How does photo dynamic Therapy work?

Advantages of Photo Dynamic Therapy

No sun exposure for 48 hours


Below is some important information if you have been prescribed PDT Treatment or Photo Dynamic Therapy. Photo Dynamic Therapy is a non-surgical skin cancer treatment or treatment for pre-cancerous lesions. Therefore, please note that non-surgical skin cancer treatments are only for non-melanoma skin cancers.

Photo Dynamic Therapy is effective and has several benefits over conventional skin cancer treatment approaches:

-It is as effective as surgery but superior to cryotherapy

-PDT Treatment is selective for cancerous tissue

-It is non-invasive and non-scaring

-It can be used repeatedly if necessary

-Cosmetic results are superior to all comparable treatments.


First, we apply a cream, which is called “ALA” or Levulanic acid, a compound related to Bilirubin and Porphyrins (substances found in your liver). In fact, all cells in the body need this compound, but abnormal cells absorb it faster than normal cells. Next, after we apply the cream, we cover it with plastic occlusion to allow it to be absorbed. Finally, after a period of 1 to 4 hours, we take the dressing off and apply a light. The light is a very strong visible (635nm) infrared light. The energy from this light activates the cream and this produces oxygen radicals. Those radicals destroy all cells that have absorbed the cream –  it destroys only abnormal cells.


Level of Discomfort During and After PDT treatment

The skin cancer cells get destroyed and die. Although it is a non-surgical skin cancer treatment, it can still be painful. The pain is at its maximum during the 8 to 16 minutes of treatment depending on which lamp we use. We prescribe Lyrica tablets to manage the pain. A local anaesthetic may also be injected into the lesions.

In the following 24 hours, the affected areas will feel like very severe sunburn. As a result, the skin will turn red, sometimes swollen. In some cases crusting and oozing can occur if the lesions were deep. In the first 24 hours, it might be necessary to take Lyrica or Panado. After that, the area normally heals within 1 to 2 weeks. It is important to keep the area well moisturised at all times (apply Nutraderm cream 3 to 4x/day). In the case of crusting or oozing, it is highly recommended to use Bactroban twice a day for 3 to 4 days. Due to this procedure being a non-invasive skin cancer treatment, the skin will peel off (similar to sunburn). However, it will heal completely over time. Unfortunately, the treated areas might be unsightly for 1 to 2 weeks. However, the end results are always good. Two treatments are required 4 to 6 weeks apart.


Conditions before and after the PDT Treatment

The pain of non-invasive skin cancer treatment depends on the amount of infrared damage. Skin types differ. Therefore it is difficult to know beforehand exactly how severe it will be. However, discomfort is manageable with Lyrica or Panado. The reddening – seen after the healing – can take up to 6 weeks, in some cases months to disappear. Again, discomfort depends on an individual’s reaction but is normally not permanent. The clearance or cure rate with this skin cancer treatment is comparable to that of surgery. However, the cosmetic outcome is normally better. If you would like to know more about non-invasive skin cancer treatments and how the procedure works, please contact us.


No sun exposure for 48 hours

NB: NO SUN EXPOSURE FOR 48 HOURS AFTER TREATMENT. Avoid ALL electronic equipment with screens such as TV, Computer screens, Laptops, Mobile Phones, Tablets, etc.


The following medicines are know to cause temporary photosensitivity:

-Chlorpromazine (Anti-Psychotic), also known as Largactil. Patients can be treated if the medicine has not been taken within the last 8 days.

-Griseofulvin (Anti-Fungal), also known as Fulcin, Grisovin. Patients can be treated if the medicine has not been taken within the last 5 days.

-Isotretinoin (Anti-Acne), also known as Roaccutane. Patients can be treated if the medicine has not been taken within the last 5 days.

-Tetracycline (Antibiotic), also known as Tetralysal, Terra-Cotril, Terramycin, Minomycin, Cyclimycin.

