Photodynamic therapy of acne using methyl aminolaevulinate diluted to 4% together with low doses of red light

European guidelines for topical photodynamic therapy part 2: emerging indications – field cancerization, photorejuvenation and inflammatory/infective dermatoses

“…Research continues to identify the optimal protocol that achieves efficacy yet minimizes adverse effects, with the likely need to combine with a therapy more effective in reducing non‐inflamed lesions. A small 16‐patient study observed a 66% reduction in inflamed lesions (no difference in non‐inflamed) 12 weeks after 2–3 MAL‐PDT treatments at fortnightly intervals using a more dilute 4% formulation of MAL and reduced red light dose of 10–20 J/cm 2 delivered after 1.5‐h incubation 36 . A mean decrease of 71% of inflamed and 66% of non‐inflamed lesions was achieved in a randomized study using a 0.5% 5‐ALA liposomal spray and IPL as well as topical keratolytic agents after a mean of 5.7 treatments 37 …”

Effective use of photodynamic therapy on the treatment of chronic leg ulcers: a pilot study

“…There are two main causes that prevent the healing of ulcers: a vascular insufficiency that causes a lack of oxygen and nutrients , and the almost constant presence of a bacterial biofilm that “paralyses” the fibroblasts and the repairing mechanism of epidermal cells . Recent studies showed the increased fibroblastic activity of photodynamic therapy (PDT) with the production of neocollagen, the modulation of matrix metallopeptidase MMP1 e MMP3, the production of both vascular endothelial growth factor and keratinocyte growth factor , and its antibacterial effect . Considering these studies and according to our experience on how PDT can heal carcinomatous ulcer lesions without or with very little scarring, we report the successful off‐label use of PDT for the treatment of CLUs.…”

Targeting of sebaceous glands by δ‐aminolevulinic acid‐based photodynamic therapy: An in vivo study

“…ALA and methyl aminolevulinate (MAL) are commercially available at concentrations of 20% and 16%, respectively, although these concentrations have been reduced to 10% ALA and 4% MAL in some clinical trials 17–19. ALA‐PpIX production is directly correlated with ALA contact time.…”