Safety and Efficacy Comparison of Blue Versus RedLight Sources for Photodynamic Therapy UsingMethyl Aminolevulinate in Photodamaged Skin
January 2011 | Volume 10 | Issue 1 | Original Article | 53 | Copyright © January 2011
Melanie D. Palm MD MBA and Mitchel P. Goldman MD
Background and Objective: Methyl aminolevulinate (MAL) is a recently FDA-approved molecule for photodynamic therapy (PDT) in
the treatment of nonhyperkeratotic actinic keratoses (AK). In the U.S., aminolevulinic acid (ALA) has been used in an off-label manner
with photodynamic therapy for the treatment of chronic photodamage. The published use of MAL-PDT for photorejuvenation is
more limited. MAL-PDT is usually conducted with a red light source, ALA-PDT with a blue light source. The purpose of this study is
to compare the use of red versus blue light sources in the treatment of photodamage using MAL-PDT, measuring safety and efficacy
outcomes following treatment.
Study Design/Material and Methods: Eighteen adult patients with moderate-to-severe photodamage of the head or upper trunk
were enrolled in a prospective, single center trial of MAL-PDT for photorejuvenation. Intrapatient randomization determined split-area
treatment with a blue or red light source. The majority of patients were also treated with pulsed dye laser (PDL) and/or intense pulsed
light (IPL) for photoactivation. Digitial photography documented the treatment area at each visit (days 0, 2, 7 and 30). Patient and
physician scoring of photodamage occurred at baseline and final visits. Side effects following MAL-PDT were evaluated.
Results: No statistically significant differences in signs of photodamage following MAL-PDT were observed between blue versus
red light treated sides. The greatest improvement in photodamage measures following 1 MAL-PDT were pigmentation, AK and
erythema. Side effects were mild in nature and did not differ between treatment sides, and all but mild erythema resolved by day 7.
Conclusion: Blue and red light have similar efficacy as the light source for MAL-PDT when combined with other light sources. Side
effects following MAL-PDT with red versus blue light were similar and mild in severity. MAL-PDT is an effective treatment modality
for chronic photodamage, in particular AK and pigmentation.
(J Drugs Dermatol. 2011;1053-60.)