Efficacy analysis of 5-aminolevulinic acid photodynamic therapy for vulvar lichen sclerosus in women of childbearing age.

Objective: To investigate the efficacy and long-term durability of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) in treating vulvar lichen sclerosus (VLS) in women of childbearing age.

Methods: Fifty-five patients with VLS who had failed long-term repeated pharmacological treatments (mean disease duration: 3.6 ± 1.4 years)were enrolled. All participants underwent four sessions of ALA-PDT. Follow-up evaluations were conducted for six months after treatment. Outcomes were assessed using the Cattaneo clinical symptom and sign score and the Dermatology Life Quality Index (DLQI) questionnaire at baseline, after four treatments, and at 3-6 months post-treatment.

Results: At the 6-month follow-up, efficacy rates were 81.8% for pruritus relief, 67.3% for skin elasticity restoration, 63.6% for skin color improvement, and 72.7% for lesion area reduction. Pain was the only reported adverse reaction during treatment.

Conclusion: 20% ALA-PDT is a safe, effective, and durable therapeutic option for VLS with minimal side effects. Notably, it provides a viable alternative for patients unresponsive to conventional therapies.