Multiple sequential light and laser sources to activate aminolevulinic acid in the treatment of photodamage: A retrospective study

Abstract

Introduction: The aim of this study was to retrospectively evaluate photodynamic therapy (PDT) with aminolevulinic acid (ALA) for cutaneous photorejuvenation using blue light sequentially with red light, pulsed-dye laser (PDL), and/or intense pulsed light (IPL). Materials and Methods: Ninety-six patients (121 treatments) had photodamage treated with field-directed ALA-PDT from 2001 to 2010 in this single-center study. Treatments were performed with blue light + PDL, blue light + IPL, blue light + PDL + IPL, or blue light + red light + PDL + IPL. Outcome measures were obtained via telephone questionnaire and graded on a four-point scale. Results: There were no significant differences in patient-reported improvement in photodamage, overall skin quality, and postprocedure adverse events between treatment arms. However, number of patients in the blue light + red light + PDL + IPL group was markedly smaller (n = 2) than that in the other groups (n = 14–46). Discussion: Although results showed a trend toward greater efficacy with similar tolerability using multiple, sequential light and laser sources with ALA-PDT for photorejuvenation, the potential for recall bias and widely disparate number of patients between treatment groups and follow-up times between patients severely limit this retrospective study. Nevertheless, despite these major statistical flaws, the results may provide valuable information regarding the safety of multiple modalities with PDT of photodamage in a single session.

Key Words::

• intense pulsed light
• photodamage
• photodynamic therapy
• photorejuvenation
• pulsed-dye laser

Funding Sources: None.

Declaration of interests: Dr. Goldman is a consultant, speaker, and has received payments for performing clinical research for Lumenis, Inc. Drs. Friedmann and Fabi are speakers and have performed clinical research for Lumenis, Inc. Isabella Guiha has no conflicts of interest.