Photorejuvination of Facial Skin with Topical 20% 5-Aminolevulinic Acid and Intense pulsed Light Treatment: A Split-Face Comparison

Background: Photorejuvenation of facial skin has been reported after intense pulsed light (IPL) therapy alone and in conjunction with topical 5-aminolevulinic acid (5-ALA), but no comparative studies between these regimens have been performed. Objective: To evaluate the safety and effectiveness of combination topical 5-ALA and IPL compared to IPL treatment alone. Methods: Ten patients with mild to moderate photodamage were randomly assigned treatment with 5-ALA + IPL on one facial half and IPL alone on the contralateral side. Two treatments were delivered at 4-week intervals. Clinical improvement scores were determined by masked evaluations of digital photographs obtained at baseline, prior to each treatment session, and at 1, 3, and 6 months after the final treatment. Results: Higher clinical improvement scores were noted on the combination 5-ALA + IPL treated areas. Mild edema, erythema, and desquamation were observed on the facial halves where 5-ALA was applied. No scarring or unwanted pigmentary alteration was seen. Conclusions: Photodynamic therapy with combination topical 5-ALA + IPL is safe and more effective for facial rejuvenation than IPL treatment alone.