Photodynamic therapy

A light-based treatment that uses a special cream and a red light (or daylight) to destroy sun-damaged or early skin-cancer cells, mainly on the face and scalp.

✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review

In short

PDT uses a cream plus red light or daylight to destroy surface sun-damage and early skin-cancer cells, often with a good cosmetic result.
It only treats surface problems; thicker or deeper skin cancers need surgery, and a biopsy may be done first to be sure.
The treated skin becomes red, crusted and sore for one to two weeks afterwards, and conventional PDT can be painful during the light.
Lesions can recur, so follow-up checks matter, and you will still need lifelong sun protection and skin monitoring.

A plain-English summary. The detail — including risks and recovery — is below.

At a glance

TypeLight-based skin treatment

AnaestheticUsually none; cooling or local anaesthetic if needed

How long it takesAbout 3 hours including cream wait time; light exposure 8–15 minutes (or 2 hours' daylight)

Hospital stayOutpatient

Time off workUsually none, but the treated skin will be sore and crusted for a few days

When you'll see resultsHealing over 2–6 weeks; effectiveness reviewed at follow-up

On the NHS?Available on the NHS for suitable skin lesions

A general guide. Your specialist will give you advice for your situation.

Best fit

Can clear surface sun-damage and early skin-cancer lesions without surgery

Pause if

Thicker, nodular or deeper skin cancers, which need surgery rather than PDT.

Main recovery point

The area is kept covered and protected from light. It will be red, swollen and sore. Avoid sun and bright light on the treated skin.

Good aftercare

A confirmed diagnosis and clear plan before treatment, including any biopsy.

First 48 hours

The area is kept covered and protected from light. It will be red, swollen and sore. Avoid sun and bright light on...

First week

The treated area crusts and may weep a little, then begins to heal. Keep it clean and follow any dressing advice...

Weeks 2–6

The crust separates and new skin appears underneath, often pink at first. Any second treatment is usually given...

Follow-up

A review checks whether the lesion has cleared. Some lesions need a repeat course or a switch to surgery if they...

Medical line illustration of skin layer cross section for Photodynamic therapy. — Illustration only - not a diagnosis, medical advice or a promise of result. Your anatomy and treatment plan may differ. Vuemedics does not publish before-and-after photos.

What is photodynamic therapy?

Photodynamic therapy (PDT) is a treatment that combines a light-sensitising cream with a light source to destroy abnormal skin cells. The cream is absorbed into the abnormal cells over a few hours, and when a special red light (or natural daylight) is shone on the area, it triggers a reaction that damages those cells while largely sparing healthy skin.

It is mainly used for sun-damage and early skin-cancer conditions: actinic keratoses (rough, scaly patches from sun damage), Bowen's disease (a very early skin cancer confined to the surface) and superficial basal cell carcinoma (a slow-growing skin cancer that has not gone deep). It is most useful for surface problems over larger or awkward areas, such as the face and scalp, where it can give a good cosmetic result.

PDT is not suitable for thicker or deeper skin cancers, which usually need surgery. It does not treat the underlying sun damage in the rest of your skin, so new lesions can still appear, and treated lesions can sometimes come back and need repeating.

It can be uncomfortable during the light exposure, and the treated skin reacts afterwards, becoming red, crusted and sore for a week or two before healing.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Conventional (red light) PDT

Cream is applied and left for about 3 hours, then a red lamp is shone on the area for 8–15 minutes. Effective but can be painful during the light.

Daylight PDT

Cream is applied, sunscreen first, then you sit outdoors for about 2 hours in daylight. Used mainly for actinic keratoses; far less painful but needs suitable weather.

Single vs repeated treatment

Actinic keratoses often need one treatment; Bowen's disease and superficial basal cell carcinoma usually need two treatments about a week apart.

PDT for other conditions

Occasionally used for acne or persistent viral warts when standard treatments have failed, though this is less common.

Conventional PDT vs daylight PDT

	Conventional (red light)	Daylight
Light source	Hospital red lamp	Natural daylight outdoors
Pain	Can be painful	Usually much less painful
Mainly used for	AK, Bowen's, superficial BCC	Actinic keratoses
Weather	Not affected	Needs mild, dry conditions

Your clinician will advise which is suitable for your lesion type, location and the time of year.

