Clinical effect of ablative fractional laser-assisted topical anesthesia on human skin: A randomized pilot study.

BACKGROUND AND OBJECTIVES: Most topical medications need a long time to penetrate into the skin owing to the stratum corneum (SC) barrier. The fractional erbium-doped yttrium aluminum garnet (Er:YAG) laser has the ability to disrupt the SC and assist in the delivery of topical drugs to penetrate into the skin. This study was intended to determine whether pretreatment with a painless fractional Er:YAG laser could assist transdermal delivery of topical anesthesia.

MATERIALS AND METHODS: In 22 healthy female subjects, three 4 × 3 cm regions on the right forearm were randomized to: fractional laser plus topical lidocaine cream (Group LaserAnes), sham irradiation plus topical anesthesia (Group Anes), and sham irradiation plus sham anesthesia (Group Con). After 5 minutes, each site was treated with yttrium scandium gallium garnet laser to evaluate the pain sensation using the visual analog scale.

RESULTS: The average pain scores of Group LaserAnes, Group Anes, and Group Con are 3.74 ± 1.93, 4.90 ± 2.09, and 5.19 ± 2.15, respectively. The pain score of Group LaserAnes has a 25.57% reduction compared to Group Anes (p < 0.001) and a 28.70% reduction compared to Group Con (p < 0.001). There is no significant pain reduction for Group Anes compared with Group Con (p = 0.094).

CONCLUSIONS: Pretreatment using fractional Er:YAG laser before topicals might be an effective method for drug delivery.