Photodynamic Therapy vs Photo Therapy and Fotofacial?

Photodynamic therapy otherwise known as PDT utilizes Levulan (levulinic acid, a naturally occurring breakdown compound of hemoglobin, part of red blood cells) and Blue light (~410nm wavelength). PDT is indicated by the FDA for actinic keratoses. There have been several published reports demonstrating efficacy for PDT for acne, aesthetic benefits, e.g. collagen production. Intense pulse light laser IPL or Photofacial laser utilizes focused, broad-spectrum light applied to the surface of the skin. IPL is quite efficacious for reduction of pigmentation and redness. IPL involves minimal downtime whereas PDT can have up to 7 days of red, scaly changes depending on the aggressiveness of the protocol. IPL alone is not all that helpful for acne whereas series of 4 PDT's, 4 weeks apart can help to shrink oil glands, minimize colonies of bacteria responsible for acne and make conventional acne therapy work even better. If expense and downtime are of minimal concern, PDT can be combined with IPL under the supervision of experienced board-certified dermatologists to achieve significant rejuvenation and reduction of sun damage.

Photofacial and IPL or intense pulsed light are nearly identical procedures. IPL and Photofacial employ a low energy laser that helps to remove red and brown imperfections from the skin such as spider veins and age spots and smooth fine lines. The downtime from IPL is generally minimal and most patients return to work right away. IPL is often performed in a series of treatments.
Photodynamic Therapy or PDT is akin to a supercharged version of IPL. In PDT, a chemical is applied to the skin that increases the sensitivity of the skin to light. After this chemical soaks into the skin for about one hour, a light source is used on the skin similar to IPL. The skin turns bright red, like a sunburn for 2-3 days after PDT. There may be some peeling. PDT is very effective in treating pre-cancerous lesions on the skin, spider veins and brown spots. The results after PDT are often more dramatic than the results after IPL alone.

Photodynamic therapy uses a medication called Levulan or Metvix which is absorbed by the bacteria and oil glands in the skin, and a light source to activate the medication.  A red or blue light can be used for activation of Levulan and a red light for Metvix.  Intense pulsed light that is used for photofacials can be used to activate these medications. 

IPL on its own has a mild effect on acne but photodynamic therapy is a more aggressive treatment with more benefit.