Methyl Aminolevulinate (Topical)

Methyl aminolevulinate is a skin cream prescribed by doctors for use on a skin condition known as actinic keratosis that combines with photodynamic light exposure to treat the condition.

Overview

Methyl aminolevulinate topical cream contains 16.8% active ingredients and is sold under the name Metvixia, among others. A prodrug, Methyl aminolevulinate does not become active until it is absorbed into the skin on a cellular level. After it is absorbed, the medication becomes photosensitive, which concentrates the light therapy given to the patient, making it more effective and efficient in treating their condition.

Methyl aminolevulinate topical cream is often prescribed for patients who have a skin condition called actinic keratosis, scaly, rough patches of skin that appear due to sun exposure. Typically found on the back of the hands, face, ears, lips, forearms, neck and scalp, this condition may also be referred to as solar keratosis. The condition slowly spreads and may eventually turn into skin cancer.

While this condition may disappear on its own if the patient limits their exposure to the sun, it often comes back after once again being in the sunlight. Photodynamic therapy is often prescribed to treat the lesions and destroy the skin cells that are damaged. Using Methyl aminolevulinate prior to the photodynamic light treatment causes the patient's skin to absorb more light, making the treatment more efficient.

Conditions Treated

Type Of Medicine

  • Photodynamic sensitizer
  • Skin agent

Side Effects

Patients have reported unwanted symptoms after treating their skin with Methyl aminolevulinate that were severe in nature. If you experience any of the following effects, get in touch with your doctor immediately:

  • Irritated, red skin
  • Scabbing at the application site
  • Skin breakdown
  • Swelling of eyes or skin
  • Pus or discharge at the application site
  • Sores not healing as expected
  • Crusty, blistered, burning, flaking or dry skin
  • Blurry vision
  • Painful, bloodshot, irritated eyes
  • Welts or hives on skin
  • Severe skin redness or itching and scaling
  • Persistent sore that does not heal
  • Growth area that appears pink in color
  • Patches on skin that are irritated or red
  • Vision changes such as flashing or sparking
  • Veiled or curtained vision or spots floating in eyes
  • Skin with shiny bumps
  • Scaly, crusty, oozing rash on skin
  • Wax-like scars, white or yellow in color on skin

Other unwanted symptoms that are not cause for alarm may also occur in some patients. Check with your doctor if you have any darkening of the skin on the application site, should it occur. Report any changes to your overall health or demeanor to your physician right away.

Dosage

Methyl aminolevulinate topical cream will be applied to your skin in a hospital or clinic by a member of the medical staff such as a surgeon, doctor or nurse. You may receive curettage treatment on your affected skin prior to application of this medicine, which is a scraping of your skin. This exposes more of the condition to treatment.

Methyl aminolevulinate should be applied to the skin only and not allowed to get in the mouth, nose or eyes. Alert your physician right away if it gets in any of these areas.

The cream itself is a mixture of oil and water to make a suspension for the powdered medication. The strength is 160 milligrams per gram of cream. The correct amount will be applied to your skin by a medical professional, as determined by the manufacturer's recommendations and your condition. The doctor or nurse will use a medical spatula to apply the cream to the affected area about 1 millimeter thick. The surrounding five to 10 millimeters will also have cream applied and be treated with the light therapy.

The skin will then be covered with a sterile, occlusive dressing for a three hour time period. After this waiting period, the skin will absorb enough of the medication to be effective and the skin will be rinsed with saline. The phototherapy light treatment will begin immediately, with a continuous exposure of 570 to 670 nanometers at the surface of the skin lesions. During light therapy, you and the medical professional administering the treatment will wear eye protection for safety, but there is no danger in exposing your untreated skin to the light. Your treatment will most likely be repeated in one week's time with a follow-up appointment to check your condition in three months.

Interactions

Communicate any sensitivity you have experienced with this medication or others like it in the past to your physician prior to your treatment. You should also let your medical professional know if you have been sensitive to any other skin treatments, preservatives, dyes, perfumes, animals or foods.

