| Background: Acne is a common chronic inflammatory skin disease appearing mostly in adolescents.At present,it is believed that hyperkeratosis of follicular keratosis of the sebaceous gland ducts,increasing sebum secretion,propionibacterium acnes infection and secondary inflammation of hair follicles are the four important pathogenic factors of it.If moderate-to-severe acne is not treated in time,it is prone to occur pigmentation and even scars,affecting the patient’s appearance and mental health.Epidemiological investigation found that the prevalence of male acne patients was higher than that of females,of which,6% were suffering from severe acne.Traditional medicines for treating moderate-to-severe acne need a long time for taking effect,and show longer duration of treatment,more side effects,and unsatisfactory results,leading to poor compliance among patients.Photodynamic therapy as a new technique applied to the treatment of moderate-to-severe acne has the advantages of taking effect rapidly,good curative effect and no obvious side effects,making more and more patients choose PDT treatment.At present,the most commonly used photosensitizer in clinical practice is 5-aminolevulinic acid,and the research focuses on the following aspects.The efficacy of ALA-PDT was compared to conventional drug therapy as well as red-blue light therapy.The efficacy of ALA-PDT combined with drug therapy was compared to ALA-PDT alone.The efficacy of ALA-PDT was compared with different photosensitizer concentrations,different light sources and different application times.Due to the short application time and the limited number of cases,there is still many problems in the treatment of acne through ALA-PDT.At present,there are few studieson ALA-PDT in treating acne with different severity and different gender.In this study,patients with moderate-to-severe acne were grouped according to severity and gender,and treated with 5% ALA-PDT,followed by the observation of efficacy and safety.Objective: To evaluate the efficacy and safety of 5% ALA-PDT in treating patients with acne of different severity and different gender.Methods: Sixty-five patients with moderate-to-severe acne collected at the outpatient clinic were included in the study.All patients were treated according to the following procedures.(1)Patients used water to clean faces.(2)Physician performed skin cleaning operation to clean the patient’s skin lesions.(3)Physician applied 5%ALA gel evenly in facial lesions areas.(4)Patients were avoided light for 1.5-2h by covering plastic wrap and dark mask in face.(5)Patients cleaned faces with clean water.Red light irradiate patient’s full face.The distance between the red light and the face is10-15 cm.The time of irradiation time is 20 minutes.(6)The time of cold distilled water spray is 30 minutes after the lighting.Treatments were given once every 7-10 days for a total of 3 treatments.Skin lesions were evaluated using the Global Acne Grading System before treatment and in the 2nd,4th,8th,and 12 th week of treatment,followed by the record of scores.With the GAGS scores of before treatment as a baseline,the efficacy was evaluated and adverse reactions was recorded.Results: The treatment effective rate of patients with type II,III,and IV acne in the2 nd week was 30.0%,43.5%,46.7%.The analysis result was P>0.05,and the difference was not statistically significant.The treatment effective rate of the three groups patients in the 4th week was 40.0%,56.5%,66.7%.The analysis result was P>0.05,and the difference was not statistically significant.The treatment effective rate of the three groups patients in the 8th week was 50.0%,73.9%,90.0%.The analysis result was P<0.05,and the difference was statistically significant.The treatment effective rate of the three groups patients in the 12 th week was 60.0%,82.6%,93.3%.The analysis result was P<0.05,and the difference was statistically significant.The treatment effective rate of male patients in the 2nd,4th,8th,and 12 th week of treatment was 40.0%,57.1%,74.3%,and 80.0%.The treatment effective rate of female was46.4%,60.7%,82.1%,and 89.3%.With the analysis of the effective rate of two groups patients,it was found that the result was P> 0.05,and the difference was not statistically significant.The treatment effective rate in all patients was 42.9%,58.7%,77.8%,and 84.1% in the 2nd,4th,8th,and 12 th week.The analysis result was P<0.05,and the difference was statistically significant.The main adverse effects followed by the treatment were pain,burning sensation,erythema,swelling,dry skin,tightness,a small amount of dandruff,pigmentation,without blisters,pustules,backward acne and allergies.Conclusion:1.To treat moderate-to-severe acne with ALA-PDT,the higher of the grading in the severity of acne,the higher the treatment effective rate.2.The effective rate was no difference in different gender of ALA-PDT in the treatment of moderate-to-severe acne.3.ALA-PDT is a good treatment of taking effect rapidly,high efficiency,less adverse reactions.It is a good therapeutic method with high safety. |
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