Photodynamic therapy is so painful

Phototherapy was often described as a painful therapy in the early stages. In the meantime, the treatment options have been improved to the extent that the pain has given way to a distinct feeling of warmth. If strong complaints should nevertheless occur under the therapy, these can be treated well with painkillers.

In addition, painkillers can be administered in advance at the next therapeutic session. To reduce the feeling of warmth, the skin can also be cooled in between. In addition, the distance to the lamp can be increased so that the intensity is no longer so strong. Current developments also show an advantage of daylight therapy over artificial light, as it causes less pain and a feeling of warmth.

Risks and side effects of photodynamic therapy

As with any medical procedure, side effects may occur. With photodynamic therapy in dermatology, these side effects mainly consist of pain, redness, swelling and crusting of the skin layers of the affected areas, which become detached in the following days. Furthermore, allergic overreactions, wound infections or burn symptoms may occur.

In rare cases, scarring may occur. After photodynamic therapy, in most cases there is a marked swelling and reddening of the irradiated skin. This usually lasts for about one to two weeks.

After photodynamic therapy, the redness is often unpleasant and causes similar symptoms to sunburn. The affected area may therefore experience a burning sensation or pain. However, this reaction of the skin is intentional, as it indicates that the skin is reacting to the photodynamic therapy.

In addition, small crusts may develop. These consist of the cells destroyed by the therapy. Therefore, crust formation is also desired.

The more crusts are formed, the more precursors of the cancer cells are killed. In addition, immediately during or after the treatment an overheating of the treated skin areas can occur.In addition, there is a significantly increased light sensitivity for about 24 to 48 hours, so direct sunlight should be avoided at all costs. Relatively often hyperpigmentation of the treated area can occur after the procedure.

In rare cases, nausea and fever may occur in the first period after an application, but this does not require any further treatment and is decreasing. It should be noted that no skin-irritating and perfumed creams should be applied to the skin in the first days after irradiation. Pain occurs during and especially after the treatment due to irritation of the nerve endings caused by the light irritation.

Not every patient feels pain in the same way and so one third of patients have no pain, one third moderate pain and one third severe pain. Pain during or after treatment also depends on the clinical picture, i.e. the treated underlying dermatological disease. Also in ophthalmology, numerous side effects and risks are associated with photodynamic therapy.

In addition to inflammation of the retina and irritation, which can lead to pain and impaired vision, systematic reactions of the skin of the body caused by drugs that are photosensitive and unintentionally illuminated by daylight must also be considered. Allergic reactions, nausea and fever have also been observed in ophthalmology during photodynamic surgery. If the light-protective measures are not observed, strong side effects can occur, which can also lead to conditions that are dangerous to eyesight.

During the procedure, the patient’s head is fixed so that the laser remains in the desired position. In very rare cases, the laser may slip and reach the area of skin that is not to be treated. This results in damage to healthy tissue, which can be associated with visual impairment and inflammation.

In extreme cases, photodynamic therapy can lead to loss of vision in the affected eye after treatment. For this reason, only one eye is treated per session for safety reasons. Direct sunlight and the resulting sunburn should be avoided after photodynamic therapy. You can find out how best to avoid this situation under How you can prevent sunburn