Photodynamic Therapy (PDT) with Levulan®
Photodynamic therapy (PDT) with Levulan Kerastick® is a highly effective, non-invasive skin treatment used to target a variety of medical and cosmetic skin conditions. Often referred to as “blue light therapy,” this innovative procedure uses a special light-sensitive medication (Levulan) activated by blue light to selectively destroy abnormal or damaged skin cells without surgery, injections, or extensive downtime.
Whether you’re looking to treat precancerous lesions (actinic keratoses), improve sun-damaged skin, or refresh your complexion with a cosmetic “Levulan facial,” photodynamic therapy offers impressive results with minimal discomfort and downtime.
Our board-certified dermatology team specializes in this treatment and will customize your PDT plan to fit your unique skin type, goals, and medical needs.
What is Photodynamic Therapy (PDT)?
Photodynamic therapy is a two-step dermatologic procedure designed to treat skin conditions at a cellular level. It combines a topical medication (Levulan®, which contains aminolevulinic acid) with a specific wavelength of blue light (BLU-U®) to activate the medication and initiate cell destruction in targeted areas.
The result? Damaged or abnormal cells are eliminated, and your skin is left looking and feeling healthier. Best of all, PDT leaves normal, healthy tissue largely unaffected.
Primary and Secondary Medical Uses of PDT with Levulan®
PDT is FDA-approved to treat actinic keratoses (AKs), which are precancerous spots that result from long-term sun damage. AKs often appear as rough, scaly patches on sun-exposed areas like the face, scalp, chest, arms, or hands. If left untreated, these lesions can progress to squamous cell carcinoma, a form of skin cancer.
Photodynamic therapy effectively treats these lesions and prevents further progression, while also delivering widespread rejuvenation across sun-damaged skin.
Other medical conditions that may benefit from PDT:
- Acne vulgaris (moderate to severe acne): PDT reduces oil gland activity and kills acne-causing bacteria, making it a great option for treatment-resistant acne.
- Rosacea (certain forms): Inflammation and visible redness may improve with carefully monitored PDT treatments.
- Sun-damaged skin: Even if AKs aren’t visible yet, subclinical sun damage (invisible precancerous changes under the skin) can be detected and treated with PDT.
Cosmetic Benefits of Photodynamic Therapy
While PDT is medically important, it also delivers notable cosmetic benefits that many patients love. This has led to its nickname in the aesthetics world: the “Levulan Facial.”
Here’s what cosmetic PDT can help with:
- Improved skin texture and tone
- Reduction in sunspots and blotchy pigmentation
- Smoother skin with fewer fine lines
- Minimization of large pores
- Brighter, more even complexion
- Reduction in active acne and future breakouts
- Stimulation of collagen production
Patients love that PDT combines medical-grade treatment with aesthetic outcomes, making it ideal for anyone wanting healthier, more youthful-looking skin with a single procedure.
How Does PDT with Levulan Work?
The process involves three main steps:
- Preparation and Application of Levulan:
The skin is first cleansed thoroughly to remove oils and debris. Then, the Levulan medication is carefully applied to the treatment area. This solution is left to incubate for a period of time, usually between 30 minutes to 3 hours, depending on your specific skin condition and goals. - Light Activation (BLU-U Light Therapy):
After incubation, you will sit under a specialized blue light (wavelength: 417 nm) for approximately 16 minutes and 40 seconds. The blue light activates the Levulan, which selectively targets abnormal, pre-cancerous, or oil-producing cells. - Post-Treatment Recovery and Results:
Once activated, the medication causes these targeted cells to die off. Your body then naturally replaces them with new, healthy skin over the following days to weeks. Redness, peeling, and sensitivity like a sunburn are expected during this phase but subside as your skin heals.
What to Expect After PDT
Immediately after treatment, your skin will likely be red and feel sunburned. Some swelling, peeling, and sensitivity to light are also expected. This reaction is normal and means the treatment is working.
Here’s what to expect in the days following your treatment:
- Day 1–3: Redness, mild to moderate swelling, and a sunburn-like sensation.
- Day 3–5: Peeling, dryness, and possibly crusting in treated areas.
- By Day 7: Significant improvement in skin texture, tone, and clarity.
You’ll need to avoid sunlight and bright indoor lights for 72 hours after treatment, as your skin will be temporarily photosensitive. It’s important to wear a wide-brimmed hat and sunscreen with SPF 50+ when outdoors.
Who is a Good Candidate for PDT?
You may be a great candidate for PDT with Levulan if you have:
- Multiple actinic keratoses
- Chronic sun damage
- Persistent or treatment-resistant acne
- Visible signs of photoaging
- Enlarged pores or uneven texture
- Concerns about skin tone or pigmentation
- A desire for a non-invasive skin refresh
It’s ideal for patients looking to prevent skin cancer, rejuvenate sun-damaged skin, or improve acne—all without surgery or systemic medications.
Benefits of PDT with Levulan
- Non-invasive and well-tolerated
- Treats both visible and invisible precancerous lesions
- Improves overall skin tone and texture
- FDA-approved for actinic keratosis treatment
- No scarring or need for general anesthesia
- Can be repeated for continued improvement
- Dual benefit: medical + cosmetic results in one treatment
How Many Treatments Do I Need?
Many patients see results after just one PDT session but depending on the extent of sun damage or acne, a series of 2–3 treatments spaced 4–6 weeks apart may be recommended for best results.
Maintenance sessions are typically considered annually to keep your skin healthy and protected.
Are There Risks or Side Effects?
PDT is generally safe, but like any procedure, there are potential side effects:
- Redness
- Swelling
- Peeling or flaking
- Crusting
- Temporary sensitivity to light
- Rarely: hypopigmentation (white spots) or hyperpigmentation (brown spots)
- HSV Reaction (Can trigger a cold sore outbreak)
- If you have a history of cold sores, we will prescribe an anti-viral medication to begin on the day of your treatment to mitigate a potential outbreak.
- PDT should be avoided if you are pregnant
Our team will review your medical history and help you determine if PDT is right for you.
Preparing for Your PDT Appointment
To get the most out of your PDT treatment:
- Avoid sun exposure for at least 72 hours prior to your appointment
- Stop using retinoids or exfoliating products 3–5 days before treatment
- Inform your dermatologist about all medications and skincare products
- Plan to stay indoors for 72 hours post-treatment
- Let your dermatologist know if you have a history of cold sores before treatment
We’ll provide you with detailed pre- and post-care instructions to ensure the smoothest recovery and best results.
When to See a Dermatologist
At DHE, we believe in proactive skin care that helps you stay healthy and feel confident in your skin. Whether you’re concerned about precancerous lesions, acne, or just want to refresh your appearance, Photodynamic Therapy with Levulan is a safe, effective, and proven treatment.
Let us help you take the next step in your skin health journey. Our experienced dermatology team will guide you through every part of the process from evaluating your skin, creating a personalized plan, to supporting your healing after treatment.