CO2 laser ablative fractional resurfacing photodynamic therapy for actinic keratosis and nonmelanoma skin cancer: a randomized split-side study

Cutis. 2020 May;105(5):251-254.


Aminolevulinic acid (ALA) photodynamic therapy (PDT) is a preferred method for treatment of multiple actinic keratoses (AKs) in broad skin areas (referred to as field cancerization). Pretreatment with CO2 laser ablative fractional resurfacing (AFR) may increase the efficacy of PDT. This study compared the effect and durability of CO2 laser AFR-assisted ALA-PDT vs ALA-PDT alone in the treatment of AKs and nonmelanoma skin cancers (NMSCs) at various body locations. In this randomized, split-side study, 19 patients had 1 side pretreated with AFR before treatment of both sides with ALA-PDT. Results indicated that pretreatment with AFR provided superior clearance of AKs and thin NMSCs at 6 months compared to ALA-PDT alone.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aminolevulinic Acid / administration & dosage*
  • Combined Modality Therapy
  • Dose Fractionation, Radiation
  • Female
  • Humans
  • Keratosis, Actinic / therapy*
  • Laser Therapy / methods*
  • Lasers, Gas / therapeutic use*
  • Male
  • Middle Aged
  • Photochemotherapy / methods*
  • Photosensitizing Agents / administration & dosage*
  • Skin / drug effects
  • Skin / pathology
  • Skin / radiation effects
  • Skin Neoplasms / drug therapy
  • Skin Neoplasms / therapy*
  • Treatment Outcome


  • Photosensitizing Agents
  • Aminolevulinic Acid