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ALA-PDT Laser Treatment is a combination of two commonly used specialist dermatologist treatments – photodynamic therapy (PDT) and vascular laser. APL is an effective treatment for sundamaged and aged skin, and can prevent future development of sunspots and skin cancers. By combining these treatments in one session, patients can get the benefit of two skin treatments simultaneously. 


APL is indicated if you have  any of the following: 

Sun damage, history of many sunburns 
previous sunspots (actinic keratoses) or skin cancers (eg. SCC, Bowens Disease, BCC’s) 
large numbers of sunspots that require frequent treatment with liquid nitrogen (freezing) or creams (eg. Efudix, aldara) 
Fair, freckled, scaly, discoloured, tender  skin 
Red patches, broken capillaries 
Flat or raised age spots (seborrheic keratoses or solar lentigines) 


APL allows large areas (eg. Whole face, scalp, hands, forearms) to be comfortably and  rapidly treated in one session with both medical and cosmetic benefits. Traditional treatments eg. Efudix, Aldara can take several weeks to work whilst the skin is very red, often eroded and uncomfortable. 

APL can reduce the number of sunspots that need to be treated in the future, and prevent the development of skin cancers. 

APL simultaneously improves the appearance and texture of sun damaged skin – reducing redness, roughness, pigmentation and improving skin texture. 


A light-sensitive compound, aminolevulinic acid, is applied to suitably prepared skin and allowed to incubate for approximately 3 hours. Following this period a laser light source (Gemini laser) is applied to the skin to activate ALA within the cells, releasing singlet oxygen species.  Sun damaged cells will selectively absorb more ALA and be more vulnerable to APL. During the laser treatment a number of other skin lesions eg. Capillaries, freckles, age spots are also targeted and removed. An LED light source (Aktilite) is used at the end of treatment for a few minutes to ensure that no light –sensitive ALA is present at the end of the procedure. 


Dr Rubel will determine if your skin is suitable for APL and if so, will recommend this procedure during your consultation. One of our specialist Registered Nurses at Woden Dermatology will discuss the procedure with you in detail to ensure that you are familiar with the treatment. It is important to avoid any tanning for two weeks prior to APL. To get the best results, pretreatment with daily sunscreen (containing nicotinamide) and nightly exfoliating acid preparations for at least two weeks is recommended. 


On the treatment day, the skin is gently prepared with either exfoliation or curettage to remove excess flakes and crusts. ALA (lotion) is applied to the skin and left to dry. Patients can leave the clinic while the lotion incubates with the skin (normally 1.5 to 3 hours) or can stay in reception area (Woden Plaza, Movie Theatres and Library are close by).If leaving the surgery a broad-brimmed hat and scarf MUST be worn to minimise light exposure . 

After the incubation time, Gemini Laser is applied to the skin (normally 15 to 20 minutes). This stage is generally well tolerated but can be uncomfortable for some patients. Finally, the LED lamp (Aktilite) is positioned over the treated area for 1 to 4 minutes. Prior to leaving, the skin is cleansed, moisturised and a sunscreen is applied. 


24-48 hours: avoid direct sun exposure as the treated skin is very light-sensitive. The treated area will be red, and may become swollen. Staying indoors is essential during strong sunlight hours. 

3-5 days:  Old, diseased skin will peel, become scabby, and lift off. 

1-2 weeks:  redness fades, skin may feel tight or tender, but heals to reveal smooth, even skin. After one week you will be reviewed at the Clinic to monitor your progress. 

It is important to note that, with all treatments for sundamaged skin, reactions can vary tremendously from person to person. Redness and peeling are signs that the treatment has been successful in removing damaged skin, which can be more extensive than expected. Peeling can continue for many weeks but generally becomes much less noticeable after the first week. Makeup can be worn after peel has commenced, if desired. 

Rare side effects include bacterial or viral infection (eg. Cold Sores – HSV), prolonged redness or peeling, or temporary discoloration eg. Darker or paler patches of skin. Long term side effects of PDT have not been described. 

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