Photodynamic therapy with topical aminolevulinic acid and pulsed dye laser irradiation for sebaceous hyperplasia

Successful and long-standing eradication of sebaceous hyperplasia has remained difficult due to the propensity of these lesions to be extensive. Current treatments include excision, electrodesiccation, laser vaporization, and oral isotretinoin, each often associated with unacceptable side effects or lesional recurrence. The purpose of this study was to evaluate the safety and effectiveness of laser-assisted photodynamic therapy using topical 5-aminolevulinic acid (5-ALA) and 595 nm pulsed dye laser (PDL) irradiation for the treatment of sebaceous hyperplasia. Ten patients with sebaceous hyperplasia received 1 or 2 treatments at 6 week intervals with topical 20% 5-ALA followed 1 hour later by 595 nm PDL irradiation. Matched lesions served as controls and were either treated with PDL alone or were left untreated. Patients were evaluated at regular intervals for 3 months. Results demonstrated that combination topical 5-ALA and PDL treatment effected better clinical results than PDL treatment alone. No changes were observed in untreated control lesions. Side effects were mild and limited to transient erythema, edema, and focal crusting. It is the conclusion of the authors that laser-assisted photodynamic therapy with topical 5-ALA and PDL irradiation can achieve safe and effective improvement of sebaceous hyperplasia. Further study is warranted to determine the longevity of the clinical results observed.