Photodynamic Therapy - Patients ask Dr. Ringpfeil answers
Please feel free to use the blog below to share information about Photodynamic Therapy or to ask Dr. Franziska Ringpfeil a question that might be of interest to others.
Photodynamic therapy is an excellent alternative to Accutane (isotretinoin). It achieves similar results and targets acne only where it is.
Photodynamic therapy is covered by insurance for skin cancer / precancer treatments only. It is not covered for acne, scars, sebaceous gland hyperplasias, and skin rejuvenation.
65-70% of our patients fully control their acne after 4-6 PDT treatments ($500 / treatment) when performed every 4 weeks.
I apply Metvixia photosensitizing agent (rather than the Levulan Kerastick, which I find less effective for acne treatment) and let it incubate on the skin under Seran wrap for 2 hours and then activated by red light 633 nm for 3-20 minutes. The exact time will be determined by the tolerance or any redness occurring on the skin during activation.
After the treatment, sun light and fluorescent light protection is crucial for 42 hours after the application of the Metvixia. Most people who undergo PDT have some redness mild swelling for 24 hours after each treatment.
5% of patients experience a severe reaction with bright redness, swelling, and reactivation of acne that lasts intensely for one week and may require oral or topical steroid for several days and oral antibiotic for 10-14 days. If this rare reaction occurs, residual redness on the face may take up to 3-4 weeks to fully resolve. In those who have this severe reaction, only one treatment rather than 4-6 is typically necessary to control the acne. While nobody is pleased while in this severe phase, our patients uniformly said they would do it again given that their acne is gone afterwards or needs only minimal topical medication for control. The severe reaction can be avoided if the incubabtion time is reduced. However, for the majority of people that would mean undertreatment and payment for an ineffective treatment.