Photodynamic Therapy Done Incorrectly?

It is not uncommon to have less of a reaction as you have more treatments as there are fewer actinic keratoses on the face in the area.  If the incubation time was shorter the third time, that could explain a kinder reaction as well.  The time under the light could also affect the treatment outcome.  I would suggest getting your records from the previous treatment, so your current physician knows how long you were incubated and how long you were under the light. more

It is not surprising that you had a decreased reaction on the third treatment. If the incubation periods were the same, it is likely that you have less pre-cancerous areas on the face.  These were probably treated after the first two treatments (typically it takes 2 for good effect) and that is why you had a decreased reaction on the third time.

Clinical outcome from photodynamic therapy (PDT) for actinic keratoses or acne unfortunately is not an exact science. Important factors include incubation time (amount of time Levulan or Metvixia is left on treated area), whether or not occlusion was utilized (such as on the scalp or back), pre-treatment protocol using topical retinoid or 5-flurouracil, and whether or not adequate pre-op cleansing was performed. On top of that, I have recognized a skin hardening effect after... more

In our experience, there are a couple issues that may affect what kind of response you receive from the treatment: The incubation period - the amount of time spent with the Levulan (amino levulanic acid or ALA) on the face. This can vary from 60 minutes to several hours and is determined by the practitioner. The device used to activate the ALA. A pulsed dye laser will generally result in a more dramatic response than an IPL or Blu Light device, but the device used depends on skin type... more

Obviously something was different - perhaps the concentration of the levulan or the settings on the IPL. See if you can find out what was done previously and let your doctor know.