Modified red light 5-aminolevulinic acid photodynamic therapy versus low dose isotretinoin therapy for moderate to severe acne vulgaris: A prospective, randomized, multicenter study

Topical 5-aminolevulinic acid photodynamic therapy (PDT) and oral isotretinoin (ISO) are two effective treatments for moderate to severe acne vulgaris. Modified PDT (M-PDT) is associated with less pain, however, lacked a direct comparative evaluation with ISO. A multicenter, randomized clinical trial was conducted with participants randomly assigned to the PDT group or the ISO group and followed up to six months post-therapy. A total of 152 patients were allocated. The overall effective rates in the PDT group were significantly higher than that in the ISO group at one month, while the reverse was the case one month after treatment. No systemic side effects occurred in the PDT group while 70.67% of patients in ISO reported systemic side effects. M-PDT offers a more rapid onset of improvement, comparable overall efficacy, good tolerability, and comparable durability of response compared with ISO.