Sun damage on our skin occurs after years of ultraviolet (UV) exposure. UVA waves can even penetrate the glass in our cars and cause damage to sensitive facial skin, mainly on the left side of the face.
The chronic exposure to the UV waves leads to changes in the skin and eventually the growth of precancerous lesions, actinic keratosis, on the face.
When these actinic keratosis or pre-cancerous spots enlarge on the face, they will emerge as red, scaly, somewhat sensitive spots.
In some cases, they feel like sandpaper or cause a slight pricking sensation when rubbed gently. Many patients describe the lesions as red scaly spots that come and go.
There are multiple treatments for these AK’s, including freezing with liquid nitrogen, topical creams and photodynamic therapy (PDT). In PDT, we treat a zone of sun damage instead of spot-treating individual lesions.
In some cases, we can detect and eliminate damaged precancerous cells before they even become a visible lesion. In a way, you can consider PDT a preventative type of treatment to eliminate years of sun damage.
When PDT is performed, the patient arrives in the dermatologist’s office and the target treatment area is thoroughly cleansed and prepped. A clear, medicated solution called Levulan is applied topically to the skin.
The solution is allowed to incubate for at least one hour. During this one-hour incubation time, the solution typically does not burn or irritate the skin.
Next, the patient sits under the “blue light” for approximately 17 minutes. The “blue light” is a U-shaped light box open on the top and bottom. The eyes are protected with goggles.
During that 17 minutes, there can be some discomfort, stinging and heat sensation. After the treatment, the skin will have the appearance of bad sunburn for three or four days.
Exposure to the sun, even through windows in the house, must be strictly avoided for 48 hours after treatment.
PDT can directly eliminate some thick AK lesions, but it does a better job of preventing new lesions and getting rid of diffuse UV damage. The treatment is usually performed on the face, but the scalp, arms, chest and legs can be treated as well.
Most insurance companies pay for the cost of PDT. If you think PDT might be a good treatment in your case, discuss it with your dermatologist.
Dr. Carmen A. Traywick, a board certified dermatologist, is the principal of May River Dermatology and co-owner of LUX Medical Spa in Bluffton.