Levulan ® Kerastick ® is part of a unique photodynamic therapy (PDT) system to treat actinic keratoses (AKs).

What are actinic keratoses?

Actinic keratoses (AKs) are rough, scaly patches on the skin, caused by excessive exposure to the sun, which can sometimes progress into dangerous skin cancers. More than 5 million Americans live with these lesions, and far too many people ignore them, leaving them untreated and too often resulting in serious consequences. Doctors estimate that 40% of squamous cell carcinomas, the second leading cause of skin cancer deaths in the United States, begin as AKs. And without performing a skin biopsy, it can be almost impossible for a doctor to distinguish an AK from a squamous cell carcinoma.

For this reason, three major medical groups - the American Cancer Society, the Skin Cancer Foundation and the American Academy of Dermatology - all recommend that people with AKs seek treatment for them immediately.

How do AKs become squamous cell carcinomas?

AKs sometimes can become larger and thicker. Doctors call this "hyperkeratotic." These enlarged lesions may then progress to squamous cell carcinomas. Patients may notice increased redness, tenderness, itching and burning. However, these symptoms can be the same for either AKs or squamous cell carcinomas. This similarity is what makes distinguishing between the two so difficult without a biopsy. Left untreated, squamous cell carcinomas may become larger, go deeper into the skin, and eventually spread to other parts of the body. Squamous cell carcinomas result in thousands of skin cancer deaths each year, many of which could be prevented.

How likely are AKs to become squamous cell carcinomas?

It is impossible to predict if an AK will evolve into a squamous cell carcinoma, or at what point it will happen. Many doctors believe that AKs and squamous cell carcinomas are really the same condition at different stages of a continuing process. The process begins with minor cell damage and, over time, ultimately results in the cell becoming cancerous. These doctors believe that AKs occur in the early stages of the process; squamous cell carcinomas occur in the final stage. One thing, however, is certain: a significant percentage of AKs develop into squamous cell carcinomas. Estimates range from 10% to as high as 20% over a 10-year period.

Is there anything I can do to prevent AKs in the future?

Long-term exposure to the sun is the single most significant cause of AKs, so the best defense against them is a comprehensive sun protection program. Suggestions include wearing protective clothing and a wide-brimmed hat, avoiding the sun at midday when ultraviolet rays are strongest, staying in the shade as much as possible, and wearing a broad-spectrum sunscreen with a sun protection factor (SPF) of at least 15.

What is the Levulan PDT system?

The Levulan PDT (photodynamic therapy) system is an advanced 2-step treatment for minimally to moderately thick AKs (those that have not yet become enlarged and thick) of the face or scalp. The system is unique because it's the only one that uses light to destroy AKs.

How effective is it?

The Levulan PDT system has been proven effective in clinical testing. Eight weeks after treatment, it had cleared 100% of AKs in about two-thirds of patients. The system more effectively cleared AKs of the face than those of the scalp. Clinical studies did not examine what happened to completely cleared AKs more than 12 weeks after treatment.

How does the Levulan PDT system work?

Step 1. The first step in the Levulan PDT system is when your Skin Health Professional applies Levulan Kerastick (aminolevulinic acid HCI) for Topical Solution, 20% to individual AKs on your skin. This unique solution is an acid that occurs naturally in your body; it makes the AKs more sensitive to light. This application prepares them for step 2 in the Levulan treatment.

Step 2. After waiting 14 to 18 hours, you return to your Skin Health Professional, who then exposes the AKs treated in step 1 to a special blue light. This light destroys the AKs, whether they are precancerous or not.

Are there any precautions I should take during the treatment?

Because step 1 makes the treated areas more sensitive to light, it is important that you avoid bright light during the 14 to 18 hours between steps 1 and 2. Sunscreens will not protect these treated areas. Stay out of sunlight or bright indoor light, and wear light-protecting clothing such as a wide-brimmed hat.

What will I experience during treatment?

During step 2 (the blue light therapy), at least half the patients in the clinical studies felt a stinging and/or burning in the treated areas. Usually, this feeling improved immediately after treatment and ended within 24 hours. (Less than 3% of patients discontinued therapy because of this discomfort.) After treatment, a small number of patients experienced some temporary reddening and swelling of the AKs and surrounding skin, which generally was completely gone by four weeks after treatment.

In addition, be sure to ask your Skin Health Professional at The Centre, P.C. about complexion analysis using the Visia system.

Contact our plastic surgeons to schedule your consultation with one of our Skin Health Professionals. The Centre, P.C. offers the latest cosmetic surgery and skin care procedures to patients in Elkhart and South Bend, Indiana, Michiana and the Southern Michigan area, and Chicago.

 

Elkhart Office

RiverPointe Medical Building
500 Arcade Ave., Suite 300
Elkhart, IN 46514
FAX: 574-293-1511

Chesterton Office

Duneland Health & Wellness Institute
810 Michael Drive, Suite K
Chesterton, IN 46304
Fax: 219.926.3534

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