Preparing for your treatment

Make sure the diagnosis is clear: a biopsy may be done first to confirm the lesion is suitable for PDT rather than surgery.
Tell the team about any condition or medicine that makes you very sensitive to light.
Expect the treated skin to be sore and crusted for a week or two, so plan around any social or work events.
For daylight PDT, check the weather plan, as it needs mild, dry conditions.
Arrange how you will manage discomfort and dressings in the days afterwards.
Ask whether you will need one treatment or two sessions about a week apart.

What happens

First, the skin lesion is gently cleaned and any surface crust or scale is removed so the cream can absorb. The light-sensitising cream is then applied to the lesion and a small margin around it, and covered with a dressing.

For conventional PDT, you wait around 3 hours for the cream to be taken up by the abnormal cells, then return so a red light can be shone on the area for about 8 to 15 minutes. During the light, the area can sting, burn or feel hot; cooling with a fan, cold water spray or, if needed, local anaesthetic can help. For daylight PDT, sunscreen is applied, the cream is put on, and you sit outdoors in daylight for about 2 hours instead.

Afterwards the area is usually covered to protect it from light for a day or two. For Bowen's disease and superficial basal cell carcinoma you usually return for a second treatment about a week later. A follow-up appointment checks healing and whether the lesion has cleared.

Is this treatment right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

May not be suitable if…

Thicker, nodular or deeper skin cancers, which need surgery rather than PDT.
Lesions where the diagnosis is uncertain and a deeper or more serious cancer cannot be excluded.
People with conditions or medicines that cause marked light sensitivity.
Pigmented lesions or suspected melanoma, which must not be treated with PDT.

Delay or rearrange if…

A confirming biopsy is needed but has not yet been done.
The skin in the area is infected or broken and needs settling first.
You are taking a medicine that markedly increases light sensitivity until reviewed.
For daylight PDT, the weather is unsuitable.

Alternatives to discuss

Surgery (excision or curettage) for deeper lesions or the most durable clearance.
Cryotherapy (freezing) for small actinic keratoses or Bowen's disease.
Topical creams such as imiquimod or 5-fluorouracil for field sun damage.
Active monitoring for very low-risk lesions in some situations.
Radiotherapy in selected cases where surgery is not suitable.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

What matters most to me?

Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.

What are all my options?

Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.

What would make me pause?

Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.

What happens if I do nothing today?

For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.

Comfort, sedation or contrast choices

If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.

No anaesthetic with cooling

Most PDT is done without injections; a fan or cold water spray helps with the stinging during the light.

Local anaesthetic

May be offered if the area is painful during conventional red-light PDT.

Benefits

Can clear surface sun-damage and early skin-cancer lesions without surgery
Often gives a good cosmetic result, useful on the face and scalp
Can treat larger or multiple areas of sun damage in one session
Avoids stitches and a surgical scar where it is suitable
Spares much of the surrounding healthy skin

Risks & complications

More common

Stinging, burning or pain during and shortly after the light
Redness, swelling and crusting of the treated area for one to two weeks
The treated skin feeling sore or tender as it heals
Temporary darkening or lightening of the skin afterwards

Less common

Blistering or a more intense skin reaction
Skin infection in the treated area
The lesion not fully clearing, needing repeat treatment or surgery
Temporary changes to hair in the treated area

Rare but serious

Lasting colour change or mild scarring
Severe pain needing the session to be paused
A more serious or deeper skin cancer being missed if the diagnosis was not confirmed first

The two biggest issues with PDT are pain during conventional treatment and the chance that a lesion does not fully clear or comes back. PDT only works on surface lesions, so the diagnosis must be right: a thicker or deeper skin cancer treated as if it were superficial could be undertreated. Ask whether a biopsy is needed first, how likely your lesion is to clear, and what the plan is if it does not. You will still need lifelong sun protection and skin checks, because PDT does not stop new sun-damage lesions forming.

Published figures to discuss

How likely PDT is to clear a lesion, and how likely it is to recur, depends heavily on the type of lesion, its thickness, its site and how it is treated. Published clearance and recurrence figures come from selected studies and vary between them, so they should be read as a guide rather than a promise. The most important uncertainty is whether the lesion is truly superficial, which is why an accurate diagnosis matters.

