A Case of Cosmetic-Induced Acne Fulminans Treated with 5-Aminolevulinic Acid Photodynamic Therapy

Significance Acne Fulminans (AF) is a rare and severe inflammatory acne variant with potential systemic complications. Conventional treatments involve corticosteroids and isotretinoin; however, their adverse effects limit patient adherence. This study evaluates 5-aminolevulinic acid photodynamic therapy (5-ALA PDT) as an alternative treatment for AF. Approach We present a case of cosmetic-induced AF in a female patient who declined corticosteroids. She received 5% ALA-PDT at 10-day intervals, using LED red light (50 mW/cm², 150 J/cm²) for three sessions. Results The patient demonstrated significant improvement, with marked regression of inflammatory lesions and complete resolution of purulent crusts. No recurrence was observed during follow-up. Conclusion ALA-PDT is a promising alternative for AF patients intolerant to systemic therapy. Further studies are needed to validate its efficacy and safety in broader clinical settings.