title: Comparative benefit of two thermal spring waters after photodynamic therapy procedure.
abstract: BACKGROUND
  Photodynamic therapy (PDT) is commonly used to treat actinic keratoses, superficial cutaneous carcinoma, photodamage, and/or acne. The aim of this study was to compare the usefulness of Avène thermal spring water (ATSW), a low mineral content spring water, to a high mineral content spring water. We evaluated post-PDT clinical symptoms and findings when used as an adjunctive therapy in postprocedure skin care.
  
  
  METHODS
  A double-blind monocentric comparative study was conducted on 25 patients suffering from either vulgaris acne or photodamage with or without actinic keratoses. The patients were treated with 5-aminolevulinic acid (5-ALA) activated with an intense pulsed light and/or blue light source. Patients were randomized so that 12 patients treated their faces with ATSW and 13 were treated with a comparative water spray. Clinical signs were evaluated by the investigator at day 0, before and 15 min after the first spraying, at days 2, 4, and 7, and each day from day 0 to day 6 by patients. Clinical signs (erythema, stinging, pruritus, pain, and tightening) were evaluated by the use of a 4-point grading scale.
  
  
  RESULTS
  The intragroup analysis showed that pain was significantly reduced by ATSW spraying at days 2, 4, and 7. The evaluation by patients showed that only ATSW alleviates pain from day 3 to day 6. The between-group analysis revealed that pruritus was significantly reduced by ATSW at day 7. Erythema, stinging, and tightening were not significantly reduced by both waters. Patients wished to continue using ATSW in 83% of cases.
  
  
  CONCLUSIONS
  This comparative clinical trial demonstrates that ATSW, a low mineral content spring water, can be useful after ALA-PDT in reducing postprocedure cutaneous inflammation and patient discomfort better than a high mineral content spring water.
authors.affiliation: La Jolla SpaMD, La Jolla, CA 92037, USA. mgoldman@spa-md.com
authors.forename: Mitchel P
authors.initials: MP
authors.lastname: Goldman
authors.forename: Christelle
authors.initials: C
authors.lastname: Merial-Kieny
authors.forename: Thérèse
authors.initials: T
authors.lastname: Nocera
authors.forename: Sophie
authors.initials: S
authors.lastname: Mery
mesh_terms: D000152:Acne Vulgaris / Q000175:diagnosis / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001452:Balneology / Q000379:methods; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D045482:Hot Springs / Q000737:chemistry; D006801:Humans; D007642:Keratosis / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D008900:Mineral Waters / Q000627:therapeutic use*; D010778:Photochemotherapy / Q000379:methods*; D011336:Probability; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D008900:Mineral Waters