Natural Daylight Photodynamic Therapy (ND-PDT)

Pymble Dermatology

What is natural daylight photodynamic therapy

Natural daylight photodynamic therapy is a simple, non-invasive procedure which is used to treat pre-cancerious skin lesions.  The treatment involves applying a cream called Metvic to the affected area of skin.  Natural daylight is then used to activate the Metvix, which destroys the abnormal cells but does not affect healthy tissue.  The affected area may require two treatment

Is this the right treatment for me

If you have large areas of sun-damaged skin, or you have been diagnosed with pre-cancerous skin lesions called actinic keratoses or Bowen’s disease, then ND-PDT is a suitable treatment option for you.

An alternative is conventional photodynamic therapy (PDT), where we use an indoor light source.  The main disadvantage of conventional PDT is the level of discomfort.  You may have already had this treatment before.  Your dermatologist will discuss the various alternative treatments with you.

ND-PDT is a recently licensed treatment and although it is a relatively new treatment, it is a treatment widely used across Europe, UK and Australia and so the benefit and side effects of the treatment are well-established.

It is very important that you tell the staff if you have any allergies (especially to peanut oil, soya or almond oil) or have any heart problems, have a pacemaker or have any major health conditions.  This may affect whether it is safe for you to have the treatment.

Who will carry out my treatment

ND-PDT is a treatment which is generally provided by nurses.  However, at Pymble Dermatology, the entire procedure is performed by our dermatologist and nursing staff are there to provide education and assisting dermatologist in the procedure.

Preparing for your treatment

Before you come for your treatment, please do not apply any sunscreen, moisturiser or other skin products, including make-up, as these may affect the ND-PDT treatment.

What does the treatment involve?

You will be asked to sign a consent to confirm that you are happy to receive the treatment.  The nurse will then apply a sunscreen with SPF 30 or higher to the treatment area.  This will protect your skin from the ultraviolet light rays but will not block the daylight.  This will take approximately 15-20 minutes to be absorbed into your skin.

Your dermatologist will then prepare the lesion(s) by cleaning your skin and gently removing any overlying crusting skin.  They will then apply Metvix cream to the lesion(s).  you will need to leave the affected area uncovered.   You will be asked to wait for 15-30 minutes before your daylight exposure can begin.

We would recommend you to have the natural light shine at Robert Pymble Park, which is approximately 800 meters (10 minutes’ walk) from Pymble Dermatology (please refer to Robert Pymble Park map and photos).  You will need to stay in this area, in the daylight, for two hours.  This activates the Metvix, which then begins to destroy the abnormal cells.  You can visit the toilet if you need to, but if you leave the area for any longer then you may need to stay ourside for more than two hours, to make up for the time misses.

Even on an overcast day there is enough daylight exposure, if you are outside.  The ND-PDT can be done throughout the year independent of seasonal changes in Australia.  If it is raining, the our admin or nursing staff will contact you by telephone in advance to tell you that the treatment is being postponed.

It is only necessary to expose the treated area.  However, we do recommend that you bring along an use your own sunscreen (at least SPF 30) or clothing to proetce the rest of your skin which is exposed during the treatment

What are the side effects

The main side effect of the treatment is that you may experience mild tingling or pain in the treated area of skin.

We will give you a water spray bottle for you to use during the treatment.  This can help to sooth any sensation or discomfort on your skin.

What should I bring along with me?

  • Sunscreen SPF 30 or higher
  • Some food and drink
  • Reading material
  • Hat
  • Long-sleeved top, full length trousers or long skirt

You may want to bring along a friend or relative to sit with you during your daylight exposure, to keep you company.  We would advise that they also bring adequate sun protection (SPF 30 or higher).

What should I do after the treatment?

You will return to Pymble Dermatology when your treatment has finished.  The nurse will attend to you and Metvix cream will then be wiped off and a dressing may be applied, depending on the size and site of the area treated.

You will need to:

  • Keep the area dry and stay indoors or cover the area, avoiding strong window light, until the following day. If this is not possible, sunscreens, a scarf, hat or a dressing should be sued to cover the treated area for the rest of the day.
  • You may shower and bathe as normal

The area may weep a little and form a crust.  Use a non-scented moisturiser or Vaseline (petroleum jelly) to prevent the area from forming a scab.  If you feel that the area is becoming red, painful or weeping a lot, please contact Pymble Dermatology at 02-80685006

You will be asked to come to a follow-up clinic appointment in three months, to assess the outcome of your treatment.

How many treatments do I need to have?

Sometimes two treatments of natural daylight PDT are needed.  You will be advised by the PDT nurse or dermatology doctor if you need to return for a second treatment.  If you need two treatments you will be given an appointment to return in one week, when the process will be repeated.  Before you return, please continue to use appropriate sun protection (e.g. sunscreens with SPF 30 or above or clothing to cover the areas treated).

Who should I Contact if I have questions?

If you have questions about which treatment is best for you, please speak to your Dermatologist.  Their contact number will be available on the website

If you wish to discuss specific issues about ND-PDT treatment, please call to speak to a PDT nurse.