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Does Topical Anesthesia Alter the Outcomes of Vascular Laser Procedures? Review of Vasodynamic Effects and Clinical Outcomes Data. Dermatol Surg 2023; 49:266-271. [PMID: 36716423 DOI: 10.1097/dss.0000000000003701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Topical anesthesia has vasodynamic effects within the skin and therefore has the potential to change the presence of hemoglobin as a chromophore before intense pulsed light (IPL) and vascular laser treatments. It is unclear whether this is clinically relevant. Global consensus on the use of topical anesthetics in this context is lacking. OBJECTIVE Review the effects of topical anesthetics on the skin microvasculature and the clinical implications of such effects on vascular treatments. METHODS PubMed and Medline searches were performed to identify studies examining the vasodynamic effects of topical anesthesia on skin and evaluating differences in efficacy of IPL and vascular laser treatments with or without topical anesthetic use. RESULTS Published studies reveal variable effects of different topical anesthetic agents on skin microvasculature. Only 3 controlled studies that directly examined the effect of topical anesthesia on clinical outcomes for pulsed dye laser (PDL) treatment of vascular conditions were identified. They did not support a difference in clinical outcomes with or without the use of topical anesthesia before PDL treatment. CONCLUSION Although topical anesthetic agents have vasodynamic effects within the skin, there is currently insufficient evidence to advise against their use before light and laser-based vascular treatments.
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Hu W, Bian Q, Zhou Y, Gao J. Pain management with transdermal drug administration: A review. Int J Pharm 2022; 618:121696. [PMID: 35337906 DOI: 10.1016/j.ijpharm.2022.121696] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 03/08/2022] [Accepted: 03/19/2022] [Indexed: 12/31/2022]
Abstract
Pain management is an urgent issue to solve with complex mechanisms. Localized acute pain requires rapid and accurate delivery of drugs with less distribution in the blood circulation while chronic pain requires controlled release of drugs with long drug retention time. The transdermal route, a promising way with high patient compliance was known for painless delivery, long drug retention time, stable blood concentration, easily controlled dosage and release rate as well as the fewer side effects. This review presents transdermal route for pain management according to the different sites of action which drugs aim to reach, and illustrates different analgesic mechanisms, dosage forms, transdermal enhancements and clinical applications. In addition, the review concludes the difference of pain types and presents the future aims of pain management, thereby providing a reference for researches focusing on percutaneous analgesia.
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Affiliation(s)
- Weitong Hu
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
| | - Qiong Bian
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
| | - Yanjun Zhou
- Zhejiang Huanling Pharmaceutical Technology Company, Jinhua 321000, China
| | - Jianqing Gao
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China; Jiangsu Engineering Research Center for New-type External and Transdermal Preparations , Changzhou 213149, China; Jinhua Institute of Zhejiang University, Jinhua 321002, China.
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Yepuri V, Patil AD, Fritz K, Salavastru C, Kroumpouzos G, Nisticò SP, Piccolo D, Sadek A, Badawi A, Kassir M, Gold MH, Große-Büning S, Grabbe S, Goldust M. Light-Based Devices for the Treatment of Facial Erythema and Telangiectasia. Dermatol Ther (Heidelb) 2021; 11:1879-1887. [PMID: 34562267 PMCID: PMC8611125 DOI: 10.1007/s13555-021-00607-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Indexed: 10/26/2022] Open
Abstract
Facial erythema is one of the most common outpatient complaints in dermatology. There are various causes of facial erythema and several devices are available for its treatment. Pulsed dye laser (PDL) and intense pulsed light (IPL) are the two common light devices used for these conditions. In this review, we evaluated the literature to assess efficacy of IPL versus PDL in facial erythema and telangiectasia. We searched published articles including clinical trials or reviews articles, case series, and case reports. Electronic databases (MEDLINE and PubMed) were searched to retrieve the articles. Reference lists of selected articles were also considered for the review. Articles published in English language until June 2021 were considered for this review.
