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Background  Actinic cheilitis ( AC ) is a variant of actinic keratosis (AK) affecting the lips and caused by chronic ultraviolet exposure.    Objective  Alacare is a self‐adhesive, skin‐coloured 5‐aminolaevulinic acid patch that has been developed for use in photodynamic therapy ( PDT ) of mild‐to‐moderate AK. Based on promising preliminary results in the treatment of  AC  with Alacare patch  PDT , we decided to extend our previous investigation to gain more data on the efficacy, tolerability, safety and cosmetic outcome of Alacare patch  PDT  for  AC .    Methods  Twenty‐one patients with a clinical diagnosis of mild‐to‐moderate  AC  were included in the study and subjected to one single session of  PDT . After occlusion with the Alacare patch for 4 h, the  AC  lesions were illuminated for 10 min with red light at a dose of 37 J/cm 2 . All patients received local anaesthesia prior to illumination. Additionally, all lesions were cooled during  PDT  with a cold air blower.  PDT ‐induced pain and skin phototoxicity were monitored during and up to 7 days after  PDT . Clinical assessment of efficacy, cosmetic outcome and global patient satisfaction was performed at 3, 6 and 12 months after treatment.    Results  Nineteen patients completed the study. Three months after  PDT , 17 patients (89.5%) had achieved complete remission. Of these, one patient presented with recurrence of  AC  at the 6‐month follow‐up, whereas all other patients remained in remission until the end of the observation period. The complete clinical cure rate at 1 year after a single Alacare patch  PDT  thus was 84.2%. Pain during illumination and the phototoxic skin reaction were in general mild to moderate. The cosmetic outcome was excellent.    Conclusion  The present prospective study on Alacare patch  PDT  for  AC  confirms its high clinical efficacy, good tolerability and favourable cosmetic effects. Alacare patch  PDT  should be considered as a valid treatment option for patients with  AC .

5‐Aminolevulinic acid patch (Alacare) photodynamic therapy for actinic cheilitis: data from a prospective 12‐month follow‐up study on 21 patients