IPL for Precancerous Spots?

Has anyone had IPL to remove precancerous spots on the face successfully? Did it require more than 1 treatment? This was recommended to replace Efudex treatment.

Doctor Answers 3

Photodynamic Therapy

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Treating precancerous spots os actinic keratoses (AKs) requires a little more than just IPL. A procedure called photodynamic therapy or PDT is really the way that it is performed. PDT utilizes a light-activated chemical. THis chemical ALA is painted over the skin in the area that is to be treated. Next, an incubation period of between 1-4 hours is required while the medication absorbs into the skin. Once this has occurred, the ALA is activated by a light source. This can be IPL, a pulsed-dye laser, red light or blue light. The light converts the ALA to a chemical that destroys the AKs.

Afterward, the patient will experience varying degrees of redness and peeling for about 4 days. Absolute sun avoidance in the first 48 hrs after application of the ALA is a must to prevent possible burns from activation of the medication by sunlight. Generally, 2 treatments are performed 4-8 weeks apart.

THis is a great treatment for AKs and also for eliminating facial redness and brown spots if the right light source or combinations of lights is used.

Efudex (5-fluorouracil) is also an excellent treatment for AKs. Consult your dermatologist for more information.

Beverly Hills Dermatologic Surgeon

IPL for precancerous spots

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IPL on its own will not treat precancerous spots, but it can be used in photodynamic therapy which combines IPL with Levulan, a photosensitizing medication.  The Levulan is applied as a liquid, kept on for about 1 hour and then activated by the IPL.  This treatment burns off precancerous spots and leaves skin smooth. 

Martie Gidon, MD, FRCPC
Toronto Dermatologist

ALA-PDT (Photodynamic Therapy) for pre-cancers

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The earlier poster, Dr. Fincher, provided an excellent response to this question, to which I am in complete agreement. IPL alone is not a satisfactory treatment for actinic keratoses ("AK") but in combination with a topically applied medication called ALA...it is! 5-Flurouracil (Efudex, for example) is a wonderful treatment, and I have been prescribing this for many years. The benefit of ALA-PDT (photodynamic therapy using a light source which may be a blue light or IPL or other specific type of light source), however, is that it is over quicker.

Photodynamic therapy with IPL or other certain type of light source (laser, for example) is effective for acne as well as for AK, and is effective for photorejuvenating the skin as well. When a patient has sun damaged skin and blotchiness, the ALA-PDT treatment with IPL does a very nice job of cleaning up the problem.

What you did not ask is whether this treatment is permanent. The answer is NO. Generally speaking, sun damaged patients with AK, no matter what treatment they have, will generally have to be followed by their dermatologist for the development of new lesions. We might wonder if such a patient was entirely confined to indoors, whether they would develop new lesions? I think they would. I simply think these patients have altered the DNA in their skin and AK will develop from time to time. Maybe less frequently if they protect themselves, but nevertheless, they will continue to develop lesions...at least from time to time.

So, whether you use efudex or photodynamic therapy, or other treatment such as aldara or chemical peel, the trick is to protect yourself from the sun very carefully thereafter.

Good luck!

Sandy Martin, MD
Fort Myers Dermatologist

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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.