What it is

→ Daylight photodynamic therapy (daylight PDT) is a modern, less painful form of photodynamic therapy used primarily for actinic keratoses (precancerous sun-damaged lesions) and widespread actinic damage.

→ Instead of activating the photosensitizing cream with artificial blue or red light in a clinic, natural daylight is used as the activating light source.

→ A topical photosensitizer (commonly methyl aminolevulinate or aminolevulinic acid) is applied to the skin, and the patient then spends time outdoors under daylight conditions.

→ The advantage is that light exposure is continuous and lower in intensity, which reduces pain and irritation compared to conventional PDT while still effectively clearing lesions.

Why it’s done

→ Daylight PDT is done to:

• Treat multiple actinic keratoses across large sun-exposed areas like the face, scalp, or arms.
• Provide a field therapy option that treats both visible and hidden lesions.
• Reduce pain and discomfort, since daylight PDT is better tolerated than traditional PDT.
• Improve skin texture, tone, and appearance while also lowering skin cancer risk.
• Offer a practical, time-efficient solution, as patients can walk outside instead of sitting under clinical lights.

→ It is particularly recommended for patients with widespread actinic damage, fair skin, or a history of extensive sun exposure.

Alternatives

→ Alternatives to daylight PDT include:

• Conventional PDT → clinic-based with red or blue light activation.
• Topical treatments → 5-FU, imiquimod, diclofenac gel, or retinoids.
• Cryotherapy → freezing lesions individually with liquid nitrogen.
• Laser resurfacing or chemical peels → improving cosmetic appearance while reducing precancerous lesions.
• Surgical excision → reserved for confirmed skin cancers, not broad actinic damage.

→ Daylight PDT is chosen when patients want less pain, good cosmetic outcomes, and efficient treatment of large skin areas.

Preparation

→ Preparing for daylight PDT involves:

• Dermatology consultation → confirm diagnosis of actinic keratoses and suitability for daylight treatment.
• Avoid tanning or sunburn → skin must not be recently burned before the session.
• Clean skin → no makeup, sunscreen, or creams on the treatment day.
• Keratolytic preparation → dermatologists may use a mild peel, microdermabrasion, or curettage before applying the photosensitizer to enhance penetration.
• Weather planning → daylight PDT requires sufficient outdoor daylight, so treatment is scheduled when weather conditions allow (not heavy rain or extreme cold).
• Protect non-treatment areas → sunscreen may be applied to areas not undergoing PDT.

How it’s Done

→ A typical daylight PDT session includes:

• Application of photosensitizer → cream applied evenly across the treatment area (face, scalp, or arms).
• Waiting period → after 30 minutes indoors, patients go outside to begin daylight exposure.
• Daylight activation → patient spends about 2 hours outdoors in normal daylight conditions. Even on cloudy days, daylight is sufficient for activation.
• Completion → after exposure, the cream is gently removed, and soothing ointments are applied.
• Follow-up → dermatologist reviews healing and lesion clearance after 1–2 weeks.

→ The procedure is simple and less intimidating since no bright lamps are used.

Recovery

→ Recovery from daylight PDT is quicker and milder than conventional PDT:

• Day 1–3 → mild redness and irritation similar to light sunburn.
• Day 3–7 → scaling, flaking, or peeling as lesions heal.
• Day 7–14 → skin clears, smoother and more even in tone.

→ Patients should:

• Avoid direct intense sunlight immediately after treatment.
• Apply gentle moisturizers and healing ointments.
• Use broad-spectrum sunscreen daily to prevent new sun damage.

→ Most people resume normal activities the same day, with complete healing in 1–2 weeks.

Complications

→ Daylight PDT is generally safe, but possible effects include:

• Redness and peeling during recovery.
• Mild burning or stinging, less than conventional PDT.
• Temporary pigmentation changes (lighter or darker spots).
• Photosensitivity reaction if patients get too much sun exposure immediately after treatment.

→ Serious complications such as infection or scarring are extremely rare.

Treatment options in Korea

→ Korea offers state-of-the-art daylight PDT programs, especially in dermatology hospitals and specialized clinics.

• Advanced protocols → Korean dermatologists use the latest photosensitizers with precise application methods for maximum safety and results.
• Integration with other therapies → daylight PDT is often combined with topical treatments or light chemical peels for enhanced outcomes.
• Cosmetic focus → Korean clinics emphasize both medical clearance of lesions and aesthetic skin rejuvenation.
• Preventive culture → patients are educated on daily sun protection and lifestyle habits to minimize further actinic damage.
• Accessibility → major centers in Seoul, Busan, and Daegu provide daylight PDT for both locals and international patients.
• AI skin imaging → some Korean hospitals use advanced imaging to track lesion clearance and sun damage reversal.
• Medical tourism → daylight PDT is popular among international patients seeking minimally painful, highly effective actinic keratosis treatment.

→ With Korea’s focus on innovation, cosmetic integration, and patient comfort, daylight PDT is a leading option for reversing sun damage and preventing skin cancers.