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A Comparative Study of Topical 5‐Aminolevulinic Acid Incubation Times in Photodynamic Therapy with Intense Pulsed Light for the Treatment of Inflammatory Acne

BACKGROUND Photodynamic therapy (PDT) with topical 5‐aminolevulinic acid (ALA) is used for effective treatment of facial acne vulgaris. OBJECTIVES To determine which of two different incubation times (30 minutes and 3 hours) is more effective in PDT with intense pulsed light (IPL) for acne vulgaris. METHODS & MATERIALS Twenty Korean subjects with moderate to severe acne were enrolled for a randomized, half‐facial treatment study. Three sessions with short incubation with ALA plus IPL (30 minutes, n=9) or long incubation with ALA plus IPL (3 hours, n=11) on one side of the face and IPL alone on the other side were performed at 1‐month intervals. RESULTS All subjects showed improvement in inflammatory acne lesions after three sessions of ALA‐PDT or IPL alone (p<.001 in all groups). The degree of improvement in inflammatory acne lesions was greater in the long incubation time group than the short incubation time group or the IPL‐alone group, although the mean reduction of inflammatory acne lesions was statistically different only between the long incubation group and the IPL‐only group (p=.01). There were no statistical differences between the short incubation group and IPL‐alone group. All three groups had decreased sebum secretion after three sessions (p<.001 in all groups), but the differences between groups were not statistically significant. Only transient erythema and mild edema were reported for all treatment groups. CONCLUSION PDT with a long ALA incubation time might be more adequate for a pronounced outcome with inflammatory acne.