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

Have any dermatologist used this procedure on a patient with melasma? Did it work? How many days did it take to clear up? How many tratments were needed? If not what other treatment should I considered? My dermatologist said that IPL can cause white patches due to my skin tone. I do use sunblock and hats to avoid further damage on my skin. Thank you in advance!!!

Doctor Answers 5

PDT and melasma, acne and freckles

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. 

Stamford Dermatologic Surgeon
4.8 out of 5 stars 23 reviews

PDT not used for melasma. Other treatments much more effective.

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 

Davin Lim, MBBS, FACD
Brisbane Dermatologist
4.7 out of 5 stars 56 reviews

PDT for Melasma Treatment

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.

David P. Melamed, MD
Los Angeles Dermatologist
5.0 out of 5 stars 3 reviews

PDT not effective for Melasma and Freckles - Only acne and Actinic Keratosis

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. 

Alim R. Devani, MD, FRCPC
Calgary Dermatologist
5.0 out of 5 stars 10 reviews


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.

Martie Gidon, MD, FRCPC
Toronto Dermatologist
5.0 out of 5 stars 20 reviews

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.