Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Red Light ALA PDT Well Tolerated in AK Treatment

Photomed Laser Surg; ePub 2017 Dec 11; Paragh, et al

Red light 5-aminolevulinic acid (ALA) photodynamic therapy (PDT) of actinic keratosis (AKs) is very well tolerated with the 2-step irradiance protocol, according to a recent study. Researchers performed a retrospective chart review to assess the level of pain during AK treatment by red light PDT (n=99). Natural density filter was used to reduce the irradiance of the light source and initially 10 J/cm2 dose was delivered at 35 mW/cm2 and then, 65 J/cm2 dose was delivered at 70 mW/cm2. Pain level was measured using a 10-point visual analog scale at 3 points during the procedure. They found:

  • Pain was low to moderate in most patients (mean ± standard error of the mean pain score: 2.35 ± 0.19).
  • Higher pain was seen mid-procedure vs at the beginning and at the end of PDT.
  • There was no significant difference in pain perception between genders and different treatment areas.


Paragh G, Zeitouni NC. Two-step irradiance treatment can achieve excellent pain control during red light 5-aminolevulinic acid photodynamic therapy for actinic keratosis. [Published online ahead of print December 11, 2017]. Photomed Laser Surg. doi:10.1089/pho.2017.4351.