Woodbridge Dermatology Centre
(905) - 851 - 1436
301 - 8077 Islington Ave. N


Click on a topic to view answers to frequently asked questions.


How does photodynamic therapy work?

The Levulan® is absorbed by oil glands, sun-damaged skin cells and bacteria. The light source used in Dr. Nield’s office is Intense Pulsed Light. Therefore, patients not only benefit from the PDT but from having a photofacial as well. The light activates the Levulan® in the targeted cells, which are destroyed without damaging the surrounding skin. Oil glands shrink and bacteria are eradicated.

These treatments improve sun damaged skin, fine lines and blotchy pigmentation and target pre- cancerous spots called actinic keratoses. They minimize pores and reduce oil glands, effectively treating acne vulgaris and acne rosacea and improving the appearance of some acne scars.


How many treatments will I need to see the best results?

To achieve maximum improvement of sun damaged skin, a series of 3 treatments, 2-4 weeks apart is usually the most effective. Many patients with actinic keratoses are happy with just one treatment, but those with acne and acne scars may require 3-5 sessions. More treatments can be done periodically to maintain the rejuvenated appearance of the skin.


How much improvement can I expect?

Patients with severely sun-damaged skin with actinic keratoses, abnormal texture, tone and mottled pigmentation and skin laxity may see excellent results. Most studies report a 70% resolution of actinic keratoses, a 40% improvement in pigmentation, and a 25% improvement in skin texture. You may also see improvement of large pores and pitted acne scars. Mild to moderate acne can also improve with a series of treatments.


What is a typical session like?

The skin is cleansed and then degreased with an acetone scrub. Levulan® is applied to the area to be treated and left on for 45-60 minutes. (We encourage you to bring a book or magazine to pass the time.) The Levulan® is then washed off, and a cool gel is applied to your skin. Your eyes are covered with protective goggles. Intense Pulsed Light (IPL) activates the Levulan® and selectively targets capillaries, rosacea, and sun damaged skin and stimulates collagen formation. The cool gel absorbs some of the heat from the energy source; most patients tolerate the procedure quite well, but the bright light can be a bit disconcerting. There may be some stinging, burning or itching. Severe stinging or burning may occur when certain individual lesions are pulsed. The treatment will last 30-60 minutes, depending on the area being treated. The skin is then gently cleansed to remove any residual gel and a sunblock is applied.


Are there any side effects?

Following PDT, the treated areas can appear red with some peeling for 7-10 days. Some patients have a strong response to PDT, and experience significant redness. Burning and stinging usually improves immediately but can last for 24 hours. There may be temporary swelling around the eyes and lips for 1-2 days. Darker pigmented patches (liver spots) can become temporarily darker and then peel off, leaving normal skin.

You will be very sensitive to the sun and even indoor lighting for 24-36 hours. Avoid direct sunlight for 24 hours; we recommend that you stay indoors with the blinds closed. (Inadvertent sun exposure will cause a more intense response with marked redness and swelling but will eventually settle down.) Patients prone to facial cold sores will be prescribed an antiviral medication to prevent activation of a herpes outbreak.


What are the advantages? For Actinic Keratoses:

Easier for patients than repeated topical liquid nitrogen, Efudex® (5FU), or Aldara® because the side effects are usually minimal, there is rapid healing, and only 1-3 treatments are required. Precancerous lesions too small to be detected clinically can be destroyed.

Reduced scarring and improved cosmetic outcome compared to cautery, surgery and Efudex®. Liquid nitrogen can leave white spots on your skin.

Levulan® improves the whole facial area treated, creating a uniform colour, texture, and tone rather than just spot treating with liquid nitrogen or cautery.

For sun-damaged skin:
Fewer sessions are needed than regular photorejuvenation, with better results. It’s well-tolerated by most patients and easily performed in our dermatology clinic. It’s a non-invasive (non-surgical) procedure with an excellent cosmetic outcome.


Is there anyone who should avoid PDT?

You should avoid PDT if you:

  • Are pregnant or nursing
  • Suffer from a sun-sensitive condition such as lupus
  • Are taking medications that cause photosensitivity (such as certain antibiotics or Accutane) Have experienced seizures activated by flashing lights


What are actinic keratoses?

Actinic keratoses (AKs) are dry, scaly, rough-textured patches or lesions that form on the outermost layer of the skin after years of exposure to sunlight. They range in color from skin-toned to reddish- brown, and can be anywhere from the size of a pinhead to larger than a quarter.

Anyone who develops AKs has extensive sun-damaged skin. AKs are considered the earliest stage in the development of skin cancer and have the potential to progress to squamous cell carcinoma, a type of skin cancer that rarely can be fatal. The presence of AKs makes you more susceptible to other forms of skin cancer, including melanoma.

See the difference revitalized skin can make in our before and after photo gallery. To arrange a consultation with Dr. Nield, please contact us any time.

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