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Photodynamic Therapy (PDT) — A Blue Stop Sign for Skin Cancer

Premier Dermatology and Mohs Surgery of Atlanta

It is often after a patient’s first Mohs surgery that I am asked a very important question: What can I do to prevent future skin cancer surgeries? Besides jumping into a DeLorean and convincing your adolescent self to use sunscreen and wear a hat, one of the best options for resolving much of your sun damage lies in none other than more exposure to light! But sun worshipers need not get too excited – this is not the light of more sun exposure or of indoor tanning beds but rather photodynamic therapy (nicknamed PDT or blue light therapy).

The question of whether someone has skin cancer is not always black or white. Often, there are shades of gray. Yes, many moles are simply healthy, and a few other growths prove to be melanoma. However, for most people and for most concerning growths, skin cancers progress through early “pre-cancerous” stages when they can be more easily treated and can be addressed non-invasively and non-surgically.

Many squamous cell carcinomas begin as a “pre-cancer” called an actinic keratosis or “AK” – a rough or discolored area that usually arises in an area of sun-damaged or sun-exposed skin. Often, a heavily sun-damaged individual will have ten or twenty actinic keratoses. AK’s typically grow slowly with perhaps 1-2% progressing to skin cancer per year. To put it simply, if you have 10 AKs on your body, you have a 10%-20% chance per year that one will develop into a skin cancer. This slow growth rate means that there is time to treat AKs before they become skin cancer.

If individuals with red or rough sun-damaged skin address their sun damage now, they will have less reason to regret their fun summer memories later. Active individuals such as the residents of our area enjoy family time outdoors, golfing, going to the pool, and outdoor exercise. These minutes clocked under the sun add up. Luckily, a single PDT treatment can erase 75% of precancers in a single area in just one treatment. So what exactly is PDT?

During PDT, a nurse or physician applies a liquid medicine called ALA to the area to be treated: often the face, scalp, neck or décolletage undergo therapy, but other areas such as the arms may also be treated. The ALA incubates and sits on the skin for one to four hours. ALA is absorbed by unhealthy cells during the incubation phase. A blue light specially designed to activate ALA is then applied for about fifteen minutes. Blue light of 410-420nm in wavelength activates the ALA, causing it to damage the unhealthy cells and allowing them to be eliminated and replaced by healthy skin. Blue light therapy is selective -- it causes the destruction of precancerous cells without significantly damaging surrounding healthy cells.

After PDT treatment, a patient should completely avoid the sun for at least 48 hrs, as the treatment will mimic a moderate sunburn. It takes roughly 4-6 weeks for patients to see the overall improvement in their skin but depending on the degree of sun damage, the effects can be dramatic! An added benefit of PDT is an overall healthier complexion, more even skin tone, reduced acne (PDT treatments are also used for acne issues), and a more youthful appearance. Usually covered by insurance, PDT is an excellent treatment option for someone looking to eliminate pre-cancers and decrease the chances of future skin cancers.

At Premier Dermatology and Mohs Surgery of Atlanta, we are proud to offer BLU-U, the gold standard in PDT treatment. Visit www.PremierDermAtl.com to learn more about PDT, Dr. Brent Taylor or Premier Dermatology’s other treatment options. ■


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