Background Superficial basal cell carcinomas of the skin (sBCC) often respond poorly to single-treatment aminolaevulinic acid-based photodynamic therapy (ALA–PDT), with a number of reports indicating a relapse rate of 50% or more.
Objectives To determine whether a second treatment at seven days can improve the response.
Methods Twenty-six lesions were treated twice with ALA–PDT, with an interval of 7 days between the two treatment sessions.
Results We observed a complete response rate of 100% 1 month after treatment. Only one lesion relapsed (16 months post-PDT), a relapse rate of 4% (median follow up 27 months; range 15–45 months). Cosmetic results were excellent.
Conclusions We consider routine double treatments with ALA–PDT to be an effective approach to the management of sBCC, particularly those located in anatomically difficult, or cosmetically sensitive, sites.