Photodynamic therapy (PDT) with use of topical 5-aminolevulinic acid (ALA, Levulan Kerastick, Dusa Pharmaceuticals, Inc., Wilmington, MA) photosensitizing agent is a new modality for the treatment of acne. Eighteen patients (aged 15 to 63) with moderate to severe inflammatory acne received ALA-PDT. ALA remained in contact with skin for 15 to 30 minutes before exposure to blue light (ClearLight [Lumenis] or BLU-U [Dusa Pharmaceuticals, Inc.]) or the Aurora DSR (Syneron Medical Ltd.), which uses Electro-Optical Synergy (ELOS), a unique combination of optical and radiofrequency (RF) energy. Patients received two to four ALA-PDT treatments over four to eight weeks or two cycles of ALA-PDT (weeks 2, 4) preceded by salicylic acid peel (weeks 1, 3) over four weeks. The average follow-up time was four months. On a scale of 0.0 to 4.0, the average acne grade improvement was 1.75. Among the 12 patients who said their acne had improved, 11 had at least 50% improvement and five had more than 75% improvement. Adverse effects were limited to erythema and peeling for up to five days after treatment and one episode of impetiginization of the affected area. Patients with moderate to severe acne can achieve durable improvement with short-contact ALA-PDT.