ArticleDermatology practical & conceptual2026
Evaluation of 30% Urea Pretreatment in Enhancing the Efficacy of Photodynamic Therapy for Actinic Keratoses of the Scalp.
Article in Dermatology practical & conceptual, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionThe use of curettage to reduce the hyperkeratotic component of actinic keratoses is a recommended step prior to photodynamic therapy (PDT); however, the procedure may not be well tolerated by the patient. Due to these drawbacks, alternative approaches aimed at reducing lesion hyperkeratosis and optimizing PDT effectiveness have been studied.
objectiveThe aim of the present study was to assess whether a 14-day pretreatment with 30% urea cream enhanced the penetration of methyl aminolevulinate (MAL) and improved clinical outcomes of photodynamic therapy (PDT) in the treatment of scalp actinic keratoses (AKs).
methodsA split-scalp design was used on adult patients with multiple AKs. One half received 30% urea emollient cream for 14 days before conventional MAL-PDT. Outcomes included PpIX fluorescence, AK reduction, pain scores, local skin reaction (LSR), cosmetic results, and patient satisfaction.
resultsPpIX fluorescence was significantly higher in the urea-treated area (P=0.0128), indicating enhanced MAL penetration. Urea pretreatment yielded significant reductions in AKs, particularly for OLSEN II grade lesions (P<0.0001). Pain scores were slightly higher in the urea group (P=0.029), while overall LSR, cosmetic outcomes, and patient satisfaction were comparable between the two sides.
conclusionPretreatment with 30% urea cream significantly improves MAL uptake and clinical response in PDT for scalp AKs without compromising tolerability or patient satisfaction.
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