title: Safety and efficacy comparison of blue versus red light sources for photodynamic therapy using methyl aminolevulinate in photodamaged skin.
abstract: OBJECTIVE
  methyl aminolevulinate (MAL) is a recently FDA-approved molecule for photodynamic therapy (PDT) in the treatment of nonhyperkeratotic actinic keratoses (AK). In the U.S., aminolevulinic acid (ALA) has been used in an off-label manner with photodynamic therapy for the treatment of chronic photodamage. The published use of MAL-PDT for photorejuvenation is more limited. MAL-PDT is usually conducted with a red light source, ALA-PDT with a blue light source. The purpose of this study is to compare the use of red versus blue light sources in the treatment of photodamage using MAL-PDT, measuring safety and efficacy outcomes following treatment.
  
  
  METHODS
  eighteen adult patients with moderate-to-severe photodamage of the head or upper trunk were enrolled in a prospective, single center trial of MAL-PDT for photorejuvenation. Intrapatient randomization determined split-area treatment with a blue or red light source. The majority of patients were also treated with pulsed dye laser (PDL) and/or intense pulsed light (IPL) for photoactivation. Digitial photography documented the treatment area at each visit (days 0, 2, 7 and 30). Patient and physician scoring of photodamage occurred at baseline and final visits. Side effects following MAL-PDT were evaluated.
  
  
  RESULTS
  no statistically significant differences in signs of photodamage following MAL-PDT were observed between blue versus red light treated sides. The greatest improvement in photodamage measures following 1 MAL-PDT were pigmentation, AK and erythema. Side effects were mild in nature and did not differ between treatment sides, and all but mild erythema resolved by day 7.
  
  
  CONCLUSIONS
  blue and red light have similar efficacy as the light source for MAL-PDT when combined with other light sources. Side effects following MAL-PDT with red versus blue light were similar and mild in severity. MAL-PDT is an effective treatment modality for chronic photodamage, in particular AK and pigmentation.
authors.affiliation: Dermatology/Cosmetic Laser Associates of La Jolla, Inc., San Diego, CA Surfside Advanced Aesthetic Dermatology, Encinitas, CA 92121, USA. melanie.palm@gmail.com
authors.forename: Melanie D
authors.initials: MD
authors.lastname: Palm
authors.forename: Mitchel P
authors.initials: MP
authors.lastname: Goldman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000622:Aminolevulinic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D015331:Cohort Studies; D004890:Erythema / Q000139:chemically induced; D005260:Female; D006801:Humans; D008027:Light / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000139:chemically induced; D010778:Photochemotherapy / Q000009:adverse effects*; D011446:Prospective Studies; D015595:Skin Aging / Q000187:drug effects* / Q000473:pathology / Q000502:physiology; D016896:Treatment Outcome
chemical_list: C475457:methyl 5-aminolevulinate; D000622:Aminolevulinic Acid