Photodynamic therapy is painful: any way around it ?

Pain associated with aminolevulinic acid-photodynamic therapy of skin disease.

Warren CB, Karai LJ, Vidimos A, Maytin EV.

J Am Acad Dermatol. 2009 Dec;61(6):1033-43. doi: 10.1016/j.jaad.2009.03.048.

• Photodynamic Therapy (or PDT) is a treatment involving the application of a photosensitizing substance (aminolevulinic acid (ALA), methyl-aminolevulinate MAL) for a few hours before shining a light for a few minutes
• It is used for the treatment of actinic keratosis (AK), skin cancers and more and more for conditions such as acne vulgaris.
• Unfortunately the action of the light on the photosensitizing substance can be painful.
• The following review of the literature (43 articles) seeks to measure the pain derived from the treatment as well as the best ways to minimize it:
  • fluence settings
  • type of light
  • anesthesia (topical, injected), cooling

• It also shows the evidence in the literature of the pain derived from ALA versus MAL.

For full access to the free article in the Journal of American Academy of Dermatology (JAAD), click here.

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Contributors

Dr Christophe Hsu – dermatologist. Geneva, Switzerland