What are actinic keratoses?

Actinic keratoses (AKs) are rough, scaly patches that develop on sun-exposed areas of the skin, such as the face, scalp, arms, and hands. They result from cumulative sun damage and are considered precancerous lesions, with the potential to progress into squamous cell carcinoma, a type of skin cancer. Treating AKs promptly and effectively is critical.

How does photodynamic therapy (PDT) treat an actinic keratosis?

PDT is a minimally invasive procedure designed to selectively target and eliminate damaged or precancerous skin cells while preserving the surrounding healthy tissue.

It works by applying a topical photosensitizing agent, usually aminolevulinic acid (ALA), to the affected area. This compound is absorbed by abnormal skin cells, making them highly sensitive to specific wavelengths of light. After a short incubation period, the treated area is exposed to a specialized light source, activating the ALA and destroying the damaged cells.

Why photodynamic therapy for a possible precursor to skin cancer?

One of the primary benefits of PDT is its precision. Unlike traditional treatments like freezing (cryosurgery) or surgical excision, PDT selectively targets damaged cells without causing significant harm to healthy skin. This makes it particularly suitable for treating large areas with multiple AKs or for areas where cosmetic outcomes are a concern, such as the face or scalp.

PDT is also highly effective, with studies showing excellent clearance rates for AKs. In addition to treating existing lesions, PDT has a preventive effect, as it addresses subclinical (invisible) sun damage that could potentially develop into new AKs. This dual action helps reduce recurrence rates and enhances long-term skin health.

Is photodynamic therapy invasive? Will I need surgery?

Another key advantage is that PDT is non-invasive, requiring no incisions or stitches. The procedure is quick, typically taking less than an hour, and involves minimal downtime. While some redness, swelling, or peeling may occur in the treated area, these effects are temporary and usually resolve within a few days.

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