Blue light in combination with the Levulan Kerastick is an F.D.A. approved treatment for actinic keratoses. Upon application of Levulan, a photosensitizer, pre-cancerous cells become sensitized to light. The scientific term is photodynamic therapy or PDT.

After cleansing the skin with acetone, Levulan is applied to the skin, and after a waiting period, the patient is placed under a Blue light which is visible light, for several minutes, usually 12-16 minutes. While under the light, there is an uncomfortable sensation of burning and stinging in the pre-cancerous ares. Discomfort is at its maximum during the first six minutes of treatment. This stops after the procedure is over only to recur, feeling like a very warm sunburn in about 12 hours. Relief will occur in a few hours and the symptoms can be relieved by using a topical anesthetic, taking oral non-steroidals such as Motrin, or Naprosyn and, oral Benadryl as needed. The lesions will look red and inflamed after treatment. If there is a lot of sun damage, you may have some swelling. This should improve greatly within the next few days and be obviously healing within a week. Some areas may remain pink for a few weeks, but this can be camouflaged with make-up for women, and is usually tolerated easily by men. Any dryness, in the first few days, can be alleviated by Vaseline. Moisturizers may be used once the skin is healed even if it is still pink, usually about 5-7 days.

Very important, is absolute sun avoidance for the first 48 hours after Levulan is applied to the skin. Remember, this medicine makes you sensitive to visible light and sunscreen will not give adequate protection. Plan on spending the next 48 hours indoors away from windows. If any errands have to be done, do them very early in the morning or after the sun is down in the evening. If you must run an errand, wear a broad brimmed hat and minimize exposure. If you are getting light to the skin, you will get a recurrence of the stinging sensation experienced underneath the Blue Light.

The original studies with the Blue Light were done by applying the Levulan only to the most obvious pre-cancerous lesions and leaving this on for a period of 14 to 18 hours, prior to applying the Light treatment. This method was very uncomfortable and many patients were not able to tolerate this treatment. More recent treatment protocols involve using the Levulan over entire sun damaged areas to treat subclinical lesions in addition to the visible lesions. The incubation period, time the Levulan is left on the skin, has been shortened to 1-8 hours, depending on the location being treated and severity of damage. Results are more thorough than with the spot treatment and seem to be on the same level of resolution as with comparable therapies such as Efudex. The procedure is much less painful with this short incubation period. Advantages to Blue Light over other treatments are, it is quick, the time ones skin looks abnormal is shortened greatly, and it is effective, is covered by Medicare and requires no prescription purchase.

Disadvantages include: it is uncomfortable, though tolerable, and one must be inside for two days. I have found the vast majority of people who have previously used Efudex or Carac greatly prefer the Blue Light treatment.

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