Table 2. The use of photodynamic therapy in acne therapy

Study

Intervention

Results

Reference

Randomized open-label trial for mild to moderate back acne (n=22)

ALA + red light, ALA, red light, no treatment; 1 treatment or 4 total treatments at 1 week intervals

Clinical and statistically significant reduction in inflammatory acne at 20 weeks post multiple treatment and at 10 weeks post single treatment

Hongcharu, et al.7667

Open-label trial for mild to moderate back acne (n=10)

ALA + red light, ALA, red light, no treatment at 4 different sites within each patient; 3 total treatments at 1 week intervals

Statistically significant reduction in inflammatory acne lesions with ALA-PDT at 3 weeks post final treatment (p<0.005) but not at any other site. Nonsignificant reduction of number of P. acnes and sebum excretion at any site.

Pollock, et al.7768

Randomized single-blind, split-face trial for facial acne (n=44)

ALA + PDL, no treatment; 3 total treatments at 2 week intervals

Improvement in Leeds score with PDT at 16 weeks post treatment (p=0.01). Statistically significant reduction of erythematous macules with PDT at 16 weeks post treatment (p=0.04). No statistical differences in the number of papules, pustules, cysts, closed comedones, and open comedones (p=ns).

Orringer, et al.7869

Randomized, open-label, split-face trial for moderate to severe acne (n=8)

ALA + KTP 532 nm, KTP 532 nm; 3 total treatments at 4 week intervals

52% improvement in acne with ALA-PDT compared with 32% improvement with KTP alone

Sadick, et al.7970

Open-label, split-face trial for moderate to severe acne (n=20)

ALA + blue light, blue light; 4 total treatments at 1 week intervals

71% reduction in inflammatory acne lesions with ALA-PDT (p=0.023) and 57% reduction with blue light (p=0.092) at 16 weeks post initial treatment. No statistical difference between treatments (p=0.092). Statistically significant reduction in non-inflammatory acne lesions with ALA-PDT (p=0.029) but no significant reduction with blue light (p=0.101) and no statistical difference between treatments (p=0.323)

Akaraphanth, et al.8071

Open-label, split-face trial for inflammatory acne (n=14)

ALA + IPL, IPL; 3 total session at 3-4 week intervals

87.7% reduction in lesions with ALA-PDT (p<0.01) and 66.8% reduction with IPL (p<0.01) at 12 weeks post final treatment

Rojanamatin, et al.8172

Randomized, single-blind, split-face or split-back trial for inflammatory back or face acne (n=10)

Pre-treatment with IR LED 970 nM + ALA + LED 630 nm, ALA + LED 630 nm; 1 treatment

73% median reduction in inflammatory lesions with pre-treated IR + ALA-PDT and 38% reduction with ALA-PDT (p<0.0001). Statistically significant reduction of non-inflammatory lesions and improvement in clinical severity with IR + ALA-PDT (p=0.037 and p=0.027)

Barolet, et al.8273

Randomized trial for moderate to severe acne (n=22)

ALA + IPL 600-800 nm, ALA + IPL 580-980 nm + RF, ALA + blue light 417 nm; 3 total treatments at 2 week intervals

Reduction of median lesion counts greatest with IPL and lowest with blue light but did not reach statistical significance (p=ns) at 1 and 3 months post final treatment. IPL had greater improvements in clinical assessment of severity as well as statistically smaller variability in response

Taub, et al.8374

Randomized, single-blind trial for facial acne (n=23)

0.5% ALA liposomal spray + IPL 530-750 nm + topical peeling agents (0.02-0.05% tretinoin, adaplene, or 5% salicylic acid); monthly treatments until no observed improvement after 2 consecutive treatments

68.2% mean improvement in total number of lesions (p<0.01), 70.6% improvement in inflammatory lesions (p<0.01), and 66.1% improvement in non-inflammatory lesions (p<0.05) at 4 weeks post final treatment. Mean number of treatments was 5.7 and mean number of months was 7.8.

de Leeuw, et al.8475

Randomized, split-face trial for moderate to severe acne in Korean patients (n=20)

ALA + IPL 590 nm for 30 minutes, ALA + IPL 590 nm for 3 hours, IPL 590 nm; 3 total treatments at 4 week intervals

89.5%, 83.0%, and 74.0% reduction in inflammatory acne lesions with long incubation, short incubation, and IPL alone at 12 weeks post final treatment (p<0.001). Mean reduction statistically different between long incubation and IPL alone groups only (p=0.01). Decreased sebum secretion in all 3 groups (p<0.001) but no statistical differences between groups.

Oh, et al.8576

Randomized, double-blind, split-face trial for moderate to severe acne (n=30)

MAL + red light 635 nm, placebo cream + red light 635 nm; 2 total treatments at a 2 week interval

54% median reduction in inflammatory acne lesions with MAL-PDT compared with 20% reduction with placebo-PDT (p=0.0006) at 12 weeks post final treatment

Horfelt, et al.8879

Randomized, single-blind trial for moderate to severe acne (n=36)

MAL + red light, no treatment; 2 total treatments at a 2 week interval

68% reduction in inflammatory acne lesions with MAL-PDT compared with no change with control (p=0.0023). No reduction in non-inflammatory lesions

Wiegell, et al.8980

Randomized, double-blind, split-face trial for inflammatory acne (n=15)

ALA + red light, MAL + red light; 1 treatment

59% median reduction in inflammatory acne lesions with MAL-PDT and ALA-PDT (p=0.455). No statistical differences in non-inflammatory lesions (p=0.6355) and acne global severity (p=0.250) between MAL-PDT and ALA-PDT at 12 weeks post treatment

Wiegell, et al.9081