Dr. Alai is an actively practicing medical and surgical dermatologist in south Orange County, California. She has been a professor of dermatology and family medicine at the University of California, Irvine since 2000. She is U.S. board-certified in dermatology, a 10-year-certified fellow of the American Academy of Dermatology, and Fellow of the American Society of Mohs Surgery.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
How do I take care of my treatment area after photodynamic therapy?
It is
generally required to check with your doctor for their specific wound care
instructions before your procedure. Often, you will be asked to go home and stay
indoors for the rest of the day. Your physician will usually give you more
detailed instructions depending on the area and size of the procedure.
Many
physicians suggest you shower and wash the area immediately and as often as you
would like. Wound care may require gently washing the area with soap and water
or hydrogen peroxide two to three times a day and applying an over-the-counter antibiotic
ointment or a nonirritating moisturizer like Purpose, Cetaphil, or Aquaphor to
the area. Avoidance of harsh or abrasive cleansers is advised. Picking or
scrubbing the skin could cause in severe irritation or scarring.
Most patients are advised to try to avoid applying makeup or powder directly on
a fresh or open wound unless the surface is fully healed. A nonirritating
sunscreen such as zinc or titanium may be applied immediately after the
procedure before leaving the physician's office. Sunscreens are ideally also
applied twice a day after PDT. It is important to follow your own physician's
instructions for wound care.
Mild to
moderate redness and or swelling is not uncommon the first day or two after PDT
and can be lessened by application of an ice bag, ice cubes or chips in a small
Ziploc bag, or frozen peas in their bag. Applying cool packs or ice every five
to 15 minutes every hour for the first eight to 24 hours after your procedure may
be very soothing. Swelling may be more common for procedures around the eyes or
lips. Sleeping propped up on a few pillows or in a reclining chair may help
decrease swelling after treatment of the head and face area.
Your physician should be notified of any infections, cold-sore outbreaks,
extreme swelling, or other unexpected reactions. Rarely, a visit to the
physician's office may be necessary for severe swelling or infection. Oral
antibiotics, cortisone creams or tablets, or other medications may be required
for adverse reactions.
Your physician will need to know if pain is increasing after one to two days after
your procedure or if you are having fever or other concerning symptoms. In such
cases, you may need to be seen at the physician's office.
Lung cancer kills more men and women than any other form of cancer. Eight out of 10 lung cancers are due
to tobacco smoke. Lung cancers are classified as either small cell or non-small
cell cancers.
Psoriasis is a long-term skin condition that may cause large plaques of red, raised skin, flakes of dry skin, and skin scales. There are several types of psoriasis, including psoriasis vulgaris, guttate psoriasis, inverse psoriasis, and pustular psoriasis. Symptoms vary depending on the type of psoriasis the patient has. Treatment of psoriasis may include creams, lotions, oral medications, injections and infusions of biologics, and light therapy. There is no cure for psoriasis.
Acne is a localized skin inflammation as a result of overactivity of oil glands at the
base of hair follicles. This inflammation, depending on its location, can take the form
of a superficial pustule (contains pus), a pimple, a deeper cyst, congested pores, whiteheads, or blackheads. Treatments vary depending on the severity of the acne.
Skin cancer is the most common form of cancer
in humans. There are three main types of skin cancer; basal cell carcinoma and
squamous cell carcinoma (the nonmelanoma skin cancers), and melanoma.
Common warts are skin growths causes by the human papillomavirus. There are many types of warts, including plantar warts, common hand warts, warts under the nails, mosaic wars, and flat warts. Over-the-counter treatments typically involve the use of salicylic acid products.
Rosacea is a skin disease that causes redness of the forehead, chin, and lower half of the nose. In addition to inflammation of the facial skin, symptoms include dilation of the blood vessels and pimples (acne rosacea) in the middle third of the face. Oral and topical antibiotics are treatments for rosacea. If left untreated, rhinophyma (a disfiguring nose condition) may result.
Esophageal cancer is a disease in which malignant cells form in the esophagus. Risk factors of cancer of the esophagus include smoking, heavy alcohol use, Barrett's esophagus, being male and being over age 60. Severe weight loss, vomiting, hoarseness, coughing up blood, painful swallowing, and pain in the throat or back are symptoms. Treatment depends upon the size, location and staging of the cancer and the health of the patient.
Alcoholism is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law.
A keloid is a scar that doesn't know when to stop. When the cells keep on reproducing, the result is an overgrown (hypertrophic) scar or a keloid. A keloid looks shiny and is often dome-shaped, ranging in color from slightly pink to red. It feels hard and thick and is always raised above the surrounding skin.
Cancer is a disease caused by an abnormal growth of cells, also called malignancy. It is a group of 100 different diseases, and is not contagious. Cancer can be treated through chemotherapy, a treatment of drugs that destroy cancer cells.
Keratosis pilaris (KP) is a common skin disorder in which small white or red bumps appear around hair follicles on the upper arms, thighs, buttocks, and cheeks. The cause of KP is unknown. There is no cure for keratosis pilaris, and the condition may resolve on its own. Gentle exfoliation, professional manual extraction, chemical peels, and microdermabrasion, along with topical products, are the best treatments for this condition.
Actinic keratoses are rough, scaly patches of skin that are considered precancerous and are due to sun exposure. Prevention is to cut sun exposure and wear sunscreen.
Barrett's esophagus occurs as a complication of chronic gastroesophageal reflux disease (GERD), primarily in white males. GERD refers to the reflux of acidic fluid from the stomach into the esophagus (the swallowing tube), and is classically associated with heartburn.
Smoking is an addiction. More than 430,000 deaths occur each year in the U.S. from smoking related illnesses. Secondhand smoke or "passive smoke" also harm family members, coworkers, and others around smokers. There are a number of techniques available to assist people who want to quit smoking.
Scar formation is a natural part of the healing process after injury. The depth and size of the wound incision and the location of the injury impact the scar's characteristics, but your age, heredity and even sex or ethnicity will affect how your skin reacts.
Age-related macular degeneration (AMD) is a disease that gradually destroys the central vision. In people over 60, AMD is a leading cause of vision loss. Wet AMD occurs when abnormal blood vessels behind the retina start to grow under the macula, leaking blood and fluid and causing rapid vision loss. In dry AMD, light-sensitive cells slowly break down in the macula, resulting in gradual vision loss. Pain is not associated with either form of AMD.
Wrinkles, whether they be fine line or deep furrows, typically appear on areas of the body that receive a high amount of exposure to the sun. Smoking, light skin type, hairstyle, the way you dress, your occupational and recreational habits, and heredity are all factors that promote wrinkling. Medical treatments for wrinkles include antioxidants, moisturizers, alpha-hydroxy acids, and vitamin A acid. Cosmetic procedures that treat wrinkles include dermabrasion, microdermabrasion, glycolic acid peels, laser resurfacing, Botox, and fillers.
Sunscreens are crucial for sun protection. Sun damage to the skin from exposure to ultraviolet rays is a risk factor for skin cancer and melanoma. To avoid sunburn, people should limit sun exposure during the peak hours of 10 a.m. to 3 p.m., wear protective clothing, and use a sunscreen. People with sensitive skin should use a sunscreen with an SPF of 30 or more.