Whole-face ALA-PDT for the treatment of facial actinic keratosis

Actinic keratosis (AK) is a precancerous condition linked to chronic ultraviolet exposure, with significant potential to progress to squamous cell carcinoma. Whole-face 5-aminolevulinic acid photodynamic therapy (ALA-PDT) addresses visible AK lesions and subclinical photoaging, offering both therapeutic and cosmetic benefits. Two elderly patients with multiple facial AK lesions underwent whole-face ALA-PDT. A 20% ALA cream was applied uniformly across the face, incubated for 3 hours, and followed by LED light irradiation (635 nm) at 40 mW/cm². Each patient received 3-5 sessions at two-week intervals, with clinical outcomes evaluated through scoring systems and follow-up assessments. Complete AK lesion clearance was achieved in both cases. Skin texture, pigmentation, and patient quality of life improved significantly. No recurrence was observed during follow-ups of 13 and 28 months. Whole-face ALA-PDT effectively treats AK while reversing photoaging. This minimally invasive and cost-effective therapy shows potential for broader application in dermatology.