title: Comparative split-face study of 5-aminolevulinic acid photodynamic therapy with intense pulsed light for photorejuvenation of Asian skin.
abstract: Photodynamic therapy (PDT) with 5-aminolevulinic acid (ALA) (ALA-PDT) using intense pulsed light (IPL) as a light source (IPL-ALA-PDT) has been used for photorejuvenation, but it is unclear if this protocol can be applied to darker skin types. We performed this study to assess our IPL-ALA-PDT protocol for photorejuvenation in Asian skin. To determine an appropriate dose, ALA ointment (0-20%) was applied to the upper arm of five healthy volunteers and the fluorescence intensity (FI) was measured using a spectrofluorometer. Non-linear regression analysis of FI 2 h after ALA application with global fitting gave a typical sigmoid dose-response curve with R² = 0.9705 and saturation after 5% ALA. The entire faces of 16 Japanese women with photodamage were then treated with IPL (500-670 and 870-1400 nm, 23-30 J/cm²) 2 h after application of 5% ALA to one side of the face. Three treatments were delivered at 4-week intervals with follow-up visits. Comparative analysis of photorejuvenation showed noticeable improvements on both sides of the face, although the reduction in the photoaging score from baseline did not differ significantly between the two sides in all subjects. Despite this finding, 75% of the patients felt that the IPL-ALA-PDT-treated side of the face showed greater improvement than the IPL-treated side. However, all IPL-ALA-PDT-treated sides showed adverse effects such as erythema and pain. Therefore, we conclude that the IPL-ALA-PDT protocol requires optimization for photorejuvenation in Asians.
authors.affiliation: Department of Dermatology, Nippon Medical School, Bunkyo-ku, Tokyo, Japan. p-chan@nms.ac.jp
authors.forename: Sachiko
authors.initials: S
authors.lastname: Kosaka
authors.forename: Minako
authors.initials: M
authors.lastname: Yasumoto
authors.forename: Oleg E
authors.initials: OE
authors.lastname: Akilov
authors.forename: Tayyaba
authors.initials: T
authors.lastname: Hasan
authors.forename: Seiji
authors.initials: S
authors.lastname: Kawana
mesh_terms: D000328:Adult; D000622:Aminolevulinic Acid / Q000008:administration & dosage* / Q000009:adverse effects; D044466:Asian People; D003357:Cosmetic Techniques; D005145:Face; D005260:Female; D005453:Fluorescence; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010778:Photochemotherapy / Q000009:adverse effects / Q000379:methods*; D017319:Photosensitizing Agents / Q000008:administration & dosage* / Q000009:adverse effects; D012044:Regression Analysis; D012060:Rejuvenation; D015595:Skin Aging / Q000187:drug effects / Q000208:ethnology*; D016896:Treatment Outcome
chemical_list: D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid