Treatment of Fordyce spots with 5-aminolaevulinic acid?photodynamic therapy

Conflicts of interest: none declared. Sir, Fordyce spots are heterotopic sebaceous glands, clinically characterized by minute orange or yellowish pinhead‐sized macules or papules. Although the condition is not generally considered as pathological, there are some problematic cases causing significant cosmetic concern. To date, carbon dioxide laser or oral isotretinoin have been reported as treatment options but no ideal treatment is available.1, 2 Photodynamic therapy (PDT) is a treatment modality which involves the sequential administration of a photosensitizer or photosensitizer precursor, and light. It was recently demonstrated that protoporphyrin IX accumulates not only in neoplastic cells but preferentially also in the pilosebaceous units, which can be target tissues in 5‐aminolaevulinic acid (ALA)–PDT.3 This provides a theoretical rationale for exploring the use of ALA–PDT to treat several disorders of pilosebaceous units. Recently, clinical trials of ALA–PDT to treat acne vulgaris, sebaceous hyperplasia and naevus sebaceus showed some promising results with good cosmetic outcome.4–8 However, there have been no reports of PDT for the treatment of Fordyce spots. We report the treatment outcomes of ALA–PDT in the treatment of Fordyce spots.