Photodynamic therapy (PDT) involves the use of topically applied aminolevulinic acid (ALA), in conjunction with a light sensitizer, to generate reactive oxygen species in the skin. Currently, the only FDA-approved indication for ALA-based PDT is for the treatment of actinic keratoses. However, through a review of the medical literature, it has been found that dermatologists and dermasurgeons alike have, through off-label uses, expanded the possibilities for treatment of a variety of conditions, which include cutaneous oncology and cosmetic dermasurgery. These off-label uses of ALA-PDT include photorejuvination and the treatment of Barrett's esophagus, Paget's disease, acne vulgaris, psoriasis, sebaceous gland hyperplasia, rosacea, and hirsutism.
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