JCDSA  Vol.1 No.2 , June 2011
Photodynamic Therapy/Assisted Photorejuvenation
Abstract: Photodynamic therapy (PDT) shows great efficacy and high tolerability for the treatment of non-melanoma skin cancer (actinic keratosis, basal cell carcinoma, Bowen’s disease) especially in patients with large and multiple lesions, in poor-healing sites and patients immunosuppressed or with co-morbidities. Besides, more recently, PDT has been used, widely and with great success, for many off-label diseases and in cosmetic dermatology, especially on photorejuvenation, therefore further and larger prospective studies with long-term follow-up are required to verify its efficacy and safety in treating these condition. The treatment of ageing skin remains a very hot topic, and many systems have been reported as having varying degrees of success. Nowadays our experience and literature data show how topical PDT can be considered a new non-invasive device for the treatment o photoaging skin with no/minimal side effects and able to bridge the world of medical and cosmetic dermatologic surgery.
Cite this paper: nullR. Rossi, T. Lotti and N. Bruscino, "Photodynamic Therapy/Assisted Photorejuvenation," Journal of Cosmetics, Dermatological Sciences and Applications, Vol. 1 No. 2, 2011, pp. 30-35. doi: 10.4236/jcdsa.2011.12005.

[1]   T. C. Fischer, E. Perosino, F. Poli, et al., “Chemical Peels in Aesthetic Dermatology: An Update 2009,” Journal of the European Academy of Dermatology and Venereology, Vol. 24, No. 3, 2009, pp. 281-292. doi:10.1111/j.1468-3083.2009.03409.x

[2]   K. Beer, “Dermal Fillers and Combinations of Fillers for Facial Rejuvenation,” Dermatologic Clinics, Vol. 27, No. 4, 2009, pp. 427-432. doi:10.1016/j.det.2009.08.011

[3]   J. D. Carruthers, R. G. Glogau and A. Blitzer, “Advances in Facial Rejuvenation: Botulinum Toxin Type A, Hyaluronic Acid Dermal Fillers, and Combination Therapies—Consensus Recommendations,” Plastic and Recon- structive Surgery, Vol. 121, No. 5, 2008, pp. 5S-30S; 31S-36S.

[4]   J. Carruthers and A. Carruthers, “Botulinum Toxin in Facial Rejuvenation: An Update,” Dermatologic Clinics, Vol. 27, No. 4, 2009, pp. 417-425. doi:10.1016/j.det.2009.08.001

[5]   P. Babilas, S. Schreml, R. M. Szeimies, et al., “Intense pulsed Light (IPL): A Review,” Lasers in Surgery and Medicine, Vol. 42, No. 2, 2010, pp. 93-104. doi:10.1002/lsm.20877

[6]   R. Rossi, T. Lotti, P. Cappugi, et al. and GIDFE (Italian Photodermatology Group), “Guidelines for Photodynamic Therapy in Dermatology: Treatment Protocol,” G Ital Dermatol Venereol, Vol. 140, 2005, pp. 637-644.

[7]   J. Jans, W. Schul, Y. G. Sert, et al., “Powerful Skin Cancer Protection by a CPD-Photolyase Transgene,” Current Biology, Vol. 15, 2005, pp. 105-115. doi:10.1016/j.cub.2005.01.001

[8]   R. Rossi, P. G. Calzavara-Pinton, A. Giannetti, et al., “Italian Guidelines and Therapeutic Algorithm for Actinic Keratoses,” G.It.Dermatol, Vol. 144, 2009, pp. 713-723.

[9]   D. De Berker, J. M. McGregor and B. R. Hughes on Behalf of the British Association of Dermatologists, “Therapy Guidelines and Audit Subcommittee. Guidelines for the Management of Actinic Keratoses,” British Journal of Dermatology, Vol. 156, No. 2, 2007, pp. 22-30. doi:10.1111/j.1365-2133.2006.07692.x

[10]   L. R. Braathen, R. Cerio, B. Cribier, et al., “Subcommittee of the European Dermatology Forum. Guidelines for the Management of Actinic Keratoses,” 2009. Available at:

[11]   E. Stockfleth and H. Kerl, “Guideline Subcommittee of the European Dermatology Forum. Guidelines for the Management of Actinic Keratoses,” European Journal of Dermatology, Vol. 16, No. 6, 2006, pp. 599-606.

