Carbon-Dioxide Laser-Associated PDT Treatment of Folliculitis Decalvans

A 48-year-old male with therapy-resistant folliculitis decalvans, a rare scarring alopecia, was successfully treated using carbon dioxide (CO2) laser-associated photodynamic therapy (PDT). Despite various treatments, including corticosteroids, antibiotics, and isotretinoin, significant improvement was not achieved. The CO2 laser treatment facilitated the penetration of 5-amino-levulinic acid (ALA), followed by illumination with red light. After two treatments, the patient showed a nearly complete response with no signs of inflammation and increased hair density. The only side effect was manageable crust formation. This case highlights the potential of CO2 laser-associated PDT as an effective treatment for folliculitis decalvans.