What Is Involved?

Methyl ester of ALA is used very much like aminolevulinic acid. It is a cream that is applied topically (directly to the skin) on the face or scalp to treat actinic keratosis lesions. The doctor may first scrape the area with a small, sharp blade. This drug does not reach other parts of the body. The lesions that it is applied to are sensitive to light, but the rest of the body is not. The drug should not be left on the skin for more than 4 hours.

About 3 hours after the drug is applied, your doctor will expose the area being treated to a red light source for 5 to 20 minutes. During the light therapy you and the doctor will wear protective goggles. You may feel stinging or burning once the area is exposed to the red light, which should go away within a day. Two treatment sessions 7 days apart should be done with this treatment. The lesion may scale and crust for a few days before healing. Lesion response should be assessed 3 months after the last treatment.

Who Should Not Get Treated With Methyl Ester of ALA?

Methyl ester of ALA is not recommended for those with:

• a disease of the blood called acute intermittent porphyria
• an allergy to porphyrins
• skin sensitivity to light
• allergies to peanuts or almonds
• immunosuppression

Methyl ester of ALA cream has not been studied for more than 2 treatment sessions. Information regarding more treatments done after 3 months for remaining or new AK lesions is not available.

Possible Side Effects

Photosensitivity reactions are reactions triggered by light. They can occur at the site on the skin where the drug is applied, and usually involve reddening and a stinging or burning sensation. Patients should stay out of the sun, away from bright indoor lights, and avoid extreme cold after the cream is applied and before the light treatment is done. For about 2 days after the light treatment, you should take care to keep the face and scalp area away from any light by

• keeping the treated area covered
• staying out of strong, direct light
• staying indoors as much as possible
• when outdoors, wearing protective clothing and wide-brimmed hats to avoid sunlight
• avoiding beaches, snow, or surfaces where strong light may be reflected

Sunscreen will not protect the skin from photosensitivity.

Skin changes: The skin being treated will likely turn red and may swell after treatment. Burning and stinging are common. The skin may also be itchy, scaly, or change color after treatment. These side effects should get better with time and should be gone by 3 weeks after treatment. If they get worse or are not gone in 3 weeks, contact your doctor.

Revised: 03/20/2007