IPL for PDT produces better results than blue light, dermatologist says

Las Vegas – Intense pulsed light (IPL) may facilitate more efficient photodynamic therapy (PDT) than blue-light PDT, according to expert at Cosmetic Surgery Forum, held here this past week.

Practicing in the high desert, "I see a lot of skin cancers," said Carl R. Thornfeldt, M.D., a Fruitland, Idaho-based dermatologist in private practice and founder/CEO of Episciences, Inc.

Though he frequently treats such patients with chemical peels and with PDT, "I was very unhappy with the results of blue light therapy," he told meeting attendees. Upon examination, "It became evident that the short wavelength of 400 nm wasn't penetrating more than half a millimeter. And when you look at the curve for how aminolevulinic acid absorbs, the Q bands start out at 500 nm. At 500 nm, you get significantly more penetration. When you reach 635 nm, you're down a good 1.5 mm."

Therefore, he attempted PDT using an intense pulsed light device that could cover the necessary Q bands.

"The other thing I was concerned about was that when I first had PDT, I got a tan. You're not supposed to get tanned unless you're being exposed to UVA. I realized I was actually inducing some damage," which compromised his results.

Focusing on the Q bands with an IPL device, "We were able to get deeper penetration and better results." For example, the treatment eliminated all but one of 51 nodular basal cell carcinomas (BCCs) in a study patient with basal cell nevus syndrome, while also significantly tightening his jowls. At last, "We were getting deep enough penetration to get rid of those nodular BCCs," he said. "It doesn't work in Gorlin syndrome, but it will be very beneficial in preventing hypertrophic actinic keratoses, which we see a lot of in our area. This will get down deep into the follicle and do the job."