A randomized split-face clinical trial analyzing daylight photodynamic therapy with methyl aminolaevulinate vs ingenol mebutate gel for the treatment of multiple actinic keratoses of the face and the scalp

Patient and physician satisfaction in an observational study with methyl aminolevulinate daylight photodynamic therapy in the treatment of multiple actinic keratoses of the face and scalp in six European countries

“…11 However, MAL DL-PDT was associated with lower pain and inflammation scores, quicker wound healing, better cosmetic outcome and higher patient preference (77% preferred MAL DL-PDT vs. 33% for ingenol mebutate). 11 Similarly, in an intraindividual comparative analysis, MAL DL-PDT showed similar effectiveness with a superior tolerability profile in terms of local skin responses and pain compared to ingenol mebutate. 12 In an indirect comparison study in the treatment of mild-to-moderate AK, MAL DL-PDT was more than four times more effective than diclofenac plus hyaluronic acid gel at 12 weeks.…”

“…A randomized, split‐face, clinical trial on small areas of 25 cm 2 harbouring a similar number of AKs, comparing a single session of MAL DL‐PDT with a 3‐day treatment with ingenol mebutate, demonstrated similar efficacy for both treatments on face and scalp AKs . However, MAL DL‐PDT was associated with lower pain and inflammation scores, quicker wound healing, better cosmetic outcome and higher patient preference (77% preferred MAL DL‐PDT vs. 33% for ingenol mebutate) .…”

Gain with no pain? Pain management in dermatological photodynamic therapy

“…Evidence from numerous cutaneous diseases shows that PDT has the same efficacy as conventional therapies. [8][9][10][11][12][13][14][15][16][17][18] However, during the course of PDT, most patients experience sensations of burning and tingling pain that vary in intensity. In some cases, patients have to stop the treatment because of unbearable pain.…”

Adverse effects of topical photodynamic therapy: a consensus review and approach to management

“…Improved preference for PDT compared with cryotherapy was reported in a RCT, with a 5‐year follow‐up, comparing MAL‐PDT with cryotherapy for superficial BCC . MAL‐PDT compares favourably with ingenol mebutate when used for AKs on the face and scalp, with superior cosmetic outcomes and an overall patient preference for PDT, owing to higher pain scores and local skin reactions being more severe and persistent with ingenol mebutate . Similarly, when dPDT was compared with ingenol mebutate in 27 participants with AK in a within‐patient study, the former was better tolerated and preferred, and was associated with fewer adverse effects; efficacy was similar between the two modalities .…”

“…Thus, when MAL‐PDT was compared with ingenol mebutate for treatment of multiple AKs on the face and scalp in within‐patient, split‐face studies, pain scores and cosmetic outcome were higher with PDT, but local skin reactions were more severe and persistent with ingenol mebutate; overall, patients preferred PDT . When dPDT was compared with ingenol mebutate in 27 participants with AK in a within‐patient study, pain scores were higher for ingenol mebutate .…”