Photodynamic Therapy Using Aminolevulinic Acid in Treating Patients With Oral Leukoplakia

Inclusion criteria

Criteria: * Histologically confirmed oral leukoplakia with dysplasia OR oral leukoplakia with hyperplasia in a high-risk area (e.g., floor of mouth, tongue, or oropharynx) * Multiple oral leukoplakia lesions are allowed however no more than 5 distinct lesions are biopsied and treated * All lesions to be treated must be technically accessible by laser * Patients with oral leukoplakia with hyperplasia in a non-high-risk location (e.g., buccal mucosa from ill-fitting dentures) are not allowed * Must be willing to undergo baseline biopsies of leukoplakia lesion(s) and surrounding normal tissue 4-8 weeks before therapy and repeat biopsies at 3 months * No evidence of ongoing radiation damage to the target site * Karnofsky performance status (PS) 70-100% or Zubrod PS 0-1 * Life expectancy \> 2 years * Hemoglobin \> 12 g/dL * Platelet count \> 100,000/mm\^3 * ANC \> 1,500/mm\^3 * Creatinine =\< 1.5 mg/dL * SGPT and SGOT =\< 1.5 x upper limit of normal (ULN) * Total bilirubin =\< 1.5 x ULN (a higher level of bilirubin due to a familial metabolism will be considered on an individual basis) * Willing to adhere to avoidance of sunlight and indoor light exposure for 24 hours after treatment * Not pregnant or nursing * No history of allergic reactions attributed to compounds of similar chemical or biological composition to aminolevulinic acid * No porphyria * No uncontrolled intercurrent illness including, but not limited to, any of the following: * Ongoing or active infection * Symptomatic congestive heart failure * Unstable angina pectoris * Cardiac arrhythmia * Psychiatric illness or social situation that, in the opinion of the investigators, would limit compliance or jeopardize the patient or integrity of the data * Prior treatment for leukoplakia allowed * No prior photodynamic therapy * More than 3 months since prior participation in a clinical trial for leukoplakia * More than 4 weeks since prior ablative therapy to the target lesion * More than 4 weeks since prior and no concurrent psoralen or PUVA therapy * No concurrent oral retinoids (e.g., isotretinoin) * No concurrent use of tanning beds * No other concurrent investigational agents * Fertile patients must use effective contraception * Patients with a previous diagnosis of stage I or II head and neck cancer are eligible provided definitive therapy, including radiation therapy, is completed and the patient has been rendered disease free for \>= 2 years * No chronic liver disease including those with normal liver function tests