Nonablative fractional laser-assisted daylight photodynamic therapy with topical methyl aminolevulinate for moderate to severe facial acne vulgaris: Results of a randomized and comparative study

BackgroundPhotodynamic therapy (PDT) has been reported as an effective alternative treatment for patients with acne. PurposeTo evaluate the efficacy and safety of DL-PDT in moderate to severe acne and to compare outcomes with those of laser-assisted daylight photodynamic therapy. MethodsPatients were randomly assigned to either a DL-PDT group (D group) or a fractional laser-assisted DL-PDT group (F group). The outcomes were assessed by measuring acne lesion counts and severity grade at 4, 8, 12, and 16weeks after therapy commenced. ResultsTwenty-eight subjects completed the study. Compared with baseline, the mean inflammatory lesion counts significantly decreased by 36.0% in the D group and 51.8% in the F group at 8weeks (P<.001). The mean acne severity grades in both groups significantly decreased starting at 4weeks (P=.012), and the beneficial effects lasted 16weeks. ConclusionDL-PDT with MAL shows clinically good responses to inflammatory lesions and is well tolerated in patients with moderate to severe acne.