Liquid Nitrogen:

• Is a cold freezing spray that is applied in the office
• It causes the spots to become red, swollen and crusted
• The spots will heal within 7 to 14 days
• You can bathe or shower normally
• The treated areas do not need to be covered by bandages

Creams:

• A variety of creams are available
• Please talk to your doctor about your options

Levulan Photodynamic Therapy (ALA PDT):

• This treatment combines a medication called Levulan with either
  • Blue Light or
  • IPL (Intense Pulsed Light) treatments
• Levulan PDT may be used to treat pre-cancerous sun spots, bowen’s disease, disseminated superficial actinic porokeratosis (DSAP), or acne

What are the advantages of Levulan PDT compared with other treatments?:

• Unlike creams it has the advantage of being able to treat large areas in a single visit
• Unlike liquid nitrogen, the treatment is not painful
• It treats precancerous spots before they can be seen
  • Preventing skin cancer from developing

Levulan-IPL Photodynamic Therapy:

• Non-invasive and effective
• Used to treat acne, actinic keratoses (prec-cancerous sun spots), Disseminated Superficial Actinic Porokeratosis (DSAP), bowen’s disease, superficial basal cell carcinomas, as well as sun-damaged skin
• Acts by killing acne causing bacteria, overactive oil glands and premalignant skin cells and precancers

• Almost any area can be treated including:
  • Face and neck
  • Arms and hands
  • Feet and legs
  • Chest and back
  • Scalp

• The Levulan-IPL PDT treatment works with most skin types (I-IV) (from pale Caucasian to dark European and very light Asian)

• Levulan-IPL PDT cannot be used for darker skin types (V, VI) (South Asian, African) or if you have a tan
  • In this situation  I recommend Blue Light PDT instead, which:
    • Can be used in all skin types
    • Can be used even if the skin is tanned
    • To learn more about Blue Light PDT, please click here

• As an added bonus, Levulan PDT also treats:
  • Brown freckling
  • Enlarged pores
  • Sun damage
  • Depleted skin collagen

• All of these lead to smoother, younger looking skin and reduced redness at the same time

• The cost of Levulan PDT is partially covered on most private drug insurance plans
• The cost of Levulan PDT is not covered on the Ontario ODSP (OHIP) drug plan for patients over 65 years of age

• If you would like to learn more about Levulan PDT for the treatment of bowen’s disease, and skin cancer prevention, please click here

Electrodessication and Curettage:

• The skin around the bowen’s disease is injected with a local anesthetic to numb the area
• The injection stings for a few seconds
  • After this, there is no pain or discomfort
• The bowen’s disease is removed from the skin in a scraping motion with an instrument called a curette
• As the area is numb from the anesthetic, this process is not painful
• The curetted area is then treated with electrocautery, a hot electric needle
  • This is not painful as the area is still numb
• Electrocautery stops and bleeding and kills any residual cancer cells
• The lesion is scraped and cauterized a total of 3 times in one visit
• No stitches are required
• Antibiotic and a bandage are used to cover the wound
• The day after surgery, the bandage should be removed and a small amount of antibiotic should be be applied
  • This should occur twice daily site is healed
• Redness, pain, swelling or a discharge from the wound may be a sign of infection
  • The doctor should be informed immediately
• You may bathe, shower and do your normal activities unless the bowen’s disease that has been removed is very large and there is a risk of the wound being damaged
  • The doctor will inform you about this
• There is a small chance that the bowen’s disease could grow back

Surgical Excision:

• The skin around the bowen’s disease is injected with a local anesthetic to numb the area
• The injection stings for a few seconds
  • After this, there is no pain or discomfort
• The bowen’s disease and a small amount of surrounding normal skin is cut with a scalpel and removed
• As the area is numb from the anesthetic, this process is not painful
• Stitches are used to close the opening
• Antibiotic and a bandage are used to cover the wound
• The day after surgery, the bandage should be removed and a small amount of antibiotic should be be applied
  • This should occur twice daily until the stitches are removed
• Redness, pain, swelling or a discharge from the wound may be a sign of infection
  • The doctor should be informed immediately
• The stitches are removed in 5 to 10 days
• The removal of stitches is painless
• You may bathe, shower and do your normal activities unless the bowen’s disease that has been removed is very large and there is a risk of the wound being damaged
  • The doctor will inform you about this
• There is a small chance that the bowen’s disease could grow back

Would you like to see a Video Demonstration?

• I am pleased to offer a new section on the website with video demonstrations of various procedures
• To watch a video-clip in which Dr. V talks about:

• Levulan PDT Treatments, please click here