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Photodynamic Therapy Vs Efudex - Best Treatment for Actinic Keratosis?
I've seen some horrible looking pics posted on the internet from patients that had horrific responses to treatment with FU-5 - they said the pain, oozing (sometimes bleeding) was almost more than they could stand for 2-4 wks. What is a ballpark cost for Photodynamic therapy @ treatment - not sure if my insurance will pay for this but I need to do something about the actinic keratosis on my face and forearms - more extensive than than would be practical for cryosurgery - according to my Dermatologist.
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5 Doctor Answers |
Asked by
Greg Adrian
in Wichita, KS
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PDT as effective as Efudex
There have been at least one head to head study with Efudex and they had similar efficacy. Patients seem to like PDT better as it is almost always completely healed at Day 8 or 9. Most patients pay less out of pocket for photodynamic therapy than they do for efudex at the pharmacy.
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5-FU versus Photodynamic Therapy
Hi there-
There is no question that 5-FU can have some ugly downtime.
Other topical choices for treatment of actinic keratoses would include Aldara, or photodynamic therapy using amino levulonic acid.
Aldara can be used a little more 'conservatively' by applying fewer times per week for a longer period. Unfortunately, though, it (like 5-FU) can cause oozing and crusting with discomfort and irritation.
The use of a topical photosensitizing agent (ala) with a red light has less down time and...
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Prefer PDT
A recent article by Gold showed that after one year, photodynamic therapy led to a greater clearing of actinic keratoses than Efudex. It should be noted that this finding was applicable if the patient had two photodynamic treatments. Another recent study demonstrated that the use of Aldara (imiquimod) for one month before and a month after photodynamic therapy gave even more outstanding results.
The treatment can cause a sunburn-like reaction, sometimes even with oozing, but this problem...
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Chemoprevention of precancerous lesions and the concept of Preventive Dermatology
Several chemopreventive modalities to treat actinic keratoses and prevent skin cancer are available and should be aggressively pursued. An experienced board-certified dermatologist with keen interest in Preventive Dermatology and Chemoprevention can outline pros and cons of topical 5-flurouracil, imiquimod, photodyanimc therapy, chemical peel, laser resurfacing, even oral acitretin (Vitamin A).
Deciding factors of utilizing any of above suggested modalities depend on location to be treated...
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Treatment for AK's
Both methods are effective for the treatment of AK's but Efudex is the "gold standard". It is not easy to use, but you do not have to become one of those pictures you mention in your question. I have patients use Efudex until they get a response, meaning until they start to get a little irritated and crusty. That may take 2 to 4 weeks or that may only take a few days depending on how sun damaged you are.
Once you start to react to the Efudex, stop. Do not continue to apply...
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