Can Photodynamic Therapy Be Used over Large Area of Body For Actinic Keratosis?

The FDA has approved photodynamic therapy for actinic keratoses on the face and scalp.  Nevertheless, many dermatologists use it on off-label areas including neck, arms, or legs.  In areas with thicker skin, such as the extremities, the incubation time for the levulan needs to be lengthened.  Studies have shown that occlusion with saran wrap during the incubation period is helpful on areas of thicker skin.  Exfoliating the skin in advance of the treatment is another way to help the medication penetrate.

I commonly perform PDT to the entire body. I may break it up into different sessions, but studies have shown that the combination of one of the immunomodulators (like efudex, aldara, or carac) with PDT, works better than either treatment alone in providing AK clearance.

PDT can be used on the face, neck, arms, legs, chest and really over any area with photodamage and AKs.  One might need a longer drug incubation on off-face areas but protocols exist by many doctors on how best to do this.