[12]   E. Stockfleth, C. Ferrandiz, J. J. Grob, et al. for the European Skin Academy, “Development of a Treatment Algorithm for Actinic Keratoses: A European Consensus,” European Journal of Dermatology, Vol. 18, No. 6, 2008, pp. 651-659.

[13]   G. F. L. Hofbauer, M. Anliker, A. Arnold, et al., “Swiss Clinical Practice Guidelines for Skin Cancer in Organ Transplant Recipients,” Swiss Medical Weekly, Vol. 139, 2009, pp. 407-415.

[14]   C. A. Morton, S. B. Brown, S. Collins, S. Ibbotson, H. Jenkinson, H. Kurwa, et al., “Guidelines for Topical Photodynamic Therapy: Report of a Workshop of the British Photodermatology Group,” British Journal of Dermatology, Vol. 146, No. 4, 2002, pp. 552-567. doi:10.1046/j.1365-2133.2002.04719.x

[15]   E. Christensen, T. Warloe, S. Kroon, et al., “Guidelines for Practical Use of MAL-PDT in Non-Melanoma Skin Cancer,” Journal of the European Academy of Dermatology and Venereology, Vol. 24, No. 5, 2010, pp. 505-512. doi:10.1111/j.1468-3083.2009.03430.x

[16]   M. H. Gold, “The Evolving Role of Aminolevulinic Acid Hydrochloride with Photodynamic Therapy in Photoaging,” Cutis, Vol. 69, No. S6, 2002, pp. 8-13.

[17]   D. J. Touma and B. A. Gilchrest, “Topical Photodynamic Therapy: A New Tool in Cosmetic Dermatology,” Seminars in Cutaneous Medicine and Surgery, Vol. 22, No. 2, 2003, pp. 124-130. doi:10.1053/sder.2003.50012

[18]   R. R. Ruiz, T. Sanz-Sanchez and S. Cordoba, “Photodynamic Photorejuvenation,” Dermatologic Surgery, Vol. 28, No. 8, 2002, pp. 742-744. doi:10.1046/j.1524-4725.2002.02018.x

[19]   M. P. Goldman, D. Atkin and S. Kincad, “PDT-ALA in the Treatment of Actinic Damage: Real World Experience,” Journal of Clinical Laser Medicine and Surgery, Vol. 14, 2002, p. 24.

[20]   D. K. Avram and M. P. Goldman, “Effectiveness and Safety of ALA-IPL in Treating Actinic Keratoses and Photodamage,” Journal of Drugs in Dermatology, Vol. 3, 2004, pp. S36-S39.

[21]   P. K. Nootheti and M. P. Goldman, “Advances in Photorejuvenation and the Current Status of Photodynamic Therapy,” Expert Review of Dermatology, Vol. 1, No. 1, 2006, pp. 51-61. doi:10.1586/17469872.1.1.51

[22]   N. S. Uebelhoer and J. S. Dover, “Photodynamic Therapy for Cosmetic Application,” Dermatol Ther, Vol. 18, 2005, pp. 242-252. doi:10.1111/j.1529-8019.2005.05023.x

[23]   M. H. Gold, V. L. Bradshaw, M. M. Boring, et al., “Split-Face Comparison of Photodynamic Therapy with 5-Aminolevulinic Acid and Intense Pulsed Light Versus Intense Pulsed Light Alone for Photodamage,” Dermatologic Surgery, Vol. 32, No. 6, 2006, pp. 795-801, discussion 801-803. doi:10.1111/j.1524-4725.2006.32163.x

[24]   T. S. Dover, A. C. Bhatia, B. Stewart, et al., “Topical 5-Aminolevulinic Acid Combined with Intense Pulsed Light in the Treatment of Photoaging,” Archives of Dermatology, Vol. 141, No. 10, 2005, pp. 1247-1252. doi:10.1001/archderm.141.10.1247

[25]   D. J. Key, “Aminolevulinic Acid-Pulsed Dye Laser Photodynamic Therapy for the Treatment of Photoaging,” Cosmetic Dermatology, Vol. 18, No. 1, 2005, pp. 31-36.

