PDT and No Reaction Whatsoever?

Two days and 7 hours ago I had PDT for cystic acne. Wish I'd listened more carefully, but I believe the Levulan only incubated for 15 minutes. Then I was under the light for 15 minutes. I believe through the goggles the light I saw was blue. Here I am, housebound, the new owner of a big hat, lots of Aquaphor, hydrocortisone, vinegar, and ice packs, and with nowhere to go because I turned down all jobs for the week. And yet: nothing! Not even pinkness, not even itching. What gives?

Doctor Answers (1)

PDT parameters need adjustment


Currently, there is no standard protocol for treating acne with PDT, so responses may differ depending on the following: 

  • the type of chemical used (Levulan versus Metvix)
  • length of time the chemical is left on the skin before activation (incubation)
  • the activating light source used (blue light versus red light versus IPL or laser).
  • the duration of exposure to the light source
  • the number of treatment sessions (commonly 3-4 total at 2 week intervals)

For severe facial cystic acne I have had the best results using red light and Levulan with 3 hour incubation.  The specific parameters depend on the particular patient, the severity of their acne, and the severity of side effects the patient is prepared to tolerate.  A more aggressive treatment can be quite painful and result in severe redness and crusting lasting a full week.  Be sure to see a physician experienced in PDT.

Englewood Dermatologist
5.0 out of 5 stars 5 reviews

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