I was treated on March 8, 2013 with the Levulan Blue Light treatment at my dermatologist's office. This is my second treatment, the first one was about 2 years ago. I chose to have the PT treatment for treatment of pre-cancerous skin cells, versus undergoing a MOHs surgery to remove a couple suspicious spots, which involves slicing away parts of my face!! I just turned 46 about 3 months ago. I grew up in Phoenix, AZ and did a lot of tanning (actually "burning" is more like it) as a teenager and into my early 20's because, hey it was the '80's and all the cool people had tans!! Unfortunately, genetics is not on my side: being of Irish/Swedish descent, my skin is not exactly able to handle lots of sun exposure. I wised up later on, but now in my mid-40's the chickens are coming home to roost! Over the years, my skin sensitivity has increased significantly; so, if something might be mildly irritating to some, it will probably have a worse reaction for me, and I often have reactions to things that don't bother the average person. Anyway, I wanted to post my experience with the Levulan/Blue Light if it will help others to make a decision on whether or not it's the right treatment for them. DAY OF TREATMENT: Had my appointment at the end of the day on Friday, so I could go home right after, and have the weekend to rest. Thank God!! I highly recommend this, unless you have a job where you can hole up without much human interaction, and/or you have a high tolerance for pain, because you will not be feeling so hot the first couple days. Anyway, at the doctor's office they removed my makeup, cleaned my skin with alcohol, then applied a stick of the Levulan. It was painless, maybe just a slight stinging, like when alcohol is on your skin. Mostly feels like someone rubbing all over your face with a wet marker. The nurse told me to wait for 1 hr, then come back; she also said I could leave the office if I wanted. I chose to go to a bakery up the road for a cup of tea to wait it out. (Now I wonder if I should have been able to go outside, since the Levulan solution is activated by UV light, and I obviously had some small exposure to and from my car - will ask the doctor about this when I go back at the end of the week.) Upon my return, she placed me under the blue light (kind of like a small tanning bed for your face) for 16 minutes. This doctor's office also had a little cold air blower that I could hold on my face, which made the time under the lamps so much more bearable (the first time I did this treatment, the doctor didn't have that, and the burning sensation was pretty intense.) That night, I washed my face with a very gentle cream cleanser and applied an all-natural skin cream to soothe my skin. Day 1: Woke up with a lot of pain/sensitivity. It felt like the mother of all sunburns, and some areas of my face, especially around my mouth/lips are so sensitive I can barely stand to touch them. Also, my lips are SO swollen; it feels like they have had a horrible sunburn, which I imagine they actually did get burned under the lights....makes me wonder why the nurse didn't offer to put some sunscreen on my lips before the treatment. IF I ever do this again (and I probably will), I will make sure to bring some 50 SPF sunscreen to protect my poor vulnerable little lips. I am truly miserable. The pain is pretty bad, I would give it a 7 out 10, due to throbbing, and heat coming off my face. Plus things are starting to swell, which is giving me a headache. I took 3 Ibuprofen every 8 hrs for the swelling/pain, and begin immediately in the morning with an all-natural skin cream made up of shea butter, almond oil, sunflower seed oil, etc. Later in the day, I add a layer of Aloe Vera gel over the cream, then a little after that, add a "balm" the doctor's office had me purchase. All this helps keep my skin moist/soothed/nourished, which is very important to help it heal. Basically, Day 1 was the most painful part, nothing really makes the pain go away, I just had to tough it out. Day 2: Happy to report that after sleeping like 12 hours (yay, Benadryl!) I wake up with most of the pain/sensitivity gone, and my raw lips are starting to feel like they are getting back to normal. Pain today is more like a 3 out of 10, so no biggie there. However, the swelling is way worse than yesterday, especially around my eyes and mouth. My face definitely looks bloated! Skin starting to feel tight, and crispy. Keeping up with the layering of skin cream, Aloe, and balm. Took a shower later in the day (no way my face could have tolerated even warm water on Day 1), and as the day wears on, feeling my face recovering slowly but surely. Wondering what I am going to do about work tomorrow.....I have several appointments in front of customers, and think 1) I probably should avoid the outdoors/sun at all costs; and 2) will people be uncomfortable having to look at my strangely red, crispy, swollen face??
There are three separate issues as it pertains to your unfortunate injury scar. 1. hypertrophic scar - a simple and classic approach is intralesional kenalog injection but this can result in hypopigmentation and atrophy in some cases. The approach I would recommend is to treat the hypertrophic scar with 585 nm -pulse dye laser with lower energies, shorter pulse durations, and intervals of at least six weeks between treatments (we routinely use 4.5 to 5.0 J/cm2 fluence with small spot size). 2. atrophied portion of the scar, which I would treat with dermal filler to raise the base of the scar to the level of the skin as best as possible (sometimes scar tissue is hard and non-cooperative). I typically use Restylane Silk for this because I like the softer, less-viscous gel. The microneedling will help blend the edges of scar as well as help with problem #3 which is the hyperpigmentation. 3. hyperpigmentation - treatment with brightening agents such as Tri-luma, in addition to a product with Kojic acid might be helpful combined with microneedling. Keep in mind that Tri-luma contains hydroquinone which needs to be used intermittently to prevent potential side effects. Best of luck with treatment!
