LEVULAN PHOTODYNAMIC THERAPY (ALA-PDT)

Serving Hamilton, Stoney Creek, Grimsby and surrounding areas.

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What is Levulan Photodynamic Therapy?

IPL (Intense Pulsed Light) is combined with a topical medication called Levulan in a procedure known as Levulan Photodynamic Therapy (PDT). Photodynamic therapy for acne, precancerous sun spots and other uses.

Photodynamic Therapy (PDT) is also known as 'ALA/PDT treatment'.

Sun damage, fine lines, and blotchy pigmentation are also improved due to the positive effects of this treatment. ALA/PDT treatment also has the unique ability to minimize pores and reduce oil glands, effectively treating stubborn acne, rosacea, and improve the appearance of some acne scars.

What is IPL?

Intense Pulsed Light (IPL) also known as photo-facial, fotofacial, and photo rejuvenation is a state-of-the-art system and the latest technique in photofacial therapy. The IPL system delivers high intensity, smooth and powerful pulses of light (not lasers) that greatly enhances the results of your skin rejuvenation. For skin therapy, IPL stimulates new collagen growth resulting in smoother, more even, healthier skin. IPL contains many wavelengths of light energy including 'blue light'.

What is Levulan?

Levulan (5-Amino Levulinic Acid) is a medication that is applied to the skin. This medication makes sun damaged areas, precancerous areas, acne-causing bacteria and overactive oil glands more sensitive to the IPL treatments.

Can Levulan Photodynamic therapy be used to treat acne?

Yes. This results in significant improvement in moderate to severe acne.

Approximately 90% of all adolescents and 25% of all adults experience acne at some point in their lives. Acne can be treated with topical creams and lotions, birth control pills, antibiotic pills, glycolic peels and microdermabrasion. Now PDT is another safe and effective alternative available for acne treatment.

IPL Levulan Photodynamic acne treatment involves three mechanisms of action against acne. Levulan treatment inactivates the bacteria that trigger acne, exfoliates the skin to unclog pores, and shuts down the oil glands (sebaceous glands) in the skin. This can produce long-lasting improvement.

Levulan acne therapy can even work in patients who have prescription treatments.

Results with Levulan PDT are especially impressive when compared with conventional treatments, such as topical medicines and oral antibiotics.

Can Levulan Photodynamic Therapy be used to treat freckles and skin pigmentation?

Yes.

They might have been cute when you were younger, but those freckles you have now probably aren't as attractive as they once were. Even more, they are actually signs of sun-damaged skin.

All those years at the beach add up, even if you can't see the damage it has caused. Many people believe that if they apply a bit of sunscreen and they don't peel, they're not at risk for sun damage or skin cancer. This is not true.

Can Levulan Photodynamic Therapy be used for skin rejuvenation and improvement of sun damage?

Yes. Levulan Photodynamic Therapy using intense pulsed light (IPL) is now the gold standard for non-surgical skin rejuvenation. This procedure results in significant improvement in precancerous conditions such as actinic keratoses, sun damaged skin and potentially superficial skin cancers. Additionally it improves wrinkles, pore size, skin texture, pigmentation, rosacea, sebaceous hyperplasia (oil gland enlargement), and potentially prevents the development of skin cancer. Levulan is revolutionizing how we perform skin rejuvenation and how we treat sun-damaged skin.

What else can Levulan Photodynamic Therapy be used for?

Acne.
Severely sun damaged skin.
Enlarged Pores.
Precancerous sun spots (actinic keratoses) (Skin Cancer Prevention).
Enlarged Oil Glands (Sebaceous Hyperplasia).
Irregular Pigmentation.
Freckling.
Liver Spots (Solar Lentigenes).
Uneven Skin Texture

Who should not have PDT (Levulan Photodynamic Therapy) treatments?

You should not be treated if you have:

Skin sensitivity to blue light.
Porphyria (a disorder of the metabolism that can lead to sensitivity to light).
Allergies to chemicals called porphyrins.
Lupus.
A tan. You must NOT be tanned when you come in for your Levulan PDT treatment . Treating skin with a tan can produce white “striping” which can take several months to fade. Your skin MUST NOT BE TANNED.

Does it Hurt?

There is some discomfort associated with the treatment. Each pulse of the IPL feels like an elastic band snapping against the skin. Numbing creams can be used prior to treatment, but are generally not required.

To make the treatment more comfortable the IPL machine is equipped with a chilling tip that cools the skin prior to treatment.

Furthermore, we have recently acquired a unique Zimmer Cryo Chiller for added patient comfort. This machine blows cool air onto the treatment area which helps to reduce discomfort. This makes the procedure significantly more pleasant. Many offices do not offer this added feature.

How Do I select where I should go for Levulan IPL treatment?

Unfortunately there are no government regulations as to who can own or operate a Blu-U machine. There is no minimal training required by regulatory agencies and virtually anyone who has the capital can purchase a machine and start doing treatments. For those reasons, you have to be very careful where you go.

There are several questions you should ask.

Is the clinic a doctor's office or a spa? Blu-U can be potentially dangerous if not used by well trained technicians.
How long have they been doing treatments?
Is there a doctor? Is the doctor someone who is specialized in skin care and Blue Light therapy such as a dermatologist? Or is the doctor a family doctor? Dentist? Chiropractor?
What are the qualifications of the technician who is treating you?
What type of Blue Light machine are they using?
Who will manage any complications is they should happen to arise?
Does the technician do a full and in depth consultation with you to ensure that you understand the pros and cons of treatment, the risks and benefits?
Do they take photographs to help monitor improvement?
Does a dermatologist check you first to make sure that you are a good candidate for therapy?

