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Pretreating with a retinoid, such as tazorac, will help to exfoliate the skin, thereby allowing better penetration of the levulan. This will enhance the treatment outcome. Other options to enhance the result include longer incubation times, occluding with saran wrap after applying levulan, or using other methods to exfoliate the skin manually or chemically.
Thanks for your question– and the answer is that PDT can be very effective for the arms and clinicalstudies have supported this for years. And, in fact, we know that pre-treatmentof the areas we are treating with a wide variety of topical agents can enhancethe penetration of the Levulan, thus making the PDT treatments work evenbetter. We have found that multiple treatments are needed on the extremities –so be prepared for this – but PDT on the arms can do wonders to remove thepre-cancerous skin lesions that develop there.
Photodynamic therapy (PDT) is a very useful treatment for pre-cancerous lesions, or actinic keratoses caused by the sun. Pretreatment with a retinoid such as tazorac will allow the levulan to penetrate deeper into the skin and will make the treatment more effective. PDT can also be done sequentially with other pre-cancer treatments like 5-FU or imiquimod.
Preparing the area ahead of time with Tazorac should help tremendously in allowing the Levulan to penetrate better in that Tazorac is a retinoid which helps encourage turnover the skin. This should greatly enhance the treatment outcome in an area with relatively thick skin.