Document Detail


Photodynamic photorejuvenation of the face with a combination of microneedling, red light, and broadband pulsed light.
MedLine Citation:
PMID:  20166166     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: High efficacy and safety, coupled with in-office, short contact protocols have made photodynamic therapy (PDT) with aminolevulenic acid (ALA) for the treatment of actinic keratoses a mainstay option over the last decade. Clinical improvement in photoaged skin has also been reported to accompany PDT treatments. The study objective was to maximize epidermal penetration and subsequent activation of ALA for the treatment of photodamaged facial skin, utilizing a microneedle roller prior to incubation and combined irradiation with red light and broadband pulsed light in a single treatment. MATERIALS AND METHODS: A full-face treatment of 21 patients was performed with 630 nm light and broadband pulsed light after multiple passes with a microneedle roller and 1-hour ALA incubation. The primary endpoint was clinical improvement, scored during two separate live assessments by three physicians blinded to previous scores, using a 5-point standardized photoaging scale. The secondary endpoint was evaluation of patient satisfaction based on a quartile scale comparing baseline to 6-month post-treatment photography. RESULTS: Statistically significant improvement was seen in the global photoaging scores, as well as sub-components of the scale (fine lines, mottled pigmentation, sallowness, tactile roughness, and telangiectasias) at 3 months as compared with baseline live assessment, and at 6-month live assessment compared with the 3 months. In addition, 90% of patients judged clinical improvement to be greater than 50% at 6 months compared to baseline photography. CONCLUSION: Use of a microneedle roller to "pre-treat" prior to application of ALA appears to be well tolerated and allows for even absorption and perhaps deeper penetration of ALA following a defined incubation period. Use of red light and broadband pulsed light allowed for deeper activation of ALA, potentially accounting for marked clinical improvement in photoaging.
Authors:
Matteo Tretti Clementoni; Marc B-Roscher; Girish S Munavalli
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Lasers in surgery and medicine     Volume:  42     ISSN:  1096-9101     ISO Abbreviation:  Lasers Surg Med     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-26     Completed Date:  2010-05-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8007168     Medline TA:  Lasers Surg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  150-9     Citation Subset:  IM    
Affiliation:
Istituto Dermatologico Europeo, Plastic Surgery, Milan, Italy.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aminolevulinic Acid / administration & dosage*
Cohort Studies
Combined Modality Therapy
Facial Dermatoses / pathology,  therapy*
Female
Humans
Immunohistochemistry
Laser Therapy, Low-Level / methods*
Lasers
Male
Middle Aged
Needles
Patient Satisfaction
Photochemotherapy / adverse effects,  methods*
Rejuvenation
Skin Aging / drug effects,  pathology,  radiation effects
Treatment Outcome
Chemical
Reg. No./Substance:
106-60-5/Aminolevulinic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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