What is the role of photodynamic therapy (PDT) in the treatment of keloids and hypertrophic scars?

Updated: May 29, 2020
  • Author: Brian Berman, MD, PhD; Chief Editor: Dirk M Elston, MD  more...
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Chiu et al studied the in vitro effect of 5-aminolevulinic acid (ALA) and 635-nm diode laser irradiation on keratinocyte-fibroblast co-culture (Raft model), determining that 5 J/cm2 reduces tissue contraction and collagen synthesis and preserves fibroblast viability. [103] The authors hypothesized that ALA-PDT may be used as an adjuvant therapy postsurgical excision of keloids.

The clinical evidence for PDT is limited. A case series reported the use of red-light MAL-PDT in 20 patients with keloids divided in 3 groups: (1) existing keloid scars (scar of no more than 2 mm in height), (2) postsurgical debulking (keloid scars of any size reduced/debulked to a keloid scar of at most a height of 2 mm), and (3) post-total surgical excision (of any size scar, which was removed in total). Patients received 3 PDT treatments at weekly intervals with an incubation time of 3 hours. After 9 months of follow up, all but one patient developed recurrence. [104] Other limited case series and case reports using ALA- or MAL-PDT have shown similar promising results. [102]

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