Does Photodynamic Therapy have a reliable track record for sebaceous hyperplasia?

Question

I am a 37yo Caucasian male with 10-12 small sebaceous hyperplasia lesions on the face. I have had electrodessication, but the lesions keep returning, and I'm not sure if I want to go on isotretinoin. What kind of track record does PDT (Levulan with red light or pulsed dye laser) have for this condition? Thank you.

Kimberly Butterwick, MD · Answer

PDT (photodynamic therapy) has helped Sebaceous hyperplasia, but will not remove them 100% due to the nature of sebaceous hyperplasia. They run very deep in the skin so you are only able to treat the top layer of the sebaceous hyperplasia, otherwise you risk scarring.

Michael H. Gold, MD · Answer

Thanks for your
question and I actually wrote one of the papers on PDT and sebaceous gland
hyperplasia several years back. Our study compared Levulan – the
photosensitizer in the US with two light sources – the blue light source and
the IPL. We found both worked equally in reducing the lesions in the patients
that were studied. We also know that the pulsed dye laser works with PDT here
as well.

The PDT therapies
are treatments for this and may not cure the lesions forever – maintenance
therapy will probably be needed in most. And remember this is an off-label use
of PDT in the US, so it is an out-of-pocket expense.

Davin Lim, MBBS, FACD - Account Suspended · Answer

Yes PDT can help as the chemical ALA or Methyl ALA is concentrated in the oil or sebaceous glands. I normally use red light at 630nm compared to blue at 430 +nm as red light penetrates deeper. I usually do not encourage PDT as treatment for seb hyper, unless this is covered by insurance. Simple treatments include electrocautery using a pin point needle at say 1.2-1.4 watt setting is reliable and safe. Laser can be used including 532 KTP or CO2 or erbium with a 1 mm spot size. For REDUCING recurrence I often prescribe Tazoretene Cream, 2-3 times a week , or adapelene/ treatinoin. Regardless, seb hyper will recur. Hope this helpsDr Davin LimLaser and cosmetic dermatologist.

Does Photodynamic Therapy have a reliable track record for sebaceous hyperplasia?

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Does Photodynamic Therapy have a reliable track record for sebaceous hyperplasia?

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Everything you need to know about Photodynamic Therapy

Our mission is to create a world where every investment in modern beauty is Worth It.