7.

How long will I take to recover following PDT for sunspots and cancer?

pdt before  pdt after

How much time off work will depends on the site and extent of treatment.

 

Full face PDT takes approximately 6-7 days to recover from, which compares favorably with Efudix treatment (downtime of 3-4 weeks). Smaller treated areas such as the nose or upper lip heal within four to five days after the procedure.

 

Your skin cancer specialist will inform you of the downtime prior to treatment.

What makes PDT different from other skin cancer treatments?

skin cancer doctor copyIn general Photodynamic Therapy treatment has-

 

  • Potentially less scarring compared to surgery
  • Less down time
  • Quicker recovery (typically days, not weeks/months)
  • Photorejuvenation effects if used on sunspots or sun damaged skin

 

Note that not all lesions are suitable for PHOTODYNAMIC THERAPY, your skin cancer doctor or Specialist Dermatologist will guide you accordingly.

How does PDT compare to Efudix for the treatment of sun damage and sun spots?

efudix for sunspotsSunspots or solar keratosis is a common pre-cancerous lesion seen in the Queensland population. Sun-spots are rough, dry, red and scaly lesions on areas of the face, ears, scalp, and hands. They should be treated because they can transform over time into skin cancer.

 

Efudix treatment involves application of a cream twice a day for a period of 3-6 weeks. It is highly effective, however downtime is significant- approaching 4-6 weeks. Additionally, with high humidity and UV index seen in Brisbane, Efudix treatment is limited to Autumn and Winter.

 

In contrast to Efudix, PHOTODYNAMIC THERAPY can be performed all year round and involves a single treatment. The procedure is over within a few hours and you skin heals up within a week of therapy. The major advantage of PDT over Efudix, Aldara and Picato is the convenience of treatment.

 Read more about Efudix for sunspots

What are all my treatment options for sun damage, solar keratosis and sun-spots?

TreatmentModality Efficacy of treatment Duration of treatment Cosmetic outcome Down time of treatment Price of treatment
PDT +++++ 3 hours Good 6-8days 1100-2800
Fraxel laser +++++ 1 hour Excellent- 7days 990 for one treatment
Efudix +++++ 3-4 weeks Satisfactory 4 weeks 60-80
Aldara ++++ Upto 6 weeks Moderate Upto 6 weeks 140-360 dollars
Picato Gel ++++ 3-4 days Satisfactory 7 days 260- 990 dollars

My Skin Clinics simplified guide to sunspot treatment options:

  • If patients are not concerned in regards to cosmetic outcome and can tolerate a downtime of 4 weeks, Efudix is the cheapest, but also a very effective treatment for sun-spots.This should ideally be conducted in winter.
  • If patients are only concerned in regards to precancerous sunspotsand can only have downtime of one week, PDT is the treatment of choice. This treatment can be conducted throughout the year, and patients will have a quicker healing time compared to Efudix.
  • If patients wish to address other signs of photoaging such as pigmentation, and would like to reduce sun spots and solar keratosis, Fraxel Laser can be a good option.Fraxel laser has a down time of 6 days, and cost $990 per treatment.
  • If sun-damage is very heavy, and associated with heavy pigmentation, age warts, as well as deep wrinkling, Laser resurfacing is the best option. This is conducted by a Specialist Dermatologist and cost between 2,900 – $5,500. Downtime approaches 9 days, however the results are excellent.

How much does PDT treatment cost?

photodynamic therapy doctorCost of photodynamic therapy will depend on the area treated and the number of sessions you will require.

 

Sunspots will require only one treatment session, whilst skin cancers such as BCCs and IECs will require two sessions. Your skin cancer specialist will assess the severity and area at the time of consultation.

 

As a guide

  • PDT- Cheeks, temples, forehead- $1,550- $2200 (depends on area)
  • Nose/ upper lip- $ 680-800
  • BCCs and Bowens Disease- $370 per treatment (two treatments advised)

 

Prices include all aspects of treatment including-

  • Photography and site documentation,
  • Histology if required,
  • Microabrasion of skin/microlaser peel if required,
  • Application of ALA- Metvix Cream
  • Local anaesthetic injections or numbing cream if required
  • Dressings
  • Subsequent follow up after large area treatment

Note: PDT is NOT covered under Medicare. Some health insurance companies do provide a partial rebate for this procedure. We advise patients to check with their cover prior to undertaking this procedure.

How do I organize a time for PDT?

An assessment by our Skin Cancer Specialist is need prior to PDT treatment. This ensures that your skin cancer or sunspot can be safely and effectively treated by this method.

 

Once an assessment has been conducted, your Skin Cancer Doctor will refer you to an appropriate centre for treatment

My Skin Cancer Centre perspective on PDT treatment

brisbane laser clinicPDT or photodynamic therapy has been a time tested treatment method for sun spots, actinic keratosis and superficial or thin skin cancers of the basal cell and squamous cell subtype (Bowens Disease). If performed in the correct setting, PDT has a very high cure rate, with a low incidence of scarring.

 

In the setting of sun spot treatments, it has a shorter downtime compared to traditional treatments such as EFUDIX, however newer methods of sun spot treatments such as FRAXEL 1927 Laser is slowly replacing large area PDT treatments. Laser treatment of sun spots has a very promising future- treatments are more cost effective compared to PDT, and is associated with better comfort levels for the patient, as well as a decreased downtime. Clearance rates following Fraxel Laser varies from 60-85%.

Read more about Fraxel for sunspots