Clinical efficacy of 5-aminolevulinic acid photodynamic therapy in the treatment of moderate to severe facial acne vulgaris

Abstract

Abstract. Acne vulgaris is considered as a therapeutic challenge in terms of managing ongoing symptoms and preventing scar formation. Although there are many available treatments for alleviating acne, therapies for resistant or moderate-to-severe forms have been limited to systemic agents that are accompanied by potentially severe side-effects. While, aminolevulinic acid (ALA) photodynamic therapy (PDT) has increasingly been used as a simple and safe therapeutic option of acne vulgaris, the clinical efficacy requires confirmation in further studies. The aim of this study was to investigate the efficacy and safety of 5-ALA-PDT in the treatment of moderate-to-severe facial acne vulgaris. A total of 50 patients with moderate-to-severe facial acne were enrolled in the study and randomly divided equally into a therapy group and a control group. In the therapy group, the patients were treated with 5% 5-ALA for 1.5 h, followed by three 20-min doses of infrared radiation once a week; in the control group, the patients were treated with three 20 min doses of infrared radiation without 5-ALA once a week. Both treatments lasted for 3 weeks. The clinical efficacy was determined by evaluating acne lesion counts at weeks 0, 2, 4 and 6. Total efficacy rate (TER) was the primary endpoint of the study, and was defined as the proportion of the patients whose treatment effectiveness evaluation was cured (≥90% of skin lesions improved) and excellent (60-89% improvement). Adverse effects were recorded throughout the study. The study was completed by 24 patients in the therapy group and 23 patients in the control group. The numbers of acne lesions significantly decreased. The TER of the therapy group was significantly higher than that of the control group at weeks 4 and 6. Adverse effects were observed in 12 patients

Adipose Stem Cells with Conditioned Media for Treatment of Acne Vulgaris Scar

“…However, cell therapy using ASCs is preferred because these cells are easy to isolate and have high relative abundance than BM-MSCs [9]. Moreover, studies suggest that transplanted ASCs accelerate wound healing by expanding the fibroblasts phenotype and increasing the supply of macrophages to the wound, enhancing granulation tissue formation [10][11][12]. Further studies showed that ASCs promote the growth of dermal fibroblasts through not only intercellular cell-to-cell contact, but also by paracrine activation of marginal cells [13][14][15][16].…”

Photodynamic Therapy and Skin Appendage Disorders: A Review

“…Nevertheless, almost 16 years have passed since the first studies on ALA-PDT in acne therapy; there is still no consensus on how to perform PDT for acne treatment, and its use still remains an off-label option for acne patients [22] . Despite numerous studies on PDT in acne (mainly mild to severe acne on the face but also acne lesions on the back and acne conglobata) [1,18,20,21,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] ( Table 1 ), they are generally difficult to compare because of the lack of controls, qualitative non-blinded methods, variable light dosimetry, and an extremely wide variation of the incubation time between drug application and light exposure. All these differences should not be neglected.…”

Current treatments of acne: Medications, lights, lasers, and a novel 650‐μs 1064‐nm Nd: YAG laser

“…Reports continued to appear describing ALA PDT with IPL, [123][124][125] the pulsed dye laser, 122,126 the KTP laser, 127 intralesional ALA, 128 MAL photosensitizer, [129][130][131][132][133][134][135] and newer photosensitizers. [136][137][138][139] ALA PDT has also been used to treat Asian, 124,140,141 Korean, 142 Japanese, 115,116,143 African-American, 144 and Chinese [145][146][147] patients.…”

“…Reports continued to appear describing ALA PDT with IPL, the pulsed dye laser, the KTP laser, intralesional ALA, MAL photosensitizer, and newer photosensitizers . ALA PDT has also been used to treat Asian, Korean, Japanese, African‐American, and Chinese patients.…”