The Study of Plum-blossom Needling Enhancing Efficacy of Aminolevulinic Acid-photodynamic Therapy for Actinic Keratosis

Background Limited in the depth of absorption and penetration of photosensitizers, ALA‐PDT treatment is not strong enough for thickening significantly AK lesions. Pre‐study has proved that plum‐blossom needling facilitates delivery of topical ALA into the dermis. It could help ALA to diffuse a little more broadly in superficial dermis and obtain similar clinical effect with a much lower cost. Objective We sought to investigate whether plum‐blossom needling (PBN) would enhance the efficacy of ALA‐PDT for AKs. Methods Two hundred and fifty patients, previously diagnosed as having AKs of the face and scalp, were randomized distribution into two groups. The PBN‐ALA‐PDT group underwent vertical skin tapping with PBN before applying 10% ALA cream and narrow‐band light‐emitting diode (LED) irradiation (mean 633 nm, with a standard deviation [SD] of 10 nm; 100‐200 J/cm2). The ALA‐PDT group received ALA cream and irradiation only. During the next 1 year period of follow up, patients were clinically evaluated for new AKs.