Can Photodynamic Therapy Be Used over Large Area of Body For Actinic Keratosis?

I have actinic keratosis severly on my legs arms and chest and I am interested in PDT therapy. It is to the point where I want my whole body covered up because it is so ugly. I have used Efudex and was wondering if the pdt would be better since I have such a large area to cover. This would be the entire front of my legs, upper and lower and the calves of both legs, both arms and my chest. Please help. I cannot seem to find a doctor that does this procedure close to where I live.

Doctor Answers 7

Actinic Keratosis Treatment with PDT

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I commonly perform PDT to the entire body. I may break it up into different sessions, but studies have shown that the combination of one of the immunomodulators (like efudex, aldara, or carac) with PDT, works better than either treatment alone in providing AK clearance.

San Diego Dermatologic Surgeon
5.0 out of 5 stars 87 reviews

Photodynamic therapy is effective on off-label body areas

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The FDA has approved photodynamic therapy for actinic keratoses on the face and scalp.  Nevertheless, many dermatologists use it on off-label areas including neck, arms, or legs.  In areas with thicker skin, such as the extremities, the incubation time for the levulan needs to be lengthened.  Studies have shown that occlusion with saran wrap during the incubation period is helpful on areas of thicker skin.  Exfoliating the skin in advance of the treatment is another way to help the medication penetrate.

Yes--PDT can be used for large areas of body

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I often use PDT (photodynamic therapy) to treat off-face areas of the face such as the arms or legs.  Oftentimes, effective treatment requires longer incubation times of Levulan and possibly occlusion with plastic wrap.  To obtain superior results and photorejuvemation, I combine blue light with IPL to remove actinic keratoses, sun spots, and red pigmentation.

Melanie D. Palm, MD - Account Suspended
San Diego Dermatologic Surgeon

PDT for AK's on large surface

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PDT can certainly be used for a large surface area, such as arms or legs (off label). However, you would have to have these areas treated one at a time. Discuss other treatment options, such as freezing and creams, with your dermatologist.

Gary Goldenberg, MD
New York Dermatologist

PDT is an excellent choice for background sun damage

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Photodynamic therapy works as great field therapy for sun-damage skin.  It is particularly effective on the head and neck.  PDT works very well with proper preparation (retinoids, moisturization regimen, exfoliation) on the hands, arms and shins.  PDT is less painful off the face and you need to see someone with a bit of experience to achieve good results off the face because the incubation times on thicker, less-sebaceous skin are different.  

PDT can effectively treat many areas with AK's

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PDT can be used on the face, neck, arms, legs, chest and really over any area with photodamage and AKs.  One might need a longer drug incubation on off-face areas but protocols exist by many doctors on how best to do this.

Michael Gold, MD
Nashville Dermatologic Surgeon
3.9 out of 5 stars 17 reviews

Photodynamic therapy

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Photodynamic therapy (PDT) can be used for a large skin area, such as arms or legs.  We usually do one big area at a time & use Levulan & BBL combination.                                                                                   

Anatoli Freiman, MD
Toronto Dermatologist

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.