title: Utilizing non-ablative fractional photothermolysis prior to ALA-photodynamic therapy in the treatment of acne vulgaris: a case series.
abstract: Aminolevulinic acid (ALA) photodynamic therapy (PDT) is an emerging modality in the treatment of acne. While ablative fractional lasers have been used to enhance drug delivery into the epidermis, recent evidence suggests that non-ablative fractional photothermolysis may also improve uptake of ALA. We explored the use of non-ablative 1550 nm laser as a safe alternative in the delivery of ALA prior to red-light PDT for refractory inflammatory and cystic acne. Subjects referred for treatment of acne refractory to several topical and oral regimens, including isotretinoin, were pre-treated with non-ablative fractional photothermolysis (NAFP). This was followed by 20 % ALA application with an incubation time of 1-3 h and then exposure to 50-100 J/cm2red light. Follow-up was at 1, 3, and 6 months. In all three cases, patients demonstrated marked reduction in inflammatory lesions. Two subjects had remission of acne after a single combination treatment. Non-ablative fractional laser applied immediately prior to PDT may be used in the treatment of acne with minimal side effects and fewer sessions needed than PDT alone. This may be due to enhanced delivery of ALA from pre-treating the skin with non-ablative fractional photothermolysis.
authors.affiliation: Harvard Medical School, Boston, MA, 02115, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Qureshi
authors.affiliation: Department of Dermatology, Brigham and Women's Hospital, Boston, MA, 02115, USA. jylin@partners.org.|Emmanuel College, Alumnae Hall 41 Avenue Louis Pasteur, Boston, MA, 02115, USA. jylin@partners.org.
authors.forename: Jennifer Y
authors.initials: JY
authors.lastname: Lin
mesh_terms: D000152:Acne Vulgaris / Q000188:drug therapy*; D000328:Adult; D000622:Aminolevulinic Acid / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007834:Lasers; D008297:Male; D010778:Photochemotherapy / Q000009:adverse effects; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D013696:Temperature; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid
keywords: Aminolevulinic acid; Drug delivery; Lasers; Photomedicine