Photodynamic Therapy with 5-aminolevulinic Acid 10% Gel and Red Light for the Treatment of Actinic Keratosis, Nonmelanoma Skin Cancers, and Acne: Current Evidence and Best Practices

Nathalie C Zeitouni; Neal Bhatia; Roger I Ceilley; Joel L Cohen; James Q Del Rosso; Angela Y Moore; Gilly Munavalli; David M Pariser; Todd Schlesinger; Daniel M Siegel; Andrea Willey; Mitchel P Goldman

Photodynamic Therapy with 5-aminolevulinic Acid 10% Gel and Red Light for the Treatment of Actinic Keratosis, Nonmelanoma Skin Cancers, and Acne: Current Evidence and Best Practices

J Clin Aesthet Dermatol. 2021 Oct;14(10):E53-E65.

Authors

Nathalie C Zeitouni^{1

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Affiliations

¹ Dr. Zeitouni is with Medical Dermatology Specialists, University of Arizona COM Phoenix in Phoenix, Arizona.
² Dr. Bhatoa is with Therapeutics Clinical Research in San Diego, California.
³ Dr. Ceilley is with Dermatology PC in West Des Moines, Iowa.
⁴ Dr. Cohen is with AboutSkin Dermatology and DermSurgery in Greenwood Village, Colorado.
⁵ Dr. Del Rosso is with JDR Dermatology Research in Las Vegas, Nevada.
⁶ Dr. Moore is with Arlington Research Center in Arlington, Texas, and Baylor University Medical Center in Dallas, Texas.
⁷ Dr. Munavalli is with Dermatology, Laser, & Vein Specialists of the Carolinas in Charlotte, North Carolina.
⁸ Dr. Pariser is with the Department of Dermatology, Eastern Virginia Medical School and Virginia Clinical Research, Inc. in Norfolk, Virginia.
⁹ Dr. Schlesinger is with the Dermatology and Laser Center of Charleston and the Clinical Research Center of the Carolinas in Charleston, South Carolina, and the Department of Dermatology, SUNY Downstate Health Sciences University and the Brooklyn VA Medical Center in Brooklyn, New York.
¹⁰ Dr. Siegel is with Long Island Skin Cancer and Dermatologic Surgery in New York, New York.
¹¹ Dr. Willey is with Surgical and Aesthetic Dermatology in Sacramento, California.
¹² Dr. Goldman is with Cosmetic Laser Dermatology, A West Dermatology Company in San Diego, California.

PMID: 34976292
PMCID: PMC8711613

Abstract

Photodynamic therapy (PDT) can be an effective treatment for actinic keratosis (AK) as well as selected non-melanoma skin cancers (NMSCs), such as Bowen's disease and superficial basal cell carcinoma. PDT has also demonstrated effectiveness in the management of acne vulgaris. Results from controlled clinical trials have shown the safety and efficacy of PDT for these conditions with the use of different photosensitizers and a wide range of light sources. PDT has been employed effectively as monotherapy and in combination with other topicals and alternate light or laser energy therapies. This article provides expert practical guidance for the use of the newest 5-aminolevulinic acid (ALA) product (ALA 10% gel) plus red light as monotherapy for AKs, NMSC, and acne. Here, information from clinical guidelines and a summary of supporting evidence is provided for each cutaneous condition. The authors also provide detailed guidance for employing ALA 10% gel, a photosensitizer precursor, for each of these applications.

Keywords: 5-aminolevulinic acid gel; Ameluz; BF-200 ALA; BF-RhodoLED; Photodynamic therapy; acne; actinic keratosis; non-melanoma skin cancer; red light.

Publication types

Review