When is photodynamic therapy recommended for actinic keratosis?

Actinic keratosis is a rough, scaly patch caused by long-term ultraviolet exposure. It can occur as one spot or across a broader sun-damaged field. Photodynamic therapy uses a light-sensitive medicine on the treatment area, followed by a specific light that activates the medicine and damages targeted abnormal cells. Redness, burning, stinging, swelling, crusting, and temporary light sensitivity are common parts of the healing response. A thick, tender, bleeding, or changing lesion may require biopsy or a different treatment rather than field therapy alone.

A clinician should examine the skin and decide whether the diagnosis is clear before treatment. Mention medicines that increase sensitivity to light, previous skin cancers, immune suppression, allergies, and problems with wound healing. Follow the preparation and aftercare instructions, including avoiding bright light for the advised period and protecting the treated skin. Let crusts shed naturally. Keep scheduled reviews so persistent lesions can be rechecked and new sun damage can be managed early.

Seek prompt assessment for a lesion that grows quickly, becomes thick or painful, bleeds, forms an ulcer, or fails to heal. After photodynamic therapy, contact the treating clinic if redness spreads, swelling worsens, pus develops, fever appears, or pain is severe or continuing. Emergency help is needed for facial swelling with breathing or swallowing difficulty.

Ask whether photodynamic therapy is appropriate for the number and distribution of your lesions, whether any spot needs biopsy, how long light precautions last, what healing looks like, and how follow-up will check the treated field. Ask about other options for isolated thick lesions.