Photoaging and Cosmetic Result with Artificial Daylight Photodynamic Therapy Using Methyl Aminolevulinate

Artificial daylight photodynamic therapy with methyl aminolevulinate is an effective and almost painless treatment approach for actinic keratoses. The objective of the prospective, non-interventional, multicentre study ArtLight (NCT05725213) was to gain comprehensive insights into the cosmetic effect of methyl aminolevulinate-artificial daylight photodynamic therapy in patients with actinic keratoses using different artificial daylight systems under real-world conditions. The study enrolled patients with Olsen grade 1 or 2 actinic keratoses on the face and scalp in Germany. Patients were treated with methyl aminolevulinate-artificial daylight photodynamic therapy. The cosmetic effect was assessed via photodamage parameters (global score for photoaging, mottled pigmentation, tactile roughness, telangiectasias, fine lines). Each photodamage variable was recorded on a 5-point scale (0-4). In total, 224 patients (median age: 75.0 years [range 50-91], 85.3% male, 62.5% Olsen grade 2, 55.4% treatment-naive) were treated with methyl aminolevulinate-artificial daylight photodynamic therapy. At month 3, all 5 parameters of photoaging were significantly reduced from baseline (p < 0.001). The majority of patients (81.3%) and investigators (83.6%) rated the cosmetic result as good or very good. Beyond effective eradication of actinic keratoses, field-directed methyl aminolevulinate-artificial daylight photodynamic therapy can improve photoaging symptoms, including tactile roughness, mottled pigmentation, telangiectasis, and fine lines. Thus methyl aminolevulinate-artificial daylight photodynamic therapy provides additional benefits, particularly for patients concerned with cosmetic outcomes during or after treatment.