Photodynamic Therapy for Sunspots

Photodynamic Therapy (PDT) is a new and exciting method used for the treatment of sunspots and sometimes superficial skin cancers.  It has revolutionised the management of facial sunspots (precancerous areas) as the whole face can be treated with much less downtime, quicker recovery, less risk of scarring and better cosmetic results than other treatment methods.

If you have more than just a few sunspots on your face then whole face be treated to reduce the risk of future facial skin cancer.  Many sunspots are too small to see and the presence of sunspots on the face indicates sun damage to the entire area.  This is called field cancerisation.  It is important to treat both visible and microscopic sunspots as these can progress into squamous cell carcinoma which requires invasive surgery to remove.

How Does it Work?

Photodynamic therapy involves two stages.  Firstly a chemical known as a photosensitiser is applied to the skin.  The photosensitiser is then activated with a light source. 

The photosensitiser is selectively absorbed by cancerous or damaged skin cells.  It is allowed to incubate on the skin for a period of thirty minutes up to three hours.  The light source that is used consists of an LED light.  This has over one thousand small globes that emit light at a precise wavelength.  Two different wavelengths can be used - blue light or a red light.  Blue light is the most potent activator of the photosensitiser but does not penetrate very deeply into the skin.  Red light penetrates more deeply into the skin.  Generally blue light with short incubation is recommended to treat sunspots.

What are the Risks?

This is considered a safe procedure.  However, it can be uncomfortable or painful.  Generally patients tolerate short incubation with blue light extremely well without compromising the outcome.

Due to the photosensitivity of the drug used, patients may feel sunburned and occasionally swollen after the treatment. Depending on the extent of PDT and the severity of the treated condition, this usually subsides within 1-3 days. Peeling and redness usually occurs for 3-6 days after treatment. Patients will need to avoid sun exposure for 48 hours after the treatment.

How Much Does it Cost?

Treatement costs vary depending on the size of the area treated, the reason for treatment and the time required under the LED light.  Treatment cost $750 for full facial treatment.

What Other Options are Available?

  • Topical Creams such as efudix and aldara.  These are effective in treating whole faces but have to be applied for between 2 and 4 weeks.  During this time the skin becomes red and inflamed.  After treatment finishes it takes up to a week for healing to occur.  Photodynamic Therapy is performed in one day and most people can return to work in 4-7days.
  • Cryotherapy.  This involves freezing individual lesions with liquid nitrogen.  It is not suitable for treating large areas such as faces as it is painful and leads to loss of pigmentation in the skin and scarring.
  • Picato Gel.  This is a gel which is applied to the face or scalp for 3 consecutive days.  It is an expensive treatment option and there is risk of severe allergic reaction

How Effective is PDT?

Photodynamic Therapy is very effective in treating sunspots.  The skin will feel smoother and look less sun damaged after treatment.  Generally about 80-90% of lesions will be removed after one treatment.  To get the best long-term results it is crucial that UV exposure be minimised following treatment.  Unfortunately sun exposure earlier in life leads to permanent DNA damage in the skin and new sunspots will appear in the future which will require further treatment.  Most people will receive a benefit for at least 4 to 5 years, perhaps longer.  Due to the decreased downtime of PDT compared to other treatment options it is an excellent option for busy professionals.




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