Ultrastructural changes seen after ALA-IPL photorejuvenation: a pilot study.

BACKGROUND Intense pulse light (IPL) treatment currently represents one of the most popular non-ablative photodamage skin treatments. Recent anecdotal evidence suggests that aminolevulonic acid (ALA) photodynamic therapy using IPL as a light source is superior to IPL alone for photorejuvenation. METHODS Seven adult subjects (six women, one man) with minimal photodamage were treated with full face IPL treatment. Half of the face was pre-treated with topical ALA. Pre-and post-treatment biopsies were analyzed for changes in collagen by electron microscopic ultrastructural analysis. RESULTS An increase in type I collagen fibers was seen after treatment in all subjects. There was a greater increase in type I collagen formation in those subjects who were pre-treated with topical ALA. CONCLUSION This small pilot study is the first to focus on the ultrastructural changes seen after ALA-IPL photorejuvenation. We found a greater shift toward type I collagen synthesis in the ALA-IPL group compared to the IPL group. The addition of ALA to IPL treatment for photorejuvenation may be superior to IPL alone.