-Tetracycline HCL, Achromycin V, Tetrex, Doxycycline, and Ciprofloxacin. Patients can be treated if the medicine has not been taken within the last 5 days.

-Methotrexate (Anti-Arthritis and Anti-Cancer), also known as Methotrexate Sodium.

-Amiodarone (Anti-Arrhythmic), also known as Cordarone, Hexarone. Treatment can be administered at the physician’s discretion.

-Bisoprolol (e.g. Ziak,) Spironolactone (e.g. Aldactone), Amitriptyline (e.g. Trepilene), Metformin (e.g. Glucophage) – please do not take on the day of PDT treatment.

-Tacrolimus (Immunosuppressant – organ transplant patients).

Steps to treat it

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-Patients who have a history of recurring cold sores (Herpes simplex type 1) should use oral Zelitrex tablets, 500mg twice a day for 5 days, starting the evening before the Photo Dynamic Therapy treatment. You need a prescription for this medicine.

-Please contact the rooms for the script.

-Make sure your skin is clean and free of all make-up, moisturisers and sunscreens before you come in for each treatment.

-BRING A HAT, SUNGLASSES AND SCARF with you on the day of your Rx.

-This is especially important for patients who need to drive a long distance back home. The sun will continue activating the cream and, therefore, causing a more severe reaction.

-Photography may be done by the staff before the ALA is applied.

-Please sign the consent form allowing the staff to take photos.

-Your skin will be cleaned to enhance the absorption of the ALA and to give more even uptake. In some patients, microdermabrasion or a chemical peel will be done immediately prior to the application of the ALA.

-ALA is applied topically to the whole area to be treated, such as the whole face, back of the hands, extensor part of the forearms and sometimes even the top.

-The ALA is left on for between 30 minutes and 6 hours before any treatment.

-The ALA is activated with the Mostleds machine. This unique spectrum of light activates the ALA.

-Please make sure that you receive the post-treatment instructions to care for your skin.


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-If you have any discomfort after your non-surgical skin cancer treatment, you should apply ice packs to the treated areas. This will help keep the area cool and alleviate any discomfort. It will also help to keep down any swelling.

-Swelling will be most prominent around the eyes and is usually more prominent in the morning.

-Remain indoors and avoid direct sunlight for 48 hours. This means that you should also not drive around in a car, sit near a window or be outside even if overcast. Sitting in front of a Computer / TV screen must also be avoided.

-As mentioned before, non-surgical skin cancer treatments might be painful varying by patient. Take Panado or Lyrica if necessary for the pain.

-You may rinse with cool water, but not with ice water. If you want to use a cleanser, use Cetaphil Gentle Skin Cleanser.

-Apply EpiMax or Nutraderm cream as needed, at least twice a day.

Day 2-10

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-Continue using the soft cleansers as instructed above.

-Your skin will feel dry and tightened. Continue using the moisturisers as often as necessary, but at least twice a day as instructed.

-Avoid direct sunlight for one week.

-Use a total sunblock that is zinc oxide or titanium oxide-based. Brand names include Bioderma PhotoDerm Max SPF50+, Heliocare Gel or Spray SPF50 or Xeroderm SPF34.

-You may begin by applying make-up once any crusting has healed. The area may be slightly red for 1-2 weeks. If make-up is important to you, please ask about the Bioderma Photoderm SPF50+ Tinted Cream or the Heliocare Oil-Free SPF50 Compacts, which act as a concealer with sunscreen. It really helps to mask redness.

-If you have any further questions or queries about non-invasive skin cancer treatments, please contact us on 012 460 4646/50 or E-mail us at

Home care instructions

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NB: NO SUN EXPOSURE FOR 48 HOURS AFTER TREATMENT. Avoid ALL electronic equipment with screens such as TVs, Computer screens, Laptops, Mobile Phones, Tablets, etc




+27 012 460 4646

+27 078 955 1256

+27 012 460 6389



P. O. BOX 95804