Lesion & Field Treatments

Aminolevulinic Acid 20% (ALA 20%) is a naturally occurring photosensitizing compound, which has been approved to treat sun induced actinic keratosis. ALA 20% is applied to the skin and subsequently “activated” by a specific wavelength of light. This process of activating ALA 20% is termed Photodynamic Therapy (PDT). 

The purpose of activating the ALA 20% is to reduce precancerous skin lesions. The treatment may also improve the appearance of the skin and other signs of photoaging, decrease acne & rosacea, reduces sebaceous hyperplasia, decrease oiliness of the skin, and improve texture/smoothness by minimizing pore size. Improvements of these skin conditions (other than actinic keratosis) are considered an “off-label” use of ALA 20%.

This procedure requires an initial consultation with a clinician. Photographs will be taken of your face before each treatment session. ALA 20% will be applied to your skin. After an incubation time determined by the doctor, the area will be treated with a specific wavelength of light to activate the ALA 20%. You should avoid direct sunlight for 48 hours following the treatment due to photosensitivity. 

Any, even indirect sun exposure during this time can increase possible side effects including; swelling, burning, redness and pain. You should wear sunscreen, a hat and a scarf on your face returning home from this treatment. 

Possible side effects of ALA 20% treatment include discomfort, burning, swelling, redness, and possible peeling, especially in any areas of sun damaged skin and pre-cancers on the skin, as well as lightening or darkening of skin tone and spots. The peeling may last many days, and the redness for one week. The greater the number of pre-cancers on your skin the more exuberant these reactions will be. 

The recommendations, based on many studies and thousands of patients treated, are 1-2 treatments for AK’s (actinic keratosis) and 2-4 treatments for acne. Medicine is not an exact science, and there can be no guarantees of your results. While some individuals have fabulous results, it is possible that these treatments will not work for you. Alternative treatments may include topical therapies, oral medications, cryosurgery, or excisional surgery.