Efficacy of 3.6% topical ALA-PDT for the treatment of severe acne vulgaris.

OBJECTIVE: To evaluate the efficacy and safety of topical 5-aminolevulinic acid (ALA) mediated photodynamic therapy (PDT) for the treatment of severe acne vulgaris. PATIENTS AND METHODS: A total of 125 patients with Pillsbury III-IV severe facial acne were treated with 3 courses of ALA-PDT with an interval of 2 weeks. ALA gel (3.6%) was applied topically to acne lesions for 1.5 h. The lesions were irradiated by a LED light of 633 nm with a light intensity of 66 mW/cm² and a light dose of 126 J/cm². Patients were evaluated for efficacy and safety at weeks 2, 4, 6, 8, 12 after the initial treatment. RESULTS: The total effective rates were 1.6%, 24.8%, 68.8%, 89.6% and 88.8% at the 2- 4- 6- 8- and 12-week after the initial treatment respectively. The clinical outcomes were the best at 4 weeks after the final treatment. The best effective rate and cure rate were 89.6% and 44% respectively. 26 patients and 16 patients showed apparent exacerbation of acne lesions before the 2nd and 3rd treatment respectively, but all of them showed good or excellent improvement after 3-course treatment. Adverse reactions were mild and transient. CONCLUSIONS: 3.6% ALA-PDT is a simple, safe and effective therapeutic option for the treatment of severe acne vulgaris.