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Affiliation(s)
- Vani Yepuri
- Venkat Charmalaya, Centre for Advanced Dermatology and Post Graduate Training, Bangalore, Karnataka, India
| | - Anant D Patil
- Department of Pharmacology, Dr. DY Patil Medical College, Navi Mumbai, India
| | - Klaus Fritz
- Dermatology and Laser Center, Reduitstr. 13, 76829, Landau, Germany.,"Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Str, 020021, Bucharest, Romania
| | - Carmen Salavastru
- "Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Str, 020021, Bucharest, Romania.,"Colentina" Clinical Hospital, Pediatric Dermatology Discipline, Dermato-Oncology Research Facility, 19-21 Stefan cel Mare Str, Bucharest, Romania
| | - George Kroumpouzos
- Department of Dermatology, Alpert Medical School of Brown University, Providence, Rhode, Island.,Department of Dermatology, Medical School of Jundiaí, São Paulo, Brazil.,GK Dermatology, PC, South Weymouth, Massachusetts, USA
| | - Steven Paul Nisticò
- Dermatology Unit, Department of Health Sciences, Magna Graecia University of Catanzaro, 88100, Catanzaro, Italy
| | | | - Ahmed Sadek
- Cairo Hospital for Dermatology and Venereology (Al-Haud Al-Marsoud) Manager, Cairo, Egypt
| | - Ashraf Badawi
- Medical Laser Applications, National Institute of Laser Enhanced Sciences, Cairo University, Giza, Egypt.,Dermatology and Allergology Department, Faculty of Medicine, Szeged University, Szeged, Hungary.,, Oakville, Canada
| | | | - Michael H Gold
- Gold Skin Care Center, Tennessee Clinical Research Center, Nashville, TN, USA
| | | | - Stephan Grabbe
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Mohamad Goldust
- Department of Dermatology, University Medical Center Mainz, Mainz, Germany.
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Loyal J, Carr E, Almukhtar R, Goldman MP. Updates and Best Practices in the Management of Facial Erythema. Clin Cosmet Investig Dermatol 2021; 14:601-614. [PMID: 34135612 PMCID: PMC8197440 DOI: 10.2147/ccid.s267203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 05/19/2021] [Indexed: 12/21/2022]
Abstract
Facial erythema is a common dermatologic complaint. There are many medical and procedure-based treatments to help reduce the appearance of unwanted facial redness. The authors review a variety of treatment options and techniques to reduce facial erythema and prominent facial veins including topical medical therapies, a variety of lasers, light- and energy-based devices as well as the use of neuromodulators and sclerotherapy. The benefits and potential pitfalls of each procedure modality are also highlighted.
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Affiliation(s)
- Jameson Loyal
- Department of Dermatology, State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
| | - Emily Carr
- Cosmetic Laser Dermatology: A West Dermatology Company, San Diego, CA, USA
| | - Rawaa Almukhtar
- Cosmetic Laser Dermatology: A West Dermatology Company, San Diego, CA, USA
| | - Mitchel P Goldman
- Cosmetic Laser Dermatology: A West Dermatology Company, San Diego, CA, USA.,Department of Dermatology, University of California, San Diego, CA, USA
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Husein-ElAhmed H, Steinhoff M. Laser and light-based therapies in the management of rosacea: an updated systematic review. Lasers Med Sci 2021; 36:1151-1160. [PMID: 33389310 DOI: 10.1007/s10103-020-03200-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 11/13/2020] [Indexed: 01/08/2023]
Abstract
Unlike other rosacea therapies which need daily takings or applications over long periods, the edge of lasers and light-based therapies (LLBT) is the limited number of sessions to achieve improvement. The proper selection of the adequate physical device in accordance with the patients' skin features and rosacea-related signs and symptoms should be considered and the management with physical sources should be updated as new data become available. This article reviews and discusses the current use of lasers and light-based therapies in rosacea with reference to all the available literature.This systematic review demonstrates the quality of evidence to support any recommendation on LLBT in rosacea is low-to-moderate. Among all the available devices, PDL holds the most robust evidence. Treatments options should be tailored for each specific clinical scenario as it is unlike that single modality results in complete resolution. Platforms that include two or more devices and combined therapies with topical agents are suitable and they warrant further investigations.
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Affiliation(s)
- Husein Husein-ElAhmed
- Department of Dermatology and Venereology, Hospital de Baza, Granada, Spain. .,Translational Research Institute, Hamad Medical Corporation, Doha, Qatar.
| | - Martin Steinhoff
- Translational Research Institute, Hamad Medical Corporation, Doha, Qatar. .,Department of Dermatology and Venereology, Hamad Medical Corporation, Doha, Qatar. .,College of Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar. .,Medical School, Qatar University, Doha, Qatar. .,Department of Dermatology, Weill Cornell Medicine, New York, NY, USA.
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