Long-pulsed dye laser versus long-pulsed dye laser-assisted photodynamic therapy for acne vulgaris: A randomized controlled trial.
BACKGROUND
Long-pulsed dye laser (LPDL)-assisted photodynamic therapy has been suggested to be superior to laser alone for acne vulgaris but no evidence is available.


OBJECTIVE
To evaluate the efficacy and safety of LPDL alone versus LPDL in photodynamic therapy with methylaminolevulinic acid (MAL-LPDL) for acne vulgaris.


METHODS
Fifteen patients received a series of 3 full-face LPDL treatments and half-face prelaser MAL treatments; the latter being randomly assigned to the left or right side.


RESULTS
Inflammatory lesions were reduced more on MAL-LPDL-treated than on LPDL-treated sides (week 4: 70% vs 50%, P = .003; week 12: 80% vs 67%, P = .004). Noninflammatory lesions reduced similarly. Patient satisfaction was slightly greater with MAL-LPDL versus LPDL treatments (scale 0-10: week 4: 7 vs 6, P = .034; week 12: 8 vs 7.5, P = .034). Fluorescence measurements detected photobleaching with MAL-LPDL (35.3%) and LPDL (7.3%) treatments (P < .001). Erythema, edema, and pustular eruptions intensified from MAL incubation. No patients experienced pigment changes or scarring.


CONCLUSIONS
The sample size was limited. The split-face design in this randomized controlled trial does not allow us to draw conclusions about the efficacy of the LPDL, only about the efficacy of MAL-LPDL compared with LPDL alone.


CONCLUSIONS
MAL-LPDL is slightly superior to LPDL for the treatment of inflammatory acne.
Haedersdal
Merete
M
Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark. mhaedersdal@dadlnet.dk
Togsverd-Bo
Katrine
K
Wiegell
Stine Regin
SR
Wulf
Hans Christian
HC
D000152:Acne Vulgaris / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology / Q000532:radiotherapy*; D000328:Adult; D000622:Aminolevulinic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004487:Edema / Q000209:etiology; D004890:Erythema / Q000209:etiology; D005260:Female; D005453:Fluorescence; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects / Q000379:methods; D008297:Male; D010146:Pain / Q000209:etiology; D017060:Patient Satisfaction; D010778:Photochemotherapy / Q000009:adverse effects; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011524:Protoporphyrins / Q000378:metabolism; D012871:Skin Diseases / Q000209:etiology; D016896:Treatment Outcome
D017319:Photosensitizing Agents; D011524:Protoporphyrins; C475457:methyl 5-aminolevulinate; D000622:Aminolevulinic Acid; C028025:protoporphyrin IX