WEDNESDAY, July 28 (HealthDay News) -- Pain from treatment of actinic keratoses with photosensitizers varies significantly depending on the location treated, and pain decreases significantly after eight hours, according to research published in the August issue of the Journal of the American Academy of Dermatology.

Patrick Gholam, M.D., of University Heidelberg in Germany, and colleagues conducted a single-center retrospective study of pain intensity occurring after photodynamic therapy of actinic keratoses in 104 patients with 411 treated fields. The patients had actinic keratoses on the face, scalp, or hands. Pain was scored using a visual analog scale immediately and eight hours after the procedure.

The researchers found that pain scores varied depending on the region treated as well as gender, with males having higher pain scores than females. There were no significant differences in pain scores between the two different topical photosensitizers used (methylaminolevulinate and 5-aminolevulinic acid). Mean pain scores were highest for the lips (7.4) and lowest for the hand (2.5), with scores for other areas falling in between (occiput, 3.6; forehead, 5.2; cheeks, 5.9). Pain scores in all regions were significantly decreased eight hours after treatment, from 5.2 to 3.0. In addition, 71 percent of the patients had a good clinical outcome.

"From our experience, we recommend premedication with 800 mg of ibuprofen 30 minutes before irradiation. For the treatment of large areas of severe photodamaged skin or sensitive regions (e.g., lips), nerve blocks can provide marked pain relief. During irradiation, an effective cooling [system] and treatment interruptions have an additional impact on pain reduction," the authors write.

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