Figure	Reported range	How to interpret it	Source / confidence
Actinic keratosis clearance	Often high initial clearance, with recurrence reported around the high single figures to low teens over 12 months in trials	Varies with cream, light source and number of treatments; daylight and conventional PDT differ.	Guide sourcesClinical context
Bowen's disease clearance	Pooled clearance reported around three-quarters of lesions, lower after accounting for later recurrences	From systematic-review data; recurrence means follow-up is important and some lesions need surgery.	Guide sourcesClinical context
Pain or burning during illumination	Common with conventional PDT; often milder with daylight PDT	Cooling, pauses, analgesia and choosing the right PDT protocol can make the treatment more tolerable.	Guide sourcesClinical context
Redness, crusting and photosensitivity after treatment	Common and usually temporary	Patients need clear light-avoidance and wound-care instructions; persistent ulceration or infection should be reviewed.	PDT for Bowen's disease: efficacy and outcomes review — PMCncbi.nlm.nih.govSource-linked context

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

There is no deep wound to heal, but the treated skin reacts strongly: it becomes red, crusted and sore for a week or two before settling, and it stays sensitive to light for a couple of days.

First 48 hours

The area is kept covered and protected from light. It will be red, swollen and sore. Avoid sun and bright light on the treated skin.

First week

The treated area crusts and may weep a little, then begins to heal. Keep it clean and follow any dressing advice. Discomfort eases over a few days.

Weeks 2–6

The crust separates and new skin appears underneath, often pink at first. Any second treatment is usually given about a week after the first.

Follow-up

A review checks whether the lesion has cleared. Some lesions need a repeat course or a switch to surgery if they have not fully responded.

What's normal — and not a worry

Redness, swelling and crusting of the treated area
Soreness for the first few days that gradually settles
Weeping or oozing from the area before it crusts over
Temporary colour change of the healing skin
New pink skin that slowly fades to match

Aftercare

Keep the treated area covered and out of direct light for the first day or two as advised.
Use any prescribed cream or dressing and keep the area clean.
Take simple pain relief if the area is sore, following the packet instructions.
Protect the healing skin and surrounding area from the sun with high-factor sunscreen, clothing and shade.
Avoid picking the crusts, which can increase the chance of scarring or infection.
Attend any second treatment and the follow-up appointment.
Continue lifelong sun protection and check your skin for new or changing lesions.

Before your treatment

Diagnosis confirmed and biopsy done if advised
Clear on whether one or two sessions are planned
Dressings and any prescribed cream ready at home
Simple pain relief available
High-factor sunscreen and a hat to hand
Follow-up appointment booked
Clinic contact details saved in case of infection

Scars and how they heal

PDT usually heals well and often gives a better cosmetic result than surgery, with scarring uncommon and generally mild. The treated area goes through redness and crusting before new skin forms, and there may be a temporary or, less often, lasting change in skin colour. Picking crusts or infection raises the small chance of scarring, so keeping the area protected and clean helps.

⚠ Get urgent help if…

Spreading redness, heat, swelling or pus suggesting infection
Pain that is severe or getting worse rather than settling
A high temperature or feeling generally unwell after treatment
Heavy bleeding from the treated area
The lesion not healing, growing back, or a sore that does not heal
Any new, changing or unusual skin lesion elsewhere

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

A good result is a treated area that heals cleanly with the lesion cleared and a good cosmetic appearance. PDT clears many surface sun-damage and early skin-cancer lesions, though success depends on the lesion type, thickness and site, and not every lesion clears with one course.

PDT cannot guarantee a lesion is gone for good, and it does not treat the wider sun damage in your skin, so new lesions can appear and treated ones can sometimes return. This is why follow-up checks and ongoing sun protection matter, and why some lesions ultimately need surgery.

How long it lasts

Many treated lesions stay clear, but recurrence does happen and varies with the condition: published series report a meaningful minority of actinic keratoses, Bowen's disease and superficial basal cell carcinomas returning over the following year or two. Surgery tends to give the most durable clearance for skin cancers, while PDT trades some of that durability for a better cosmetic result and no cutting. Lifelong skin monitoring is advised because sun-damaged skin keeps producing new lesions.

