ABSTRACT
Current therapies for sebaceous hyperplasia (SH) have a high risk for adverse effects and recurrence of treated lesions. The theoretic basis for the treatment of SH by photodynamic therapy (PDT) with 5-aminolevulinic acid (ALA) has been established. Studies show that 1 hour is sufficient ALA incubation time to achieve clearance, and ALA-induced protoporphyrin IX may be activated with a 585-nm pulsed dye laser device, blue light source, or an intense pulsed light device. Complete clearance may be achieved with one to six treatments; however, long-term recurrence rates are not established. ALA PDT is a safe and effective modality for the treatment of SH lesions of all sizes.
Subject(s)
Aminolevulinic Acid/therapeutic use , Facial Dermatoses/drug therapy , Photochemotherapy , Photosensitizing Agents/therapeutic use , Sebaceous Gland Diseases/drug therapy , Humans , HyperplasiaSubject(s)
Acne Vulgaris/drug therapy , Aminolevulinic Acid/therapeutic use , Keratosis/drug therapy , Photochemotherapy/methods , Photosensitizing Agents/therapeutic use , Aminolevulinic Acid/adverse effects , Attitude to Health , Humans , Photochemotherapy/economics , Photochemotherapy/trends , Photosensitizing Agents/adverse effectsABSTRACT
BACKGROUND: Treatment of perioral dermatitis (POD) consists of topical steroids, oral antibiotics, and topical antibiotics. OBJECTIVE: To evaluate the safety and efficacy of photodynamic therapy (PDT) with topical 5-aminolevulinic acid (ALA) in the treatment of POD. METHODS: A split-face 21-patient study was conducted in which one side of the face was treated 4 times weekly with ALA PDT (30-minute ALA incubation) with blue light activation and the other side with topical clindamycin. Lesions were counted and photographs were taken before and after the final treatment. Patient satisfaction was also evaluated. RESULTS: Fourteen patients (66.7%) completed the study. Facial sides treated with ALA PDT achieved a mean clearance of 92.1% compared to 80.9% for the clindamycin-treated sides. The difference was significant (P=0.0227). The mean patient satisfaction level for the ALA PDT-treated side was 4.4 (1-5 scale). CONCLUSION: ALA PDT may be a promising alternative to antibiotics for the treatment of POD.
Subject(s)
Aminolevulinic Acid/therapeutic use , Dermatitis, Perioral/drug therapy , Photochemotherapy/methods , Photosensitizing Agents/therapeutic use , Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle AgedABSTRACT
Photodynamic therapy (PDT) has significant promise in improving outcomes of patients with a variety of cutaneous conditions. A group of experts met to review the principles, indications, and clinical benefits of PDT with 5-aminolevulinic acid (ALA). They also reviewed PDT with methyl aminolevulinate. The experts established consensus statements for pretreatment, posttreatment, ALA contact time, light sources, and numbers of sessions associated with ALA PDT for actinic keratosis and superficial basal cell carcinoma, photorejuvenation and cosmetic enhancement, acne, sebaceous skin, rosacea, and rhinophyma. They based consensus recommendations on their clinical experience and the medical literature. They also suggested future applications of ALA PDT. Experts concluded that ALA PDT is a safe and effective modality for the treatment of conditions commonly encountered in dermatology. Since downtime is minimal, the technique is suitable for patients of all ages and lifestyles. Appropriate light sources are available in many dermatology offices. The expanding clinical and financial benefits of PDT justify the purchase of an appropriate light source.
