Is Levulan Kerastick with Blue Light Photodynamic Therapy Illuminator effective on melasma, freckles and acne? (Photo)

Melasma or facial hyperpigmentation is a very difficult
condition to treat. In our office, we use a variety of treatments including
skin care products (containing retinoic acid, hydroquinone, glycolic acids),
sunscreens, chemical peels (light, medium, deep including the blue peel), and
lasers (IPL/BBL, Q-switch, PICO, Fraxel).

Over the last few years, we have had great success with the
ZO® Blue Peel in treating hyperpigmentation. This is a robust in-office
procedure that provides dermal and epidermal stimulation allowing for maximal
tightening, restoration and rejuvenation of the skin. It also minimizes or
eliminates the appearance of melasma [both epidermal and dermal melasma] and
facial pigmentation. All patients require 6 weeks of skin
conditioning prior to the procedure with the ZO Hydroquinone or
Non-Hydroquinone kit. 

These are advanced techniques so be sure to get an
experienced dermatologist or plastic surgeon consultation for recommendations
and treatment options. 

Although Photodynamic Therapy is very effective in treating acne, acne scars, and AK lesions, cancer lesions, there is no science to back the treatment for Melasma.  There are other available treatments available that have shown to improve melasma such as Q-Switch laser that does not use heat since heat worsens Melasma.  This can be used in combination of chemical peels and a course of Hydroquinone and Retinol prescribed by your doctor.It is important to consult with an experience doctor to differentiate Melasma from superficial sun and age spots as the course of treatment will vary.

Neither PDT nor IPL are appropriate treatments for melasma.  Sun avoidance, fading products and chemical peels should be tried first, perhaps certain lasers afterwards. Melasma is difficult to treat and often recurs. Please consult a cosmetic dermatologist for treatment.

There is no strong evidence published showing the benefit of photodynamic therapy with ALA and blue light to improve melasma or freckles. Options for melasma include creams, sun avoidance first and if those don't help, laser may be another option. For freckles, lasers are the gold standard. Acne can be improved by Blue light and PDT but there are also many other good options available to help control acne. Good luck. 

See video for what PDT is used for. Melasma is a totally different disorder and responds to low level lasers, chemical peels, and HQ creams. In some situations a new form of PDT known as KLERESCA (yet to be released in the US, probably in 2018), has shown to cause temporary skin darkening and worsening of melasma. All the best, Dr Davin Lim