ALA-PDT, IPL combine for safer, faster acne tx

This was the topic of a poster session, "The Use of ALA-PDT and Intense Pulsed Light Therapy in the Treatment of Moderate to Severe Acne Vulgaris," presented at the 63rd Annual Meeting of the American Academy of Dermatology.

Michael H. Gold, M.D., director of the Tennessee Clinical Research Center in Nashville, says that this combination therapy is an improvement over the original protocol for ALA-PDT treatment.

In order to make this kind of treatment easier for dermatologists, as well as minimize patient discomfort, investigators focused on reducing 5-ALA contact time and using a variety of laser and light sources to activate protoporphyrin IX (PpIX).

"In my own research, I treated patients three times using one-hour ALA incubation and 30 to 60 minutes exposure to intense pulsed light (IPL)," Dr. Gold says. "Three months after the final treatment, patients showed 90 percent improvement in crow's feet appearance, 100 percent improvement in tactile skin roughness, 90 percent improvement in mottled hyperpigmentation, 70 percent improvement in facial erythema, and clearance of 83 percent of targeted AKs."

Dr. Gold says the 5-ALA is absorbed into the sebaceous gland, tumors, etc., and once absorbed, triggers the PpIX more effectively to combat the acne lesions. He says his research employed Radiancy's Skin Station low-intensity IPL device, but that the treatment works well with any proven, reputable IPL device.

According to Dr. Gold, other, similar studies show results that confirm the idea that short-contact, full-face ALA-PDT is safe and effective, and thus provides a new way in which to treat patients with multiple AKs or photodamage - or both. He adds that the potential of short-contact, full-face ALA-PDT treatment is not limited to routine treatment of AKs and photodamage, but is effective in treating moderate to severe inflammatory acne, sebaceous-gland hyperplasia (SGH), hydradenitis suppurativa and other dermatologic conditions.

"The efficacy of this treatment is outstanding," Dr. Gold says. "Partly because of increased concerns with such pharmaceuticals as Accutane, we're striving to come up with adjunctive treatments for acne patients. The ALA-PDT procedure is an exciting new development for dermatologists and laser surgeons; with this technique, we can more effectively treat patients by using laser and light sources already in many offices. ALA-PDT is safe and requires fewer treatments than the previous techniques."