This narrative review examines advancements in photodynamic therapy (PDT) for treating actinic keratoses (AKs) and nonmelanoma skin cancers (NMSCs). PDT, using photosensitizers like 5-aminolevulinic acid (ALA) and methyl aminolevulinate (MAL), offers a non-surgical option. The review explores improvements in PDT protocols, including alternative light sources (intense pulsed light, pulsed-dye lasers), pretreatment methods (microneedling, ablative fractional resurfacing), and modifications to incubation time and illumination to enhance efficacy and reduce pain. The use of PDT for field cancerization and its application in organ transplant recipients are also discussed. The review concludes by highlighting the need for further research to optimize PDT protocols and expand its clinical applications.

Aaron S Farberg, W Justin, Teo Marson, Soleymani, T. Soleymani