Photodynamic therapy (PDT) arose as a method for treating actinic keratosis (AK) but also demonstrated a conspicuous side effect: beautification of the skin through rejuvenation of photodamage. Photodynamic photorejuvenation has become a common tool for the aesthetic physician, yet it still is underutilized for the treatment of conditions such as acne, enlarged pores, rejuvenation, and sebaceous gland hyper-plasia (SGH), as well as skin cancer prevention. Mechanisms of action and protocols will be discussed for treatment of these conditions. Options for photosensitizers, light sources, and incubation strategies also will be reviewed. Finally, new methods for enhancing treatment results such as microneedle-assisted dermal infusion for more confluent and vastly increased uptake of photosensitizers and pretreatment with infrared light (IR) for improving efficiency of production of protoporphyrin IX (PpIX) also will be presented.