Practical Issues

Issues Arising During Treatment with Metvix®: Patient Management

  • In 60-80% of patients who use Metvix®, local discomfort is felt at the treatment site during and after light exposure:

Frequency of Reported Side Effects

Very Common, >10% of Patients
  • Burning
  • Stinging, pricking or tingling skin sensation
  • Redness
  • Itching
  • Swelling
Common, >1%, <10% of Patients
  • Crusting
  • Ulceration
  • Blistering
  • Weeping or discharge· Skin Infection
  • Peeling
  • Bleeding
  • Changes to the colour of the skin
Uncommon , 1% of Patients
  • Urticaria
  • Eczema

  • Repeated use of Metvix® does not increase the incidence or intensity of the discomfort and pain.
  • The swelling and the redness experienced by more than 10% of the patients tends to dissipate after 1-2 weeks.
  • The majority of the local adverse reactions that are experienced by the patient are of a mild or moderate intensity.
  • The use of Metvix® in the elderly does not increase the incidence or intensity of the side effects experienced. 

Treatment of Side Effects

Most patients can tolerate treatment discomfort associated with Metvix® without intervention. However, in specific cases the following can be considered:

  • Water can be sprayed on the lesion during the treatment.
  • Pre-treatment paracetamol or aspirin/NSAIDs may be useful for reducing pain or swelling. Aspirin and NSAIDs limit the production of the pain and inflammation mediator, prostaglandin.
  • With Aktilite® , a fan included in the lamp will automatically switch on and cool the skin area being treated. This will reduce or prevent the pain and discomfort that may arise during treatment.
  • If during treatment the discomfort becomes unbearable, the light from the Aktilite® lamp can be paused for a short while. This has rarely been necessary in clinical trials as illumination times are short.
  • A recommended local anaesthetic such as lidocaine cream/spray or any adrenaline-free anaesthetics may be applied after cream application, as oxygen availability is needed for the lesions during the PDT process.
  • As a precaution, ice packs may be used after treatment to minimise swelling and redness.
  • Cooling gels/ sprays could be used to alleviate some of the burning sensations felt after treatment. Sprays and gels that contain up to 0.5% lidocaine as their active ingredient would be best suited for post-treatment healing.
  • After treatment with Metvix® the treated skin is more sensitive, therefore it is advised that all patients avoid direct sunlight for a few days.
  • Patients are advised to be careful with sun exposure on the treated area for at least six weeks. Earlier sun exposure could lead to hyper- or hypopigmentation of the treated area.