A split-face study of methyl aminolevulinate plus red light shows improvement in photodamage, but time and pain are considerations.

Several reports have suggested that aminolevulinic acid plus blue or intense pulsed light has photorejuvenating benefits beyond the treatment of actinic keratoses. In this split-face, double-blind, randomized, placebo-controlled study funded by the manufacturer, 48 women with photodamage received two treatments, 3 weeks apart, of methyl aminolevulinate (MAL) plus red light on one half of the face and placebo plus red light on the other. The MAL was incubated for 3 hours under occlusion before an 8-minute red-light irradiation. One month after the second treatment, a blinded investigator assessed improvement of photodamage using the 5-point Dover global photodamage scale. One point was considered improvement, and improvement of more than one point was considered success. Subsequently, the subjects underwent two split-face treatments in which the treatment sides were reversed.


Global photodamage improved on the MAL side in 69% of patients and was considered a success in another 29%, compared with no improvement on the placebo side. Improvement of fine lines, coarse lines, mottled pigmentation, tactile roughness, sallowness, erythema, and sebaceous hyperplasia was statistically significant on the MAL side. Only telangiectasia did not improve significantly with MAL. Self-limited adverse effects were significantly more prevalent on the MAL side, including erythema, edema, desquamation, pigmentation, and vesiculation; one case of skin infection involved both sides. On a 10-point scale, treatment-related pain increased on the MAL side from a mean of 5 at the first treatment to 8, 9, and 10 during treatments 2, 3, and 4, respectively. Eighty percent of subjects reported high or total satisfaction after four treatments.


Citation(s):

Sanclemente G 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. J Eur Acad Dermatol Venereol 2011 Jan; 25:49.