What recommendations or protocol do you have in reducing pain when using levulan with blue light for field therapy to treat AKs?

Applying the blue light directly after the application of Levulan without an incubation period practically eliminates all of the discomfort associated with this type of field therapy for actinic keratoses.

You may choose to double the usual exposure time to 34 minutes, but this is not necessary.

There are machines that give a cooling spray, and I have given the patient the hose to put the cooling spray where the discomfort is. This has given good relief.