Photodynamic Therapy and BBL for precancer lesions and AK?

I'm a fair skinned, freckled person. Over the last eight years I have been moderately aggressive with skin care. I know have a fraction of the freckles on my face. Despite BBL, Blue Peel , hydroquinone and retinol products I have two age spots that will not go away. I'm scheduled for PDT next week on face, chest and hands. How close before or after can BBL done to PDT for optimal results? Also, if patient has a history of Fever Blisters do you treat prior with Vamfir? Thank you

Doctor Answers 3

Wait two week, or do on the same day.

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PDT (see video below) can be activated with various light sources, including blue, red and believe it or not even IPL or BBL (Sciton). If your Specialist is comfortable, he or she can perform the BBL at the same time when you are undertaking PDT. This can activate the chemical ALA, as well as address your brown pigmentation - freckles. All the best, Dr Davin Lim. Brisbane. Australia. 


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I would do PDT and IPL at least 1 week apart, just to ensure that the skin heals properly between treatments. IPL addresses sun damage and sun spots, whereas PDT is preventative for precancerous skin lesions, but also helps improve skin quality and color.   Age spots are best addressed with lasers that target pigmentation (none of which you have done), and unlike sun spots, do not respond to IPL treatments (like BBL).

With cold sores, I usually give valacyclovir pills twice a day for 5 days after doing treatment, but many doctors have different ways of preventing sores with treatments, so there is not only 1 answer.

Roni Munk, MD
Montreal Dermatologic Surgeon
4.3 out of 5 stars 10 reviews


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Photos, and knowing your age would be of great benefit here.  Your title refers to pre cancerous changes but it seems from the text that you are chasing "aging spots"..I am assuming these are residual areas of pigmentation..PDT will likely not benefit this much.  If in fact you are chasing AKs and not freckles or brown spots PDT is very effective and you could do BBL around 1 mos pre and post PDT.  If you have a history of cold sores than prophylaxis with an antiviral around PDT will be important and your care giver should be steering you in right direction.  I am assuming you are being managed by a dermatologist or plastic surgeon. 

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.