Photodynamic photorejuvenation.

Background: The visible signs of photodamage are characterized by wrinkling, coarse skin texture, pigmentation alterations, telangiectases, and in some case actinic keratosis (AKs). Intense pulsed light (IPL) photorejuvenation has been shown to improve each of the different components of photodamaged skin except AKs.

Objective: To present photodynamic therapy with topical 5-aminolevulinic acid (ALA-PDT) using IPL as a light source for treatment of AK in patients having IPL photorejuvenation.

Methods: Seventeen patients with varying degrees of photodamage and AKs (total of 38 AKs) were treated with two treatments with a 1-month interval of ALA-PDT using IPL as a light source.

Results: Thirty-three of 38 AKs disappeared with two ALA-PDT treatments using IPL. The follow-up period was 3 months. The technique was very well tolerated. Erythema and crusting took 1 week to resolve in the AK area. The cosmetic results were excellent in all patients without pigmentary alterations or scarring.

Conclusions: This study describes a new application of IPL technology. Patients who are candidates for photorejuvenation procedures presenting with AKs can now have AKs treated as part of the photorejuvenation process rather than necessitating separate topical therapy with 5-fluorouracil (5-FU) or cryotherapy. In addition, many patients with AKs may benefit from the combination treatment with 5-ALA and IPL.