How to Tell if Redness Are Scars from ALA-PDT Treatment?

Question

I had an ALA(Aminolevulinic Acid)-PDT (Photodynamic therapy) treatment done and got a severe reaction with scabs and blisters. Some of the scabs and blisters came off early. I am left with these red areas on my cheeks for 5 months now. They were always red but level. Is this scar tissue or just redness? Is there a way I can tell? I had 3 V-beams but is is pink now so I assume I need more treatments. When I put pressure on the areas, blood goes away for that split second, I see my normal skin color. Thank you.

William Ting, MD · Answer

You have experienced post-inflammatory erythema from PDT-ALA. This may occur when the protocol involved is aggressive. Unfortunately, conservative protocol (e.g. abbreviated incubation time and blue light exposure time) used in PDT-ALA may not be as efficacious as a more aggressive protocol. IPL or photofacial treatment, oral nicotinamide, and/or low-dose doxycycline may be helpful to minimize prolonged inflammation resulted from PDT-ALA treatment.

How to Tell if Redness Are Scars from ALA-PDT Treatment?

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