A light-activated medicine used in photodynamic therapy
Aminolevulinic acid
A light-activated medicine used in photodynamic therapy for some skin lesions, and as a dye that makes brain-tumour tissue glow during surgery.
What is Aminolevulinic acid?
Aminolevulinic acid is a specialist medicine that makes cells sensitive to light. On the skin it is used in photodynamic therapy to treat sun-damage lesions such as actinic keratosis: a cream or gel is applied, left to soak in, and then a special light is shone on the area to destroy the abnormal cells. As a drink before brain surgery, it makes tumour tissue glow under a special light so the surgeon can see it more clearly. The most important point is that it makes the skin and eyes very sensitive to light, so bright light and sunlight must be avoided for a period afterwards. It is always used by a specialist team.
Education and reference only. This is a plain-language guide to Aminolevulinic acid — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Aminolevulinic acid is a photosensitiser, which means it makes certain cells very sensitive to light. It has two main specialist uses. On the skin it is part of photodynamic therapy, where it is applied to areas of sun damage, such as actinic keratosis or some early skin changes, and then activated with a special light to destroy the abnormal cells. Taken as a drink before some brain-tumour operations, it builds up in tumour cells and makes them glow under a special blue light, helping the surgeon tell tumour from healthy tissue. It is always given and supervised by a specialist team.
How it works
Aminolevulinic acid is taken up by cells and turned into a light-sensitive substance that gathers more in abnormal or tumour cells than in healthy ones. When the right kind of light is then shone on the area, this substance reacts and produces a burst of activity that damages and destroys those cells. In skin photodynamic therapy, the light is aimed at the treated patch to clear sun-damage lesions. In brain surgery, instead of destroying tissue, the substance is used so that tumour cells glow under a special light, guiding the surgeon. Because the whole body becomes light-sensitive for a time, careful light protection is needed afterwards.
Company & origin
Originated / developed by: Specialist manufacturers.
A specialist medicine used in the UK to treat certain sun-damage skin lesions with light therapy, and to help surgeons see brain-tumour tissue more clearly during surgery.
Practical use
How to take Aminolevulinic acid
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- For skin treatment, the cream or gel is applied to the area by the team and left to soak in before a special light is shone on it.
- For brain surgery, it is given as a drink some hours before the operation, exactly as the team directs.
- Avoid strong sunlight and bright lights for the period your team advises afterwards, as your skin and eyes are very light-sensitive.
- Protect treated skin and your eyes, and follow all instructions on covering up and staying out of bright light.
- Tell the team about other medicines, as some can also increase light sensitivity.
Weighing it up
Advantages & disadvantages of Aminolevulinic acid
Advantages
- Allows targeted treatment of sun-damage skin lesions while sparing much of the surrounding healthy skin.
- In brain surgery, helps the surgeon see tumour tissue more clearly, which can guide a more complete removal.
- Used as a precise, specialist-directed treatment rather than a long course of daily medicine.
Disadvantages
- Makes the skin and eyes very sensitive to light, so bright light and sunlight must be avoided for a period.
- Skin treatment can cause stinging, burning, redness, swelling and crusting as the area heals.
- It is a specialist hospital treatment and is not suitable for use at home on its own.
Practical use
Good to know
The single most important thing to understand is that aminolevulinic acid makes your skin and eyes very sensitive to light for a period after it is given, so you must avoid strong sunlight and bright indoor lights as your specialist team advises, even on cloudy days, to prevent burns or eye irritation. With skin photodynamic therapy, the treated area can sting, burn, redden, swell and crust over as it heals, which is expected and usually settles. With the brain-surgery use, the light sensitivity applies to the whole body for a time after the drink. This is a hospital and specialist treatment, not something used at home on its own, and the team will give you clear instructions on light protection, what to expect, and when normal light exposure is safe again.
Who should not take it / use with caution
- People who have had a serious allergic reaction to aminolevulinic acid should not be given it.
- It is avoided in people with certain light-sensitivity conditions, such as porphyria.
- It is used with care, and under specialist guidance, in pregnancy and breastfeeding.
Monitoring
- Checking how the treated skin heals and how well the lesions respond.
- Making sure light protection is followed for the advised period.
- With the brain-surgery use, watching blood pressure and blood tests around the operation.
Side effects
- Stinging, burning, redness, swelling and crusting of treated skin, which usually settles as it heals.
- Strong sensitivity of the skin and eyes to light for a period after treatment, risking burns if light is not avoided.
- With the brain-surgery use, temporary changes in blood pressure or blood tests, watched for by the team.
Key interactions
- Other medicines or substances that increase sensitivity to light can add to the effect, so tell your team about everything you take.
- Some herbal products, such as St John's wort, can increase light sensitivity and should be mentioned.
- There are few routine medicine interactions beyond this, but always give your team a full medicines list.
Available as: A cream or gel applied to the skin, and a powder made into a drink for use before some brain operations.
Answers
Aminolevulinic acid: frequently asked questions
What is aminolevulinic acid used for?
It is used in photodynamic therapy to treat some sun-damage skin lesions, and as a drink before some brain operations to make tumour tissue glow so the surgeon can see it.
Why must I avoid light afterwards?
It makes your skin and eyes very sensitive to light for a period, so strong sunlight and bright lights can cause burns or eye irritation unless you protect yourself as advised.
Will the skin treatment hurt?
The treated area can sting, burn, redden, swell and crust over as it heals; this is expected and usually settles, and the team can advise on soothing it.
How does it help in brain surgery?
It builds up in tumour cells and makes them glow under a special light, helping the surgeon tell tumour tissue from healthy tissue during the operation.
Is this something I use at home?
No. It is a specialist hospital treatment, given and supervised by a trained team, with clear instructions about light protection.
Authoritative sources
- BNF
- NICE CKS
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