Photodynamic Therapy in
Marietta & East Cobb
Board-certified dermatology care using light-activated treatment to destroy precancerous cells, treat superficial skin cancers, and rejuvenate sun-damaged skin – with minimal downtime and excellent cosmetic outcomes.
What Is Photodynamic Therapy (PDT)?
Photodynamic therapy (PDT) is an FDA-approved, light-based treatment that combines a topical photosensitizing agent with a specific wavelength of light to selectively destroy precancerous cells, superficial skin cancers, and sun-damaged tissue. It is one of the most effective treatments for widespread actinic keratoses and field cancerization.
Unlike cryotherapy or topical chemotherapy that treat individual lesions one at a time, PDT treats the entire affected area simultaneously – addressing both visible precancerous spots and the subclinical (invisible) damage in the surrounding skin. This "field treatment" approach is what makes PDT uniquely effective for patients with extensive sun damage.
At DESSNA, PDT is performed by board-certified dermatologists who customize the treatment parameters – photosensitizer type, incubation time, and light source – to your specific condition, skin type, and treatment goals for optimal results with manageable recovery.
How the procedure works
Photosensitizer Application
A topical photosensitizing agent (aminolevulinic acid or methyl aminolevulinate) is applied to the treatment area. This solution is preferentially absorbed by abnormal, rapidly dividing cells – including precancerous and cancerous cells – while largely sparing healthy tissue.
Incubation Period
The photosensitizer is allowed to incubate for 1 to 3 hours (depending on the agent and condition being treated). During this time, abnormal cells convert the solution into protoporphyrin IX, a light-sensitive compound that accumulates selectively in damaged cells.
Light Activation
A specific wavelength of light (blue light or red light) is directed at the treatment area. This activates the protoporphyrin IX, generating reactive oxygen species that destroy the targeted abnormal cells from within – while leaving surrounding healthy tissue intact.
Healing & Skin Renewal
Over the following 7 to 14 days, the treated area heals as damaged cells are cleared and replaced with new, healthy skin. The result is smoother, more even-toned skin with significantly reduced precancerous lesions and improved overall skin quality.
When Is PDT the Right Choice?
PDT is most effective when sun damage is widespread and multiple precancerous lesions need treatment simultaneously. Your dermatologist selects PDT when it offers the best combination of thoroughness, cosmetic outcome, and field treatment capability.
Actinic Keratoses (Precancerous)
Rough, scaly patches caused by decades of cumulative UV damage. PDT is particularly effective because it treats both visible lesions and the surrounding field of subclinical damage that harbors early precancerous changes invisible to the naked eye.
Superficial Skin Cancers
Select superficial basal cell carcinomas and Bowen's disease (squamous cell carcinoma in situ) can be effectively treated with PDT when surgery is not preferred or when the cancer is in a cosmetically sensitive location.
Field Cancerization
When an entire area of skin (face, scalp, forearms) has been chronically sun-damaged, individual lesion treatment is insufficient. PDT addresses the entire 'field' of damaged skin, reducing the risk of new precancerous lesions developing.
Photorejuvenation
Beyond treating precancerous lesions, PDT improves overall skin quality by reducing fine lines, evening skin tone, shrinking pores, and reducing oil production. Many patients notice a rejuvenated appearance after treatment.
How We Perform PDT at DESSNA
We combine precise photosensitizer application with controlled light activation – treating the entire field of sun damage while managing your comfort throughout the procedure.
Pre-Treatment Evaluation
Your dermatologist evaluates the extent and severity of your sun damage, identifies all precancerous lesions, and determines whether PDT is the most appropriate treatment. We assess your skin type, medical history, and photosensitivity risk to customize the treatment protocol for optimal results and safety.
Photosensitizer Application & Light Treatment
The photosensitizing agent is applied to the treatment area and allowed to incubate for the prescribed duration. The area is then exposed to the appropriate light source (blue light or red light) for a specific period. During activation, you may feel warmth, tingling, or stinging – which we manage with cooling fans and comfort measures.
Recovery & Follow-Up
After treatment, strict sun avoidance for 48 hours is essential as the photosensitizer remains active. We provide detailed aftercare instructions including gentle cleansing, moisturizing, and sun protection protocols. Follow-up at 4 to 8 weeks assesses treatment response and determines if additional sessions are needed.
