Clinical Observation of Photodynamic Therapy for Severe Acne with Psychological Comorbidities—A Case Report of a Refractory Case

Severe acne with psychological comorbidities poses a significant therapeutic challenge, particularly in cases refractory to conventional treatments. This case report demonstrates the potential of photodynamic therapy (PDT) to address both dermatological and mental health symptoms in such patients. A 19-year-old female with severe acne (GAGS score: 37) and moderate depression (PHQ-9 score: 12), previously unresponsive to isotretinoin, underwent 5-aminolevulinic acid photodynamic therapy (ALA-PDT) (635nm red light, 37J/cm²) at 4-week intervals. Clinical and psychological outcomes were monitored. After two PDT sessions, inflammatory lesions reduced by 40%, nodules and cysts resolved by 70%, and scarring softened (GAGS score: 14). By the 3-month follow-up, no new lesions emerged, and depressive symptoms remitted (PHQ-9: 5). No adverse effects were observed. ALA-PDT is an effective and safe treatment for severe acne with psychological comorbidities, offering dual dermatological and mental health benefits. This approach is particularly valuable for patients refractory to traditional therapies.