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Levulan Photodynamic Therapy

Levulan Photodynamic Therapy

Overview

Levulan (Aminolevulinic acid 20%) is a naturally occurring photosensitizing compound which has been approved by the FDA and Health and Welfare Canada to treat pre-cancerous skin lesions called actinic keratosis. Levulan is applied to the skin and subsequently “activated” by specific wavelengths of light. This process of activating Levulan with light is termed Photodynamic Therapy.

Levulan will be applied to the skin for 30 – 90 minutes. Subsequently, the area will be treated with a specific wavelength of light to activate the Levulan. Following treatment, Levulan will be washed off the skin. The patient should avoid direct sunlight for 48 hours following the treatment due to photosensitivity. On the treatment day, please bring a hat or umbrella to protect the treated area.

  • Levulan should not be used if the patient is pregnant.
  • Inform your providers if you have history of Herpes Simplex or active lesions prior to start of photodynamic treatment.

Side Effects of Levulan Treatment

Anticipated side effects of Levulan treatment include stinging, itching, burning, swelling, redness and possible scaling/crusting, especially in any areas of sun damaged skin and pre-cancer of the skin, as well as lightening or darkening of skin tone and spots, and possible hair removal. The peeling may last many days, and the redness for several weeks if there is an exuberant response to treatment.

Photographs of the treatment area may be taken before treatment session. Several treatment sessions spaced 4 – 6 weeks apart may be needed to achieve optimal results.

Medicine is not an exact science in that there are no guaranteed results. Some people experience excellent results, but it is possible that these treatments may not work for everyone. Alternative treatments include topical medications, oral medications, cryosurgery, excisional surgery, and clinical observation. For further questions or concerns, contact your dermatologist.

Post Treatment Instruction

You have completed Photodynamic therapy. It is important for you to remain out of direct sunlight for 2 days, as this will further activate the remaining product on your skin and can make post-procedural symptoms worsen. Be mindful that even inside your house and car, the light passing through the glass can activate the product as well.

As you leave the office, you will notice your skin feeling slightly warm. Post-procedural symptoms commonly experienced by patients include: redness, swelling, burning, stinging/tingling, itching, tightness, and scaling/crusting. These symptoms may increase over the next 24 – 48 hours. Your tolerance to these sensations will vary. To minimize these discomfort sensations, we recommend the following:

  • No direct sunlight on your treated skin for 2 days.
  • Apply a cold compress to red areas for 10 – 15 minutes per application.
  • Apply calming moisturizers, creams, ointments, or Aloe Vera gel to treated areas. If Aloe Vera gel is used, apply a moisturizing cream in addition to the gel, since the gel tends to dry out the skin. Frequent application of moisturizers will minimize skin discomfort.
  • Use a gentle cleanser to wash the skin, followed by moisturizer, one to two times a day for at least 7 days.

After 2 days, the stinging/tingling will subside, and you will start to notice the skin becoming darker, feeling tighter, and peeling may occur. This is when you need to increase the application of a moisturizer/ointment and apply it frequently. We recommend petroleum ointment, Aquaphor or any heavy moisturizer will do. The skin will continue to darken, and in 5 – 7 days, you will start to see the skin peeling off. Allow this to happen on its own. Do not pick or attempt to peel off the layer of dead skin as this can result in scarring.

As the old layer of skin peels off, you will notice a new layer of slightly pink skin appear. Overall, the new skin will have a lighter color. You can begin to apply your favorite light moisturizer to this new layer of skin. The new layer of skin can burn easily, so protect the affected area with a hat and sunscreen. Once the old skin has completely peeled off, you will notice that the new skin feels soft and has a smooth texture. Congratulations on your successful treatment.