Table 4.

Protocol for daylight photodynamic therapy (daylight PDT) with methyl aminolevulinate (MAL) in patients with actinic keratoses (AK) of the face or scalp

Variable	Recommendation
Patient population	Patients with grades I and II AK on the face and scalp
Treatment period	Any time of the year within office hours, ensuring sufficient time is available for 2 h of daylight exposure following the application of MAL cream
Weather conditions	All weather conditions except rain; dependent on the toleration of patients to heat, cold, and humidity
Treatment modality	Prepare treatment area (wash affected area, apply a chemical sunscreen to the treatment area and to all sun‐exposed areas of the skin before or after skin preparation, and remove any scales or scabs). Apply a thin layer of MAL to treatment areas, without occlusion. Begin daylight exposure within a maximum of 30 min of applying MAL cream, patients to receive a total of 2 h of outdoor daylight exposure. Wash off any residual MAL cream after daylight exposure, patients to be instructed to use a sunscreen at the end of daylight exposure and continue to protect the treated areas from the sun with clothing and sunscreen until sundown, and hydrate treatment area with a moisturiser for up to one week following treatment.
Follow up	According to usual clinical practice; treated lesions should be evaluated after 3 months and, if necessary, a second treatment session should be given.