“Do I Still Need Treatment If My Pre-Cancer Spots Look Better After PDT?”
By: Dr. Ashley Baldree
At Village Dermatology in Katy, Texas and Houston, Texas, many patients return after treatment for precancerous skin lesions wondering what comes next. A 63-year-old male patient recently came in for a follow-up visit after undergoing photodynamic therapy (PDT) for actinic keratoses on the face.
At his appointment, he asked a very common and important question:
“Do I still need treatment if my pre-cancer spots look better after PDT?”
Follow-Up After Photodynamic Therapy (PDT)
This patient had previously been treated with red light photodynamic therapy, a highly effective treatment for actinic keratoses (AKs).
During his follow-up visit:
There was significant improvement
Previously visible lesions had markedly reduced
The patient reported no complications from treatment
Because of this excellent response, no additional treatment was needed at this time, and the plan was to continue routine monitoring.
What Are Actinic Keratoses?
Actinic keratoses are precancerous skin lesions that develop due to long-term sun exposure.
They typically appear as:
Rough, scaly patches
Red or pink spots
Areas that may feel like sandpaper
AKs are important to treat because a small percentage can progress to:
Squamous Cell Carcinoma (SCC)
Early treatment and follow-up significantly reduce this risk.
Do You Need Treatment After PDT?
Even when lesions improve or disappear, ongoing monitoring is essential.
Why?
New AKs can develop over time
Sun damage is cumulative
Some lesions may recur
If no active lesions are present, dermatologists often recommend:
Observation
Routine skin exams
Sun protection
Treatment is only restarted if new lesions appear.
How to Prevent Actinic Keratoses from Returning
Patients were counseled on the importance of sun protection:
Daily Prevention Tips
Use broad-spectrum sunscreen SPF 30+ every day
Wear sun-protective clothing and hats
Avoid peak sun hours when possible
Reapply sunscreen every 2 hours outdoors
Consistent sun protection is the most effective way to prevent recurrence.
Additional Diagnosis: Rosacea
During the visit, the patient was also noted to have rosacea, a chronic inflammatory skin condition.
Symptoms included:
Redness
Acne-like bumps (papules and pustules)
Facial sensitivity
Treatment Plan for Rosacea
To help manage rosacea, the patient was started on:
Oral Doxycycline 20 mg
Taken twice daily with food
Helps reduce inflammation and breakouts
Topical Triple Cream
Applied nightly to the face
Helps control redness and lesions
Rosacea Triggers to Avoid
Patients were advised that rosacea can flare with:
Sun exposure
Heat
Spicy foods
Alcohol
Stress
Wind
Avoiding triggers can significantly reduce flare-ups.
When to Follow Up
The patient was scheduled to return in 3 months to reassess both:
Patients should return sooner if they notice:
New rough or scaly spots
Persistent redness or worsening bumps
Painful or non-healing lesions
Dermatology Care in Katy and Houston, Texas
At Village Dermatology, we specialize in:
Actinic keratosis treatment
Photodynamic therapy (PDT)
Rosacea management
Skin cancer prevention
Comprehensive skin exams
If you have sun-damaged skin, rough spots, or facial redness, our dermatology team can help you maintain healthy skin.
