title: Evidence-based review of photodynamic therapy in the treatment of acne.
abstract: BACKGROUND
  Photodynamic therapy (PDT) has been used for acne, however, the efficacy and safety need to be determined.
  
  
  OBJECTIVE
  To assess the effects and safety of PDT for acne using an evidence-based approach.
  
  
  METHODS
  Randomized controlled trials (RCTs) on the treatment of acne with PDT were identified by searching PubMed, CNKI and the Cochrane Library.
  
  
  RESULTS
  A total of 14 RCTs involving 492 patients were included. Photosensitizers included aminolevulinic acid (ALA), methylaminolevulinate (MAL), and indole-3-acetic acid (IAA). Light sources included red light, pulsed dye laser (PDL), intense pulsed light (IPL), long-pulsed dye laser (LPDL) and green light. The PDT protocols, including ALA + red light, ALA + PDL, ALA + IPL, MAL + red light, and MAL + LPDL, all showed great efficacy on inflammatory lesions. ALA + red light also had effects on non-inflammatory lesions and sebum secretion. ALA + IPL and IAA + green light significantly decreased sebum secretion. Triple treatment protocols showed great improvement on inflammatory and non-inflammatory lesions. Increasing ALA concentration, ALA incubation time, PDT sessions, dose of light source or using occlusion for photosensitizers, or a combination of other treatments with PDT may achieve greater efficacy. The common side effects of PDT were tolerable and transient.
  
  
  CONCLUSIONS
  Limited evidence indicates that PDT shows good efficacy in the treatment of acne with acceptable side effects. ALA + red light was shown to be the optimal choice. However, more RCTs are needed to determine the types and concentrations of photosensitizers and light sources, and the duration of light activation and incubation.
authors.affiliation: Department of Dermatology, The First Hospital of China Medical University, 155 North Nanjing Street, Shenyang 110001, China, Cosmetic Dermatology & Laser in Aesthetic Surgery, Hangzhou Plastic Surgery Hospital, Hangzhou, 310014, China.
authors.forename: Weifeng
authors.initials: W
authors.lastname: Zheng
authors.affiliation: Department of Dermatology, The First Hospital of China Medical University, 155 North Nanjing Street, Shenyang 110001, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Wu
authors.affiliation: Department of Dermatology, The First Hospital of China Medical University, 155 North Nanjing Street, Shenyang 110001, China.
authors.forename: Xuegang
authors.initials: X
authors.lastname: Xu
authors.affiliation: Department of Dermatology, The First Hospital of China Medical University, 155 North Nanjing Street, Shenyang 110001, China.
authors.forename: Xinghua
authors.initials: X
authors.lastname: Gao
authors.affiliation: Department of Dermatology, The First Hospital of China Medical University, 155 North Nanjing Street, Shenyang 110001, China.
authors.forename: Hong-Duo
authors.initials: HD
authors.lastname: Chen
authors.affiliation: Department of Dermatology, The First Hospital of China Medical University, 155 North Nanjing Street, Shenyang 110001, China.
authors.forename: Yuanhong
authors.initials: Y
authors.lastname: Li
mesh_terms: D000152:Acne Vulgaris / Q000188:drug therapy*; D019317:Evidence-Based Medicine; D006801:Humans; D010778:Photochemotherapy / Q000009:adverse effects / Q000379:methods; D016032:Randomized Controlled Trials as Topic
keywords: acne; photodynamic therapy; randomized controlled trial