Over the past years, photodynamic therapy has been widely used in dermatology mainly for oncologic indications. However, first reports of its efficacy in non-oncologic skin conditions were reported already in the past century, and even the work of the first Nobel prize winner, Niels Ryberg Finsen (phototherapy of lupus vulgaris (skin tuberculosis)) has been identified to rely on the photodynamic principle.
Unfortunately, so far there is no regulatory acceptance of PDT for non-oncologic indications in dermatology. In recent guidelines, and based on field-directed treatments for actinic keratoses, aesthetic aspects with improvement of age-related skin changes reached an excellent grading according to quality of studies and level of recommendation. Other approaches with larger experiences are in the field of microorganism-associated skin diseases like cutaneous leishmaniasis and fungal infections. Current treatment protocols also study the effects of PDT in acne and rosacea. One possible drawback is the presence of relatively cheap alternatives and the need of repetitive treatment approaches which is cumbersome and associated with multiple side-effects.
Perhaps there will be an enlivenment of PDT also in this field based on the new developments in the treatment itself: Daylight-PDT, or artificial daylight-PDT enables the treatment of large areas without painful sensations which is one important prerequisite for patient's acceptance.