Having a little work done, thanks to the sun

Over Christmas, I had a photodynamic therapy treatment (Levulan) on my face, as a preventative treatment for skin cancer. I had already had a basal cell cancer removed, and my dermatologist recommended this treatment, because of a proliferation of facial "sun spots" (actinic keratoses or AKs) that kept flaking, especially evident on my nose.

He thought it was a good idea given my age and history. All those years of sunbathing on dorm roofs with those tinfoil reflectors? Hah, not so smart! Though I had converted to sunscreen and shade by my thirties, my misspent youth on beach blankets had caught up with me.

The treatment is administered in an office by his nurse. I'd read accounts, and was prepared. I spent two hours with my face coated with goo, then exposed to hot, UV light. By the time I left, the skin was tender and tight but not painful. Unlike my university days, they didn't blast the Dead on their radio.

I rode the subway home covered like a bank robber, a slit of eye showing between my muffler and hat. A mother checked me out, grabbed her kids and held them close.

By nightfall, my face bloomed into a moderately severe "sunburn", with discomfort well-managed by Advil and vodka. Kidding, but would have been nice.

Post-procedure protocol requires 40 to 48 hours in a dim room to promote the effectiveness. Because the light reveals patches below the surface, you can see where formerly hidden sunspots lurk, rather like an archaeological dig down to decades past. The next morning, I took this shot:

See the tip of my nose? That's where the most obvious damage was, but the treatment also raised welts on my forehead and even ears.

Patients are told to expect redness and peeling for up to a month; nearly all of mine was gone within two weeks. Some women cover it with makeup, but I thought that looked worse.

At three weeks:

There's just the faintest tinge of pink at the tip of my nose, and the flaking, persistent AK is gone. The last step is a forty-night application of Aldara cream.

Some patient testimonials claimed the treatment faded their age spots, but I wasn't that lucky. However, I had it not for aesthetics, but to prevent the two most common forms of non-melanoma skin cancer, basal cell and squamous cell.

AKs are also treated with topical creams, cryosurgery (liquid nitrogen), peels, lasers and other methods; see this list. If you are discovering spots that have AK characteristics, talk to your doctor. Those scaly patches are now considered part of the skin cancer spectrum.

Some persons repeat the therapy, but since it is not covered by insurance, I hope this is the only one I need. Cost in Canadian dollars was $650.

I learned that fair-skinned persons who don't tan easily are more at risk. I wish that, back when I wore a bikini, instead of slathering on more iodine and baby oil and turning over for another hour to Let The Sun Shine In, I'd just resigned myself to being A Whiter Shade of Pale.