Efficacy of erbium:yttrium-aluminum-garnet laser-assisted delivery of topical anesthetic.
BACKGROUND
Penetration through the stratum corneum limits effectiveness of topical anesthetics.


OBJECTIVE
Our aim was to evaluate the effectiveness of 5% lidocaine (ELA-Max) cream applied after erbium:yttrium-aluminum-garnet (Er:YAG) laser ablation of the stratum corneum.


METHODS
Randomized, controlled, split-face comparison of anesthesia was performed on 12 volunteers. The stratum corneum was painlessly ablated with a low-fluence Er:YAG laser on half of the face, then the whole face was covered with ELA-Max cream for 60 minutes. Full-face laser resurfacing was performed, and visual analog pain scores (0 to 10) were recorded during each of 2 passes.


RESULTS
Laser-assisted topical anesthesia demonstrated significantly lower mean pain scores than topical anesthesia alone. This was more pronounced during the more painful second pass. Resurfacing after laser-assisted topical anesthesia was well tolerated by 72% of subjects in pass 1 and 58% in pass 2.


CONCLUSIONS
Laser-assisted topical anesthesia is fast, painless, and substantially more effective than conventional topical anesthesia but does not provide adequate anesthesia for full-face resurfacing in all subjects.
Yun
Patricia Lee
PL
Wellman Laboratory of Photomedicine and Massachusetts General