Photodynamic Therapy/Assisted Photorejuvenation

Riccardo Rossi,Torello Lotti,Nicola Bruscino

doi:10.4236/jcdsa.2011.12005

Abstract

Photodynamic therapy (PDT) shows great efficacy and high tolerability for the treatment of non-melanoma skin cancer (actinic keratosis, basal cell carcinoma, Bowen’s disease) especially in patients with large and multiple lesions, in poor-healing sites and patients immunosuppressed or with co-morbidities. Besides, more recently, PDT has been used, widely and with great success, for many off-label diseases and in cosmetic dermatology, especially on photorejuvenation, therefore further and larger prospective studies with long-term follow-up are required to verify its efficacy and safety in treating these condition. The treatment of ageing skin remains a very hot topic, and many systems have been reported as having varying degrees of success. Nowadays our experience and literature data show how topical PDT can be considered a new non-invasive device for the treatment o photoaging skin with no/minimal side effects and able to bridge the world of medical and cosmetic dermatologic surgery.

Highlights

Aging is a complex and multifactorial process that occurs in all individuals at a variable rate, influenced by environmental, hormonal and genetic factors which result in several functional and aesthetic changes in the skin
As actinic keratosis (AK) can be considered the end stage of the skin ageing process, and has been successfully treated for several years using photodynamic therapy (PDT) with important therapeutical and cosmetic outcome, Photodynamic therapy (PDT) has been suggested to be used in skin photorejuvenation and we would like to focus, on this paper, our attention on this therapy and its role alone or in conjunction with a variety of lasers and light for cosmetic purposes in the treatment of many facets of photoaging, like tactile skin roughness, crow’s feet appearance, dyschromias and teleangectasias
At the time of this writing MAL-PDT is approved for AK, superficial/nodular basal cell carcinoma (s/n BCC) and Bowen’s Disease (BD) in 22 European countries, as well as New Zealand and Australia, where it is marketed under the trade name Metvix® (Photocure, Oslo, Norway and Galderma, Paris, France) and has recently been launched under the name Metvixia® in USA

Summary

Introduction

Combination of effective wavelengths, fluences, pulse durations and pulse intervals facilitates the treatment of a wide spectrum of lesions: hirsutism, pigmentary changes associated with photoaging, vascular lesions such as teleangiectasias or vascular malformations, acne scars and wrinkles [5]. As actinic keratosis (AK) can be considered the end stage of the skin ageing process, and has been successfully treated for several years using photodynamic therapy (PDT) with important therapeutical and cosmetic outcome, PDT has been suggested to be used in skin photorejuvenation and we would like to focus, on this paper, our attention on this therapy and its role alone or in conjunction with a variety of lasers and light for cosmetic purposes in the treatment of many facets of photoaging, like tactile skin roughness, crow’s feet appearance, dyschromias and teleangectasias. PDT Treatment of the AK lesion and of the field cancerization is part of an optimal strategy aimed at resolving both the clinically obvious alterations as well as those of the surrounding skin that probably is already the site of genetic alterations and of an initial gradual replacement of normal cells

Discussion

PDT Action in Photorejuvenation

Findings

Our Experience

Conclusions