Comparison of efficacy of aminolaevulinic acid photodynamic therapy vs. adapalene gel plus oral doxycycline for treatment of moderate acne vulgaris–A simple, blind, randomized, and controlled trial

Abstract

ALA-PDT offers promise as an alternative treatment for moderately severe inflammatory acne that has a higher effectiveness than the combination of doxycycline and adapalene gel in reducing noninflammatory and total lesions at 6 weeks. There were significantly superior reductions at 12 weeks in the combination of PDT group followed by adapalene gel in total, inflammatory, and noninflammatory lesions.

Approaches to limit systemic antibiotic use in acne: Systemic alternatives, emerging topical therapies, dietary modification, and laser and light-based treatments

“…134,135 A recent randomized trial evaluating 46 patients treated with either ALA-PDT followed by adapalene 0.1% gel or oral doxycycline 100 mg/daily plus adapalene gel found a greater reduction of inflammatory and total lesion counts in the PDT group at 12 weeks. 136 However, additional high-quality trials are needed, since most studies of PDT are small, unblinded, and observational with varying treatment protocols. 19,137 Other light-based and laser treatments Since photoexciting porphyrins produced by C. acnes could release singlet oxygen species that kill bacteria, devices that emit blue and/or red light (including at-home light emitting diode based devices), have been explored as therapeutic modalities, although the quality of evidence is low to support their efficacy.…”

Fighting Acne for the Fighting Forces

“…Aminolevulinic acid and photodynamic therapy (ALA-PDT) has been successfully used in the management of acne. 10 In addition to inducing selective damage to sebaceous glands, it has been proposed that PDT also destroys Propionibacterium acnes and reduces keratinocyte shedding and immunologic changes that play key roles in the development of acne. 10 A recent randomized controlled trial comparing the efficacy of ALA-PDT vs adapalene gel plus oral doxycycline for treatment of moderate acne included 46 patients with moderate inflammatory acne.…”

“…10 In addition to inducing selective damage to sebaceous glands, it has been proposed that PDT also destroys Propionibacterium acnes and reduces keratinocyte shedding and immunologic changes that play key roles in the development of acne. 10 A recent randomized controlled trial comparing the efficacy of ALA-PDT vs adapalene gel plus oral doxycycline for treatment of moderate acne included 46 patients with moderate inflammatory acne. 10 Twenty-three participants received 2 sessions (spaced 2 weeks apart) of 20% ALA incubated for 90 minutes before red light irradiation with a fluence of 37 J/cm 2 , and the other 23 received 100 mg/d of oral doxycycline plus adapalene gel 0.1%.…”

“…10 A recent randomized controlled trial comparing the efficacy of ALA-PDT vs adapalene gel plus oral doxycycline for treatment of moderate acne included 46 patients with moderate inflammatory acne. 10 Twenty-three participants received 2 sessions (spaced 2 weeks apart) of 20% ALA incubated for 90 minutes before red light irradiation with a fluence of 37 J/cm 2 , and the other 23 received 100 mg/d of oral doxycycline plus adapalene gel 0.1%. By 6-week followup, there was a significantly higher reduction in total lesions within the PDT group (P=.038), which was sustained at the secondary 12-week follow-up (P=.026).…”

“…There was a 79% total reduction of lesions in the ALA-PDT group vs 67% in the doxycycline plus adapalene group. 10 Although some studies have shown promise for PDT as an emerging treatment option for acne, further research is needed. A 2016 systematic review of the related literature determined that although 20% ALA-PDT with red light was more effective than lower concentrations of ALA and also more effective than ALA-PDT with blue lightwhich offered no additional benefit when compared with blue light alone-high-quality evidence on the use of PDT for acne is lacking overall.…”