Related tests, treatments or support

PDT is sometimes used alongside other field treatments for sun damage, such as creams (for example imiquimod or 5-fluorouracil) for actinic keratoses, or after cryotherapy. The choice between PDT, freezing, creams, curettage and surgery depends on the lesion and is best discussed with your dermatologist.

Follow-up & long-term care

You will usually be reviewed a few weeks to months after treatment to check the lesion has cleared and the skin has healed. Bowen's disease and superficial basal cell carcinoma are skin cancers, so follow-up and skin surveillance are important, and any lesion that has not fully responded may be re-treated or removed surgically. Report any non-healing or recurrent sore promptly.

Lifelong daily sun protection on sun-exposed skin
Regular skin self-checks for new, changing or non-healing lesions
Attending follow-up and surveillance appointments, especially after skin-cancer lesions
Treating new sun-damage lesions early as they appear

Repeat, follow-on and what comes next

Bowen's disease and superficial basal cell carcinoma usually need two PDT sessions, not one.
Lesions that do not fully clear may be re-treated or removed surgically.
New sun-damage lesions commonly appear over time and may need further treatment.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

A confirmed diagnosis and clear plan before treatment, including any biopsy.
Written aftercare for the sore, crusting area and a named contact for infection.
A follow-up review to confirm the lesion has cleared.
Skin-cancer surveillance for Bowen's disease and basal cell carcinoma.
Strong, repeated advice on lifelong sun protection and self-examination.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

Whether one treatment or two sessions are needed
Conventional red-light PDT versus daylight PDT
Any biopsy needed beforehand to confirm the diagnosis
The size, number and site of the lesions treated
The photosensitising cream used
Follow-up appointments and skin surveillance

Make sure your written quote includes

The number of sessions included and the cost of any repeat
Whether a confirming biopsy and its reporting are included
The cream and light treatment fees
Follow-up review to check the lesion has cleared
What happens, and the cost, if the lesion does not respond and needs surgery
Who to contact if the treated area becomes infected

On the NHS? PDT is available on the NHS for suitable sun-damage and early skin-cancer lesions; private care may be used for faster access, but the lesion still needs to be appropriate for this treatment rather than surgery.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Choosing a specialist safely

Check the specialist is on the GMC Specialist Register for this area.
Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Questions to ask your medical professional

Take this to your consultation. A good specialist will welcome every one of these.

Has my lesion been confirmed as suitable for PDT, or do I need a biopsy first?
Will I need conventional red-light PDT or daylight PDT, and one session or two?
How likely is my lesion to clear, and what happens if it does not?
How should I manage the pain and the healing skin afterwards?
How will you follow this up and check it has not come back?
What sun protection and skin checks do I need from now on?
Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
Will you be the specialist who carries out my treatment, and who looks after me afterwards?
What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
What does a realistic result look like — and what can this treatment not achieve?
What are my options, including waiting, doing nothing for now, or choosing a different approach?
Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Frequently asked questions

Does photodynamic therapy hurt?

Conventional red-light PDT can sting or burn during the light exposure, and the area is sore afterwards; cooling or local anaesthetic can help. Daylight PDT is usually much less painful.

What conditions is PDT used for?

Mainly surface sun-damage and early skin-cancer lesions: actinic keratoses, Bowen's disease and superficial basal cell carcinoma. It is not suitable for thicker or deeper skin cancers, which need surgery.

How long does the skin take to heal?

The treated area is red, crusted and sore for one to two weeks, then heals with new skin that may stay pink for a while. Most people carry on with normal activities during this time.

Will the lesion definitely be gone?

PDT clears many lesions but cannot guarantee it, and some come back. This is why follow-up checks matter and why some lesions ultimately need surgery.

Will I be scarred?

Scarring is uncommon and usually mild, and PDT often gives a better cosmetic result than surgery. Keeping the area protected, clean and crust-free helps reduce this risk.

Is PDT available on the NHS?

Yes, PDT is available on the NHS for suitable lesions. Private treatment may be used for speed or convenience, but the lesion still needs to be appropriate for PDT.

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NHS — Photodynamic therapy (PDT) British Association of Dermatologists — Photodynamic therapy (patient information) Cancer Research UK — PDT for non-melanoma skin cancer PDT for Bowen's disease: efficacy and outcomes review — PMC Long-term follow-up of PDT for actinic keratosis (phase III trials) — PMC

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.