Introduction: A Photodynamic Therapy known as ClearLight TM or laser light in a blue 430nm range has been used to treat acne and Actinic keratosis. With the use of a topical photosensititizer this has been reported to clear acne and sundamage while rejuvenating the skin. Topical Aminolevulonic acid is converted into protoporphyrin via the porphyrin pathway and accumulates in the pilosebaceous glands of the skin. When phototherapy in the visible blue light range is applied to the affected area, the protoporphyrin is activated and reacts with oxygen to produce singlet oxygen. This photodynamic reaction is reported to kill bacteria and destroys tissue. Purpose: Our purpose is to report our clinical experience with blue light and 20% aminolevulonic acid for the treatment of actinic keratosis, acne and photorejuvenation. Methods/Techniques: Sixty consecutive patients were treated with an immediate mixture of 20% Aminolevulonic acid for 30 minutes during a one year period. Then the ClearLight TM was applied to the affected area for another 30 minutes. The Aminolevulonic acid was applied during the first treatment session only. Therapy continued weekly until lesion clearing. A survey of patient satisfaction was taken. Photodocumentation of the lesions were obtained. Patients were followed until lesion clearing. Results/Complications: An average number of 3 treatment sessions were required to treat actinic keratosis and 7 treatment sessions for acne Vulgaris. There was a higher patient satisfaction rate 95% for actinic keratosis than for acne vulgaris 70%. Eighty percent of the patients received first-degree burns with superficial exfoliation and crusting. Less then 5% of patients reported stinging or burning during the treatment. Seven percent were dissatisfied with the treatment, but happy with the final results. One patient received second-degree burns on an area being treated. Fifty percent of the acne patients had an acne flare-up one month following lesion clearance. One percent of the actinic lesions did not clear and resulted in surgical excision. Ninety nine percent reported improvement in their skin texture. Conclusion: Our study supports that ClearLight TM used with Aminolevulonic acid is safe and effective for the treatment of Actinic keratosis and may aid some patients with Acne Vulgaris.
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