Photodynamic therapy (PDT) - Levulan, MAL, etc. reviews

3/5 - 173 reviews
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NOT recommended for sensitive skin; Caused infection and scarring
Reviewed on November 1, 2014

I really want to warn people with acne-prone, sensitive skin NOT to consider this treatment.

I received two ALA photodynamic therapy treatments about two months apart; the last one I received about 5 months ago. I would NOT recommend this treatment to anyone, and especially not anyone with sensitive skin, because the first and second treatment did nothing to help my acne, and the second treatment caused me to break out into hundreds of itchy, red bumps, infected pustules, and painful cysts across the lower half of my face, which led to pitted scarring.

The treatments seemed to stimulate the formation of cystic acne in places I never before experienced cystic acne, such as my forehead, which also resulted in permanent scarring. I actually did not previously have skin that would easily scar, but after this treatment, my skin was more sensitive and prone to scarring. I am not sure why, but once the peeling process began with the second treatment (about 4 days in), my skin erupted into a terrible break out around my mouth, on my chin, and across my jaw like nothing I've ever experienced before. My dermatologist (who only emailed me in response to my concern) thought it was a "purging" effect, and I only wish I had gone to see someone else sooner because the reaction actually wasn't normal. After a month of dealing with a severe infection that I foolishly thought was "purging" and that I hoped would subside on its own, I finally went to see a different derm who prescribed me antibiotics. It cleared up in two weeks on the minocycline I was prescribed. I really wish I had gone on the antibiotics sooner.

Since then, I have been treating my skin with Differin cream which has cleared up my skin and improved the hyperpigmentation from scarring. Unfortunately, I am left with many boxcar and shallow icepick scars, though they have improved slightly over time. I am hoping over the next year I will see more improvement. Since my scars are quite shallow, I hope that at some point they won't hardly be noticeable. I am considering getting acne scar treatments once a year has passed from my initial infection (since scar formation and healing can take about a year).

I give this treatment ONE star because it can possibly be effective at facial rejuvenation. Some parts of my face responded well (upper forehead) and looked brighter and more uniform afterward. However, the majority of the parts of my treated skin did not respond well at all and made my skin more acne- and scar-prone than before. Please, do not waste your money. There have not been enough research trials to confirm that this as an effective method at treating acne for the majority of patients.


avoid Levulan, did not help acne and caused much permanent scarring!
Reviewed on December 13, 2013

I stupidly had Levulan done in 2010: In addition to not helping my acne at all, now I have rolling scars on any area where I have dry skin (both my cheeks from jawbone to eye). Also, I looked like a burn victim for 10 days immediately after the treatment and got sunburnt easily for months afterwards. This treatment scarred my skin for life and did not help my acne at all.


Worst acne treatment I have ever experienced on my skin. Horrible beyond words!!!
Reviewed on October 17, 2013

I have been fighting moderate/severe acne since late teens. Now I am 24 and still have breakouts now and then. There are days when my skin seems to be improving, then it once again drops back at being the usual nasty self. In other words, the same acne experience as most of us have. I have tried accutane (Roaccutane by Roche), it was amazing, my skin had never been so perfect before! Though I had a severe depression, apathy, suicidal thoughts as well as weight loss. However, back then I did not consider those "severe side effects", I made it through and got a beautiful skin without any imperfections at all! After more than a year my breakouts came back. This time it wasn't that bad, so I hoped to keep it under control by more natural remedies. Time passed and I got sick and tired of stressing out about my skin everyday, so my doctor advised this new "amazing, risk-free and side effect-free" method to help cure my facial skin. She said I would need 2 to 3 treatments. I read some stuff about this therapy online, the photos of people who had it done and the bad reviews did not stop me from doing it, somehow I got hooked and thought, let's give it a go! What a mistake!!!!!! At least that's what I think now. Some may say, you should go through all 3 necessary treatments before saying anything.. well, truth be told, it is the most horrible experience I have EVER had in my life. And I have had natural childbirth, so I know what pain is like. This is truly awful, I cannot even look at myself in the mirror. I had the Levulan thing put on my face for three hours on Tuesday (today is Thursday), then 15 minutes of intense burning under LED red light. I though then, I can handle this, it wasn't that bad. It stung and hurt, but it was bearable. Then the next morning came. My face swollen literally like a red Halloween pumpkin. Horrifying. Then by the end of day 2 the whiteheads started to come out. Millions of them, everywhere where the Levulan was put. Since it was only day 2, I though, oh, well, this will get better. Day 3 came. Nothing had improved, only got much worse. Even more whiteheads, everywhere, every square inch covered in them. I not only looked horrible, I felt much worse seeing my face in the mirror. I though I would get at least some improvement from this, but I have a feeling this treatment will make my situation worse. I did not even have severe acne before the treatment, just a couple of tiny spots on the cheeks and one or two occasional cystic pimples. Not comfortable, of course, but now I think I would much rather live with them, with make up caked upon them, then go through this hell once again. It's horrible, plus there is so much pain, I cannot even sleep at night, my face hurts as soon as it touches the pillow or anything really. I know, some might say this is only day 3, what are you moaning about???? Well, this isn't worth it. If it meant only one treatment and going through this hell just once for amazing results, I would probably stay quiet and just wait for it to end. Now that I know it is just the beginning of a series of self torture sessions, I am pretty sure I will disappoint my doc and refuse any further Levulan sessions. This kind of pain is only for the crazy ones who are really ready to punish their skin for being bad this way. Plus, everyone who says that acne must be treated from within, is totally right. All these topical treatments are just temporary (IF they work at all...). I know this might not be useful for anybody, since I am in the middle of the healing process still, but who knows, somebody like myself might be just as desperate and mad in this same situation.. and then this will be a small comfort to know that they are not alone in this hell!!! I will update next week, how my situation has changed.


