A comparison of intense pulsed light, combination radiofrequency and intense pulsed light, and blue light in photodynamic therapy for acne vulgaris.

BACKGROUND: Photodynamic therapy (PDT) with 5-aminolevulinic acid (ALA) is an emerging modality for the treatment of acne vulgaris. However, optimal therapeutic protocols have not been established. OBJECTIVES: To compare the efficacies of 3 different light sources for activating ALA-induced protoporphyrin IX for the treatment of acne vulgaris. METHODS: Twenty-two patients with moderate to severe acne vulgaris were randomly assigned to receive ALA-PDT with photoactivation by intense pulsed light (IPL, 600-850 nm), a combination of IPL (580-980 nm) and bipolar radiofrequency (RF) energies, or blue light (417 nm). Each patient received 3 ALA-PDT sessions at 2-week intervals. Follow-up evaluations were conducted 1 and 3 months after the final treatment. RESULTS: At 1 month and 3 months, median lesion count reduction percentages were highest with IPL activation and lowest with blue light activation, although the differences did not reach statistical significance. At 1 month and 3 months, median investigator-assessed improvements were highest with IPL activation and lowest with blue light activation. The variability of responses was significantly smaller with IPL activation than with either RF-IPL or blue light activation. CONCLUSION: ALA-PDT with activation by IPL appears to provide greater, longer-lasting, and more consistent improvement than either RF-IPL or blue light activation in the treatment of moderate to severe acne vulgaris.