[26]   D. J. Key, “Evaluation of 585-nm Pulsed Dye Laser Activated Photodynamic Therapy (PDT) Using Topical Aminolevulinic Acid HCL 20%,” Lasers in Surgery and Medicine, Vol. 15, 2003, p. 160.

[27]   M. R. Alexiades-Armenakas and R. G. Geronemus, “Laser Mediated Photodynamic Therapy with of Actinic Keratoses,” Archives of Dermatology, Vol. 39, No. 13, 2003, pp. 113-120.

[28]   G. Sanclemente, L. Medina, J. F. Villa, et al., “A Prospective Split-Face Double-Blind Randomized Placebo-Controlled Trial to Assess the Efficacy of Methyl Aminolevulinate + Red-Light in Patients with Facial Photodamage,” Journal of the European Academy of Dermatology and Venereology, Vol. 25, No. 1, 2010, pp. 49-58. doi:10.1111/j.1468-3083.2010.03687.x

[29]   C. Zane, R. Capezzera, R. Sala, et al., “Clinical and Echographic Analysis of Photodynamic Therapy Using Methylaminolevulinate as Sensitizer in the Treatment of Photodamaged Facial Skin,” Lasers in Surgery and Medicine, Vol. 795, 2007, pp. 203-209. doi:10.1002/lsm.20470

[30]   R. Ruiz-Rodríguez, L. López, D. Candelas, et al., “Photorejuvenation Using Topical 5-Methyl Aminolevulinate and Red Light,” Journal of Drugs in Dermatology, Vol. 7, No. 7, 2008, pp. 633-637.

[31]   M. C. Issa, J. Pi?eiro-Maceira, M. T. Vieira, et al., “Photorejuvenation with Topical Methyl Aminolevulinate and Red Light: A Randomized, Prospective, Clinical, Histopathologic, and Morphometric Study,” Dermatologic Surgery, Vol. 36, No. 1, 2010, pp. 39-48. doi:10.1111/j.1524-4725.2009.01385.x

[32]   G. Buggiani, M. Troiano, R. Rossi and T. Lotti, “Photodynamic Therapy: Off-Label and Alternative Use in Dermatological Practice,” Photodiagnosis Photodynamic The- rapy, Vol. 5, No. 2, 2008, pp. 134-138. doi:10.1016/j.pdpdt.2008.03.001

[33]   E. Tierney, A. Barker, J. Ahdout, et al., “Photodynamic Therapy for the Treatment of Cutaneous Neoplasia, Inflammatory Disorders and Photoaging,” Dermatologic Surgery, Vol. 35, No. 5, 2009, pp. 725-746. doi:10.1111/j.1524-4725.2009.01117.x

[34]   A. T. Shamban, “Current and New Treatments of Photodamaged Skin,” Facial Plastic Surgery, Vol. 25, No. 5, 2009, pp. 337-346. doi:10.1055/s-0029-1243083

[35]   P. K. Nootheti and M. P. Goldman, “Aminolevulinic Acid-Photodynamic Therapy for Photorejuvenation,” Dermatologic Clinics, Vol. 25, No. 3, 2007, pp. 35-45. doi:10.1016/j.det.2006.09.010

[36]   T. Lotti and R. Rossi, “Correction of Aesthetic Defect—from Peeling to Photodynamic Therapy,” European Journal of Dermatology, Vol. 3, No. 1, 2008, pp. 59-60.

[37]   D. J. Gilbert, “Incorporating Photodynamic Therapy into a Medical and Cosmetic Dermatology Practice,” Dermatologic Clinics, Vol. 25, No. 3, 2007, pp. 111-118. doi:10.1016/j.det.2006.09.012