PDT Treatment Options at Our Marietta Practice
The specific PDT protocol is tailored to the type and extent of your sun damage, the lesions being treated, and your tolerance for downtime. Here is how we apply this versatile treatment.
ALA-PDT (Aminolevulinic Acid)
The most commonly used photosensitizer in the U.S. ALA (Levulan Kerastick) is applied topically and incubated for 1 to 3 hours before blue light activation. Highly effective for treating multiple actinic keratoses and widespread sun damage across the face, scalp, and extremities.
MAL-PDT (Methyl Aminolevulinate)
Metvixia (MAL) is a modified photosensitizer activated by red light, which penetrates deeper into the skin. Preferred for superficial basal cell carcinomas and Bowen's disease where deeper tissue penetration is needed for complete treatment.
Short-Contact PDT
A modified protocol using shorter incubation times (30 to 60 minutes) that reduces post-treatment redness and discomfort while maintaining effectiveness for mild to moderate actinic keratoses. Ideal for patients who need a faster recovery.
Daylight PDT
A gentler alternative where the photosensitizer is activated by natural daylight rather than an artificial light source. Significantly less painful than conventional PDT while maintaining good efficacy for thin actinic keratoses.
Combination Therapy
PDT can be combined with other treatments – including cryotherapy, topical 5-fluorouracil, or curettage – for enhanced effectiveness against resistant or recurrent precancerous lesions. Combination approaches improve clearance rates for difficult cases.
Post-Treatment Surveillance
Regular follow-up examinations at 4 to 8 weeks post-treatment assess response and identify any residual lesions requiring retreatment. Long-term surveillance monitors for new precancerous changes and ensures sustained results with a comprehensive sun protection plan.
What to Expect After PDT
PDT produces a controlled inflammatory reaction that is essential to its effectiveness. Understanding the recovery timeline helps you prepare:
Peaks at 24 – 48 hours, resolves in 5 – 7 days
During and immediately after light activation
Days 3 – 7 as damaged cells are shed
Strict sun avoidance for 48 hours post-treatment
Smoother, clearer skin emerges in 2 – 4 weeks
Why PDT Is Uniquely Effective
PDT vs. Cryotherapy (Freezing)
Cryotherapy treats individual lesions one at a time and cannot address subclinical damage between visible spots. PDT treats the entire field simultaneously, clearing both visible actinic keratoses and the invisible precancerous changes in surrounding skin – reducing the rate of new lesion development by up to 75%.
PDT vs. Topical Chemotherapy (5-FU, Imiquimod)
Topical chemotherapy creams require weeks of daily application with prolonged redness and irritation. PDT achieves comparable or superior clearance rates in a single in-office session with a shorter, more predictable recovery period. Patient compliance is also significantly higher with PDT.
If you have widespread sun damage with multiple actinic keratoses, PDT offers the most comprehensive single-session treatment available – addressing both visible and invisible precancerous changes while improving overall skin quality.
What Our Patients Say
“Doctor Edward Chen is the BEST! He's very professional, very caring, he will always give you his honest advice. He helped my son who had acne issues – his skin now looks great like never before.”
“Dr. Candace Green has a very warm bedside manner and makes you feel very comfortable! Great office, staff, and overall experience.”
“The office is well run and Dr. Green is thorough.”
Photodynamic Therapy FAQs
Answers to the questions our Marietta and East Cobb patients ask most about PDT.
During the light activation phase, most patients experience a stinging, burning, or prickling sensation that ranges from mild to moderate. The intensity depends on the extent of sun damage being treated – more damaged skin tends to react more strongly. We use cooling fans, cold compresses, and breaks during treatment to manage discomfort. The sensation subsides within minutes of completing the light exposure.
Dealing With Widespread Sun Damage in Marietta or East Cobb?
Your first step is a consultation with one of our board-certified dermatologists. We will evaluate the extent of your sun damage, count and assess your actinic keratoses, and determine whether PDT is the most effective treatment for your specific situation.
PDT can clear 75 – 90% of actinic keratoses in a single session while treating the entire field of sun damage.
Related Conditions & Services
Explore other surgical and skin cancer services we offer at our Marietta practice