The following is a summary of “Modified red light 5-aminolevulinic acid photodynamic therapy versus low-dose isotretinoin therapy for moderate to severe acne vulgaris: A prospective, randomized, multicenter study,” published in the December 2023 issue of Dermatology by Zhang, et al.

Moderate to severe acne vulgaris can be effectively treated with modified 5-aminolevulinic acid photodynamic therapy (M-PDT) and isotretinoin (ISO). For a study, researchers sought to evaluate the efficacy and adverse effects of M-PDT and ISO in treating moderate to severe acne vulgaris.

A multicenter, randomized clinical trial was conducted, randomly assigning participants to the M-PDT group (up to 5 weekly sessions following manual comedone extraction) or the ISO group (oral ISO, 0.5 mg/kg/d for 6 months). Follow-up extended to 6 months after therapy.

Out of 152 patients, the M-PDT group showed significantly higher overall effective rates at 1 month (67.74% vs. 10.26%), while the ISO group surpassed at 1 month post-treatment (75.81% vs. 97.44%). The time to achieve 50% lesion improvement was significantly shorter in the M-PDT group (1 vs. 8 weeks). Systemic side effects, such as hepatotoxicity, were observed in 70.67% of the ISO group, whereas M-PDT group side effects were skin-limited. Study limitations included a relatively low participant number and a high withdrawal rate.

M-PDT provided a faster onset of improvement, comparable overall efficacy, good tolerability, and similar durability of response compared to ISO in the treatment of moderate to severe acne vulgaris.

Source: jaad.org/article/S0190-9622(23)02417-9/fulltext