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Reviewed on March 1, 2013

If you have the money an have stubborn acne, go for it. Or if you can get your health insurance to pay for it, do it! It's amazing! And can take years off of your skin in the process of helping your acne. My skin is BEAUTIFUL after the treatments. I've tried all topical acne meds, Accutane, antibiotics, etc. and Levulan is truly the best.


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Reviewed on September 14, 2012

I only got one treatment, maybe it would have worked after all 3.


Reviewed on August 21, 2012

I did this treatment because my acne was getting out of control. I had so many acne popping up everyday, therefore I went to my first dermatologist and he advised me to do Levulan Blue Light. First, I doubted this treatment would be effective but it doesn't hurt to try since my face was already a disaster. So I had the treatment done and my face felt a bit stingy afterwards.

The next day my face flared up in flames and in the sun my face burned like ****! It was so embarrassing to go out since I looked like I got a sunburn on my face. (BTW, huge whiteheads formed, which is totally suppose to happen.)

On the fourth day, my entire face began to peel. Strips of dead skin would flake off my face like snow. (The whiteheads got smaller and turned black (blackheads??).) So nasty however it was worth it. My face started to itch.

By the sixth day, the redness reduced but flaking got worse. My entire face became really itchy. Try not to touch it!!

By the eighth day, redness reduced, peeling reduced, itchiness reduce.

By ninth day, my face returned to normal. Yay!!

Today is the seventeenth day and NOT A SINGLE PIMPLE appeared yet! And Mother nature's monthly gift was given to me two days ago. Usually a week before I start, my pimple would pop up like daisies!

Well That's All. Thanks For Reading.


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Reviewed on May 10, 2012

So this is the procedure, 1st week: levulan Treatment.. next 2 weeks: Care. and then back on levulan for the repetition of three times. I just got my second Levulan treatment yesterday (week four).. and from what i read on the review i'm trying to avoid the sunlight for a week by wearing a mask..even at work.. My co-workers thought i was some kind of robber.. anyway..

My doc said this is just because i had so much infections stored in my skin (lower jaw specifically) and that the levulan is literally pulling all the acne from deep within my skin.. hopefully it's all healed up by this week.. or i might go crazy.. stinging pains reoccurring now and then.. my doctor is also prescribing me drungs including procutane (weaker version of accutane i think) and some strong antibiotics.. i don't even think this is allowed.. but Korea is different i suppose.. anyways here's to hoping that this will get progressively better..


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Reviewed on January 5, 2012

I have recently had had the levulan activated acne treatment. I have underwent my second one out of four. The pain is the worst you can possibly imagine, Horrible, excruciating. I have had a 75% clearing and have two more treatments to undergo. I HIGHLY reccomend this treatment is defienently worth the price and is truly a cure for acne.


member avatar
Reviewed on December 28, 2011

This is an update to my original post about five months ago.

I actually typed "AHA" instead of "ALA," but you all knew what I meant. :)

When I went in for my third treatment, in my drug-induced haze (haha) I asked the doctor would I have to come back any more and unfortunately, I'm one of the lucky ones that this treatment apparently doesn't cure. I still break out with pus-filled lesions as well as cysts. The treatment and lasers the doctor used on me helped some to flatten an old raised Fraxel Re:store burn scar right under my jaw, but, as stated, I still break out. With these treatments running almost $700 a pop, I'm looking at new options.

Even though this didn't work for me, I do encourage you to go for it IF you have the funds. Use all options available to you...just realize this may not be the end all be all.

Current routine: using Glytone cleanser with a Clarisonic I received for Christmas. Received a new Tanda for Christmas as well. Started the Tanda and Clarisonic this week. Have been using Glytone for months. Trying a trick I heard about...Head & Shoulders shampoo. Been doing this for about a month. I think the zinc is supposed to help. Seeing a dermatologist now...back on spirolactone (for about a week now) after years of being off. Still on doxycycline and taking Vitamin C, lysine, and bromelain as supplements. Still on Ortho-Lo and using Retin-A.

Although I'm still having some serious breakouts and major scarring, and I hate looking at myself and having others look at me, I am trying to stay positive and look forward to getting these breakouts under control so I can have my Fraxel Re:pair. I hope that's a godsend. My new dermatologist wants to use a Sciton (spelling?) laser treatment after we get a hold of my acne instead of Re:pair.

Keeping fighting the fight and sharing your experiences. As hideous as I feel, I am stronger than most for going through all that I have. And so are you.