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Topical PDT in the Treatment of Benign Skin Diseases: Principles and New Applications
Open accessAbstract
Photodynamic therapy (PDT) uses a photosensitizer, light energy, and molecular oxygen to cause cell damage. Cells exposed to the photosensitizer are susceptible to destruction upon light absorption because excitation of the photosensitizing agents leads to the production of reactive oxygen species and, subsequently, direct cytotoxicity. Using the intrinsic cellular heme biosynthetic pathway, topical PDT selectively targets abnormal cells, while preserving normal surrounding tissues. This selective cytotoxic effect is the basis for the use of PDT in antitumor treatment. Clinically, PDT is a widely used therapeutic regimen for oncologic skin conditions such as actinic keratosis, squamous cell carcinoma in situ, and basal cell carcinoma. PDT has been shown, under certain circumstances, to stimulate the immune system and produce antibacterial, and/or regenerative effects while protecting cell viability. Thus, it may be useful for treating benign skin conditions. An increasing number of studies support the idea that PDT may be effective for treating acne vulgaris and several other inflammatory/infective skin diseases, including psoriasis, rosacea, viral warts, and aging-related changes. This review provides an overview of the clinical investigations of PDT and discusses each of the essential aspects of the sequence: its mechanism of action, common photosensitizers, light sources, and clinical applications in dermatology. Of the numerous clinical trials of PDT in dermatology, this review focuses on those studies that have reported remarkable therapeutic benefits following topical PDT for benign skin conditions such as acne vulgaris, viral warts, and photorejuvenation without causing severe side effects.
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![Figure 2 Representative photographs before (A,B) and after chlorophyll-PDT treatment (C,D). After three treatment sessions of chlorophyll-PDT, there was a significant decrease in the number of papules and pustules in moderate inflammatory acne patient [34].](/paper-figures/09bd05ae72fe471fab8db52234436cba/topical-pdt-in-the-treatment-of-benign-skin-diseases-principles-and-new-figure-2.jpg)
![Figure 3 Representative photographs before and after ILI-PDT. Wart lesions on the foot at baseline (A,C) and 1 month after three sessions of ILI-PDT (B,D). Marked reduction of warts was shown on the great toe and little toe [67].](/paper-figures/314bfd68684049da8c1d2226f76d9443/topical-pdt-in-the-treatment-of-benign-skin-diseases-principles-and-new-figure-3.jpg)
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“For the treatment of acne, the total dose of red light needs to be adjusted for FST as discussed by multiple authors for patients of Asian origin.65,118–120”
From Effect of skin color on optical properties and the implications for medical optical technologies: a review (2024) · cites this paper as [120]
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Cites
The present and future role of photodynamic therapy in cancer treatment
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Cell Death Pathways in Photodynamic Therapy of Cancer
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Research advances in the use of tetrapyrrolic photosensitizers for photodynamic therapy
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Topical ALA-Photodynamic Therapy for the Treatment of Acne Vulgaris
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Macrophages During the Fibrotic Process: M2 as Friend and Foe
Braga, T. T., Agudelo, J. S. H., & Câmara, N. O. S. (2015) · Frontiers in Immunology · doi:10.3389/fimmu.2015.00602 · Cited by 481
A clinical review of phototherapy for psoriasis
Zhang, P., & Wu, M. X. (2017) · Lasers in Medical Science · doi:10.1007/s10103-017-2360-1 · Cited by 304
Trends and targets in antiviral phototherapy
Wiehe, A., O’Brien, J. M., & Senge, M. O. (2019) · Photochemical & Photobiological Sciences · doi:10.1039/c9pp00211a · Cited by 260
The potential of photodynamic therapy (PDT)—Experimental investigations and clinical use
Oniszczuk, A., Wojtunik‐Kulesza, K. A., Oniszczuk, T., & Kasprzak‐Drozd, K. (2016) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2016.07.058 · Cited by 214
Recent advances in innovative strategies for enhanced cancer photodynamic therapy
Hu, T., Wang, Z., Shen, W., Liang, R., Yan, D., & Wei, M. (2021) · Theranostics · doi:10.7150/thno.54227 · Cited by 210
Metadata
- Authors
- Kim, M., Jung, H., & Park, H.
- Affiliations
- The Catholic University of Korea Yeouido St. Mary's Hospital (KR)
- Corresponding author
- Park, Hyun
- ORCID
- Venue
- International Journal of Molecular Sciences
- Publisher
- MDPI AG
- Published
- 2015-09-25
- Volume
- 16
- Issue
- 10
- Pages
- 23259-23278
- ISSN
- 1422-0067 (ISSN-L)
- PMC
- PMC4632697
- OpenAlex
- W2155002081
- Cited by
- 133
- References
- 96
- Citations by year
- 2026: 11 · 2025: 12 · 2024: 15 · 2023: 8 · 2022: 15 · 2021: 16 · 2020: 11 · 2019: 14 · 2018: 14 · 2017: 7 · 2016: 8 · 2015: 1
- FWCI
- 1.77
- Type
- journal article
- Language
- en
- Open access
- gold
- dx.doi.org
- Licence
- Locations
- International Journal of Molecular Sciences (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- National Research Foundation
- National Research Foundation of Korea (2012046972)
- Ministry of Education, Science and Technology (2012046972)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Photodynamic Therapy Research Studies
- Health Sciences › Medicine › Dermatology › Nonmelanoma Skin Cancer Studies
- Health Sciences › Medicine › Dermatology › Acne and Rosacea Treatments and Effects
- Keywords
- photodynamic therapy, topical photodynamic therapy, benign skin disease, photosensitizers, reactive oxygen species, heme biosynthesis, acne, viral warts, photorejuvenation, psoriasis, rosacea, actinic keratosis, Bowen's disease, basal cell carcinoma, light sources, immunostimulation
- MeSH terms
- Administration, Cutaneous, Female, Humans, Male, Photochemotherapy, Skin Diseases, Photosensitizing Agents
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