What it is

→ ALA photosensitizer therapy refers to a type of photodynamic therapy (PDT) that uses aminolevulinic acid (ALA) as the photosensitizing agent.

→ When applied to the skin, ALA is absorbed by abnormal or rapidly growing cells (such as precancerous or acne-related cells). Inside the cells, ALA converts into protoporphyrin IX (PpIX), a compound that becomes highly sensitive to light.

→ When the treated area is exposed to a specific wavelength of light (blue, red, or daylight), PpIX produces reactive oxygen species that destroy abnormal cells.

→ ALA therapy is widely used for:

• Actinic keratoses (precancerous sun-damaged lesions).
• Acne vulgaris (by reducing sebaceous gland activity and acne-causing bacteria).
• Photorejuvenation (improving wrinkles, texture, and pigmentation).
• Superficial skin cancers (in selected cases).

Why it’s done

→ ALA photosensitizer therapy is performed for both medical and cosmetic purposes:

• To treat actinic keratoses, preventing their progression to squamous cell carcinoma.
• To manage moderate-to-severe acne without long-term antibiotics or isotretinoin.
• To achieve cosmetic rejuvenation, reducing fine lines, pigmentation, and uneven skin tone.
• To clear field damage in areas with widespread sun exposure.
• To provide a minimally invasive, non-surgical alternative to more aggressive treatments.

→ It is especially recommended for patients with chronic sun damage, precancerous lesions, or persistent acne that does not respond to standard therapies.

Alternatives

→ Alternatives to ALA photosensitizer therapy include:

• Other photosensitizers → Methyl aminolevulinate (MAL) PDT.
• Topical therapies → 5-FU, imiquimod, or diclofenac gel for actinic keratoses.
• Cryotherapy → liquid nitrogen for individual lesions.
• Laser therapy and chemical peels → resurfacing treatments for sun damage.
• Oral acne medications → isotretinoin, antibiotics, or hormonal therapy.
• Conventional skincare → retinoids, vitamin C, and sunscreens for mild photoaging.

→ The choice depends on the extent of damage, patient’s tolerance, and cosmetic goals.

Preparation

→ To prepare for ALA photosensitizer therapy:

• Dermatology evaluation → confirm diagnosis and suitability for PDT.
• Avoid sun exposure → at least 1–2 weeks before therapy.
• Stop photosensitizing medications if possible (e.g., tetracyclines).
• Clean skin → no makeup, sunscreen, or lotions on treatment day.
• Discontinue harsh skincare → retinoids, peels, or exfoliants should be paused 3–5 days before.
• Plan downtime → mild redness, peeling, and sensitivity are expected post-treatment.

How it’s Done

→ A typical ALA PDT session includes:

• Application → ALA solution or cream applied to the treatment area (face, scalp, chest, or back).
• Incubation → the cream is left for 30–180 minutes to penetrate cells and convert into PpIX.
• Light activation → dermatologist exposes the area to a specific light source:
  • Blue light → more superficial effects (ideal for acne and actinic keratoses).
  • Red light → penetrates deeper, effective for thicker lesions.
  • Daylight → a gentler activation method with less pain.
• Reaction → abnormal cells absorb light, producing reactive oxygen species that destroy them.
• Completion → cream is removed, skin is cleansed, and sunscreen or soothing ointments are applied.

→ The procedure usually lasts 1.5–3 hours, depending on incubation time.

Recovery

→ Recovery after ALA photosensitizer therapy is generally quick:

• Day 1–3 → redness, mild swelling, and sensitivity like a sunburn.
• Day 3–7 → peeling, crusting, and flaking as damaged cells shed.
• Day 7–14 → skin heals, appearing clearer, smoother, and more even-toned.

→ Patients should:

• Avoid direct sun exposure for at least 48 hours.
• Use broad-spectrum sunscreen daily.
• Apply gentle moisturizers and healing ointments.
• Avoid harsh skincare until the skin recovers.

→ Most patients resume normal activities within 1–2 days, but visible peeling may continue for up to a week.

Complications

→ ALA photosensitizer therapy is safe, but potential side effects include:

• Temporary redness, swelling, and irritation.
• Burning or stinging sensations during light exposure.
• Peeling or scabbing during recovery.
• Hyperpigmentation or hypopigmentation, especially in darker skin types.
• Photosensitivity reactions if exposed to sunlight too soon.

→ Rare but possible risks: scarring or infection if aftercare is neglected.

Treatment options in Korea

→ Korea is a global hub for advanced dermatology, and ALA photosensitizer therapy is widely used for both medical and cosmetic purposes.

• Cutting-edge devices → clinics use the latest PDT systems with precise light wavelengths for safe activation.
• Customized incubation times → Korean dermatologists adjust protocols based on skin type, severity, and treatment goals.
• Combination treatments → ALA PDT is often paired with chemical peels, lasers, or microneedling for enhanced results.
• Acne focus → many clinics use ALA PDT to treat resistant acne, combined with K-beauty skincare regimens.
• Cosmetic integration → clinics emphasize not only medical clearance of lesions but also rejuvenation and anti-aging benefits.
• International patient services → English-speaking dermatologists and structured medical tourism programs are common.
• Preventive emphasis → Korean dermatology clinics stress long-term sun protection and skin health education after PDT.

→ With its combination of medical precision, cosmetic expertise, and advanced technology, Korea offers some of the most effective and patient-friendly ALA photosensitizer therapy options worldwide.