How do I prepare for my treatment?

The face should be cleansed with soap and water and free of any oil. Ladies need to be make-up free during the treatment. Make-up may be re-applied immediately after the treatment.

What is the procedure for Levulan Photodynamic therapy?

At your first visit a Levulan IPL technician will provide a free consultation. During the consultation she will discuss the benefits of Levulan IPL Photodynamic therapy, explain the procedure to you and answer any questions that you may have. Furthermore she will explain how the procedure works and how many treatments you will need, and provide you with a price quote. She will also ask you a series of questions to determine if you are a good candidate for the procedure and to determine your skin type and sensitivity.
After your FREE consultation the technician will call in Dr. Vignjevic. He will assess your skin type and whether Levulan IPL would be suitable for you. In addition, he will answer any further questions that you may have. You cannot be treated by the technician unless you are assessed by Dr. Vignjevic first.
If you decide to go ahead with a treatment, photographs will be taken of the treatment area. These photographs are strictly for your chart and will not be released or used without your permission. Your privacy is of the utmost importance to us.
You will be asked to wash your face and to remove any makeup. It is not necessary to remove mascara, lip stick or lip liner.
Your skin will be cleansed and make-up will be removed. Microdermabrasion, a fine spray of crystals, is used to remove dead skin cells and to improve the penetration of the Levulan. An IPL Photodynamic Therapy technician will apply the Levulan, which is a clear solution, to the freshly cleansed skin with a cotton applicator. After a period of 60 minutes, the area is illuminated with an appropriate light source. This 60 minute application time is termed the incubation period. Longer inclubation periods of 180 minutes are used for the chest, back, arms and legs.
The therapy is suitable to treat all areas of the body, including the back, chest and face.
After the incubation period the Levulan will be activated with IPL (Intense Pulsed Light).
You may use an anaesthetic cream prior to the light exposure.
You will be given special goggles to wear to protect your eyes during the treatment.
During the treatment you may feel stinging, tingling, prickling, or burning of the lesions, but this should go away after the treatment.
After treatment with the Levulan PDT, the solution will be washed off the skin using soap and water following the light activation. A healing cream is applied to the skin, and then a layer of sunscreen is applied last prior to leaving the office.
You will be provided with a booklet of after-care instructions and the technician will recommend specific products to take care of your skin after the treatment.
You will be provided with Doctor Vignjevic's personal cell phone number should you have any questions or concerns that arise after office hours.

What should I expect after my treatment?

There will be redness, and occasionally, mild blistering or bruising of the treated areas lasting from several hours to 3-14 days. This will depend on the sensitivity of your skin and the severity of your sun damage. Most people are completely healed within 7 days.
The treated area might “crust”, “flake”, or look like a “cat scratch.” Any areas that become crusted are pre-cancerous areas that have been successfully treated. Some crusting and scabbing is considered a good result. This should resolve within 3-14 days.
Your skin will be more sensitive for a few days up to a couple of weeks after your treatment.
There should be some discomfort, but no significant pain.
After 1 week, there might be some residual redness that will subside after a few days and can be covered with make up.

Special precautions for 1 week after your treatment:

Keep the treated area out of the sun and bright lights for 48 hours. Exposure to the sun within this time period can lead to a severe blistering burn in the areas that were treated.
If outdoor exposure sun is unavoidable, wear a hat with a brim, cover your face with a scarf, wear large sunglasses and use sunscreen. Sunscreen alone is NOT ENOUGH PROTECTION to prevent a burn in the first 48 hours after treatment.
You should continue to use sunscreen daily for at least 4 weeks following treatment regardless of the time of year or if it is overcast or cloudy. Sun exposure may lead to the production of blotchy dark pigmentation which may take several months to fade.
Avoid excessive heat exposure such as saunas, steam rooms, hot showers or baths, and strenuous exercising for 24 hours. This prevents the risk of blistering.
You can return to normal activities immediately after treatment, as long as you avoid bright light and sunlight for 48 hours.
Avoid any aggressive skin care products such as scrubs, exfoliants, alpha or beta hydroxy acid products.
Keep clothing from rubbing the treated area and avoid other irritation to the area.
Do not get hairspray on the treated area.
Notify the office should you have any prolonged redness, excessive puffiness, or other unusual side effects.

Dr. Vignjevic recommends the following Skin Care Regimen – immediately after treatment and between your treatments

Specific instructions will be provided to you on the day of your treatment.

What should a person do if they get significant redness, swelling, or pain after a treatment?

Avoid the sun or bright lights as much as possible.
Call the office where you had your treatment. They should be happy to help you and to answer your questions.
If you are concerned that you have had an abnormal reaction, have a cold sore, or an infection - call your doctor's office immediately.

Is the cost of Levulan PDT covered by drug insurance?

Sometimes.

Treatment of acne, rosacea and actinic keratoses (precancerous sun spots) MAY be PARTIALLY covered if you have PRIVATE drug insurance. OHIP and regular provincial drug plans do NOT cover the cost of Levulan PDT therapy.

To see if your private drug insurance will cover a portion of the cost of the treatment , call your insurance company and provide them with the Drug Identification Number (D.I.N.) for Levulan - 02243933. They can tell you if it is covered and how to get coverage.

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