There have been no studies performed on the pediatric population that provide adequate data to confirm that this group is safe to be treated with Methyl aminolevulinate nor does this age group typically experience the condition that calls for this treatment. Use in adults under 18 years old is not recommended.

Geriatric patients should be able to use this medication safely and effectively as described, with no limit to the effectiveness or safety due to age-related conditions.

Women who are pregnant or nursing have not been studied with regard to the safety of this treatment on their unborn children or infants. It is best to avoid any treatments such as this when you are pregnant or breastfeeding unless they are clearly needed and your doctor has specifically prescribed the treatment.

Some medications should not be combined due to their adverse reactions to each other. If you are using any other topical medication, it is best to inform your physician of this prior to your treatment. You should also disclose any other prescriptions you take as well as non-prescription medications, vitamin and herbal treatments and holistic therapies for your own safety.

Discuss the consumption of alcoholic beverages, certain types of foods and the use of tobacco products with your physician in case there are known adverse reactions to any of these substances when combined with Methyl aminolevulinate.

If you have the following medical conditions, alert your physician prior to your treatment:

  • Almond or peanut oil allergy
  • Porphyrin allergy
  • Photosensitivity
  • Bleeding issues
  • Skin lesions or cancer unrelated to your condition

Some of these conditions could be triggered or become worse if you have treatment with Methyl aminolevulinate, so be sure to mention your full medical history to your physician for safety reasons.

Warnings

Your physician will want to see you at regular intervals for examination of your condition to make sure the treatments are effective on you and haven't caused you any adverse health effects. Keep all appointments scheduled on time and examine your own skin regularly, reporting any new growths or concerns to your doctor right away.

After your photodynamic therapy treatment, your skin will become light sensitive to not only the sunlight but also to lights used in medical examinations or operating rooms, tanning lamps and beds and any light sources near your skin. Avoid bright lights and sunlight in the treated area for at least 48 hours after your treatment. If you cannot avoid being outdoors or in bright light, protect your skin with clothing layers, hats or other barriers against light. Consult your physician if you have concerns about this condition.

For at least three hours after your photodynamic therapy, do not expose your treated skin to cold temperatures. Cover the affected area with warm clothing in loose layers if you cannot avoid being out in the cold.

Seek emergency medical attention of you experience a hypersensitive reaction to this medication, symptoms of which include redness, burning, stinging or oozing and swelling at the site of the treated skin.

Patients with soy or peanut allergies that include sensitivity to the oil they contain should avoid treatment with this medication, which contains these oils and possibly almond oil. Those diagnosed with basal cell carcinoma and porphyria should also avoid this treatment therapy. Discuss your treatment with your physician if you suffer from these conditions.

Storage

This medication will be administered and stored in a professional medical setting such as a hospital or clinic. The manufacturer recommends that the aluminum tube of medication be refrigerated for storage for no longer than 15 months if kept closed. If opened, the medication should be disposed of safely if not used within 28 days.

Summary

Actinic keratosis is a skin condition that usually occurs in patients over 40 years old as the result of years of unprotected sun exposure. If left untreated, this condition may become skin cancer over time. Treatment with Methyl aminolevulinate on the skin lesions that occur will reduce the chances of them turning into cancer. Patients with this condition often have raised or scaly, red patches of skin on the forearms, face, ears, scalp, neck or lips.

Methyl aminolevulinate is applied to the skin by a doctor or nurse just prior to photodynamic therapy. This cream, once absorbed into the skin, creates a photosensitivity to light that makes the treatment more effective and efficient in eliminating the damaged skin cells. The body can then begin to form new skin cells as a replacement.

Adverse effects may include hypersensitive reactions to the medication or light exposure, which include swelling, redness, itching or oozing at the site of application. These conditions may occur up to three weeks after your treatment and should be reported immediately to your doctor.

Women who are pregnant or nursing, children under 18 years old and patients with light sensitive conditions, skin cancers and allergies to the oils found in almonds, peanuts or porphyrins should avoid taking this medication.

Your skin will be more sensitive to sunlight as well as intense indoor lighting and cold temperatures after your treatment and should be kept loosely covered and warm for at least three days after your treatment.