Does anyone use this modality to treat moderate actinic damage? As a dermatologist most of my clients have significant amount of photodamage, looking a combination treatment of photorejuv and a field treatment for solar keratoses without the down time of 5FU... Does anyone mix their own ALA, rather than buying it from galderma? I heard that canada has high grade ALA at a reasonable price.

You need to watch using the compounding pharmacies. I know that multiple compounding pharmacies have been sued by Dusa the manufacturer of Levulan.

I just worry some about it as I know one of the physicians that got burned by the compounded botulinum toxin type A. You do not want to get caught in the middle of 2 companies fighting. Also, I believe that it is currently illegal to import this stuff from Canada but I may be wrong.

I have used the Levulan on many patients. We will do an acetone wash or microderm then apply the ALA and incubate 30 to 60 minutes. We then activate with 420 IPL. I recommend 4 treatments. We have seen nice resuts but you will still need to watch their skin. Be ready some of the patients will have a few days of down time.

When we first started using it we were told it would work well for pigmentation. Do not plan on a lot of pigmentary mprovement but you will see some.

Agreed with LH. Don't use "generic" ALA, and don't try to import it across international borders. It could be serious trouble if you're caught, or have a problem with a patient.

We use the short incubation times (as above) for acne, and long incubation times for AK's. We activate with the Blu-U, but other light sources also work, as long as you're hitting the necessary wavelength.

I also agree w/ LH< I tried locally "compounded" ALA and the results were not the same--there was a response--but dissapointing. "Nothing like the real thing Baby"

thanks for that. I'll stick with the big companies as you guys have suggested. I expected a few days of downtime, but figured if I IPL'd as both an activating source and as a photorejuvinating modality I d be able to achieve both reduction in actinic and age related teles and solar Ks. I guess I ll have to see what results I get incomparison to 5FU for the reduction in solar keratoses. By using Metvix and activation by the aktilite light source we re getting rather poor clearence rates ( poor bang for your buck) compared to Efudix. Will let you guys know of the results over the next few months.

I am derm practising in Toronto. The only source of ALA in Canada is Levulan Kerastik from DUSA. We do not nor would I recommend compounding your own ALA.