Photodynamic Treatment (PDT)


PDT is a very powerful way to reverse the signs of sun-damage and is a favourite of Dr vanVliet’s. If you love the sun but you have paid the price with aging spots, skin roughening, actinic keratoses, or worse yet, early skin cancers this is the treatment for you!

What is Photodynamic

Photo-dynamic therapy or PDT is a powerful, revolutionary way to reverse some of the damage. It also can reduce one’s lifetime risk of developing skin cancer. The silver lining with PDT treatment is that it also removes a lot of the age spots while it significantly improves the health and the appearance of the skin. It doesn’t really matter if it’s vanity bringing you in to see me or your fear of developing skin cancer. The good news is that PDT will attend to both issues at once.

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Why Photodynamic Therapy?  Much of what we assume is “natural aging” is in fact, sun or photo-damage that has accumulated over the years. Many of the wrinkles, age spots and rough patches of skin (referred to as actinic keratoses or AK’s) are easily preventable. A patient with extensively damaged skin also has a significantly higher risk of developing skin cancers. AK’s have a 10% lifetime risk of developing into squamous cell cancer, a relatively aggressive skin cancer. Men are more likely to develop skin cancer. In fact, it represents the most common cancer in men over the age of 50 (higher than bowel or prostate cancer). This is partly due to their biology, but it’s also behavioral. Men are less likely to apply a topical broad spectrum SPF to protect their skin from the sun, partially because they are more accepting of weathered skin and they don’t like applying lotions. Unfortunately for them, the weathered look is also the skin cancer look.

Until recently, we had no real way to reverse this skin damage.

Although cryotherapy (liquid nitrogen), surgery and other topical therapies (Aldara) work well for the treatment of localized damage and early cancers, laser mediated PDT is a more effective and practical approach to treatment of large numbers of lesions over large surface areas. For example, the entire face, extremity or trunk can be treated at once.

Conditions That Can Be Treated With PDT:

  • photodamaged skin
  • AKs
  • early non-melanoma skin cancers
  • acne
  • sebaceous hyperplasia

Photodynamic therapy involves applying topical Levulan, a natural occurring photo-sensitizing medication, to the skin. This is then activated by our BBL (Broad Band Light) therapy to selectively destroy rapidly growing pre-cancerous skin cells or the bacteria involved with problematic acne. Additional skin rejuvenation benefits of PDT include decreased wrinkles and pore size, and improved skin texture and pigmentation. This is a very powerful treatment option for patients with extensive skin photo-damage. The skin rejuvenation benefits include decreased wrinkles and pore size with improved skin texture and pigmentation. PDT also works beautifully for patients with acne, making significant inroads into acne and its variants, including: rosacea, sebacious gland hyperplasia and enlarged skin pores. PDT’s effect on acneic skin is three-fold: it inactivates the bacteria that cause acne, it exfoliates the skin to unplug pores, and it reduces sebacious gland activity. It turns out that laser mediated PDT is fast revolutionizing not only how we treat sun damaged skin, but also acne prone skin.

Below are more examples of the type of diffuse and extensive photo-damage that responds beautifully to PDT. For men in particular, the face, scalp and ears are significantly affected. All those rough dry patches that break open are called actinic keratoses (AKs) – these have a 10% chance of transforming into squamous cell skin cancer over time.  PDT can reverse 60-70% of this damage to reduce the life time risk for skin cancer.


Excellent clearance of early pre-cancerous skin lesions and photo-damage can safely be achieved often with just one or two sessions.  The social down-time is only 5 days and an entire face or scalp can be treated at one time.  This beats the constant redness we often have to tolerate with our more localized liquid nitrogen, or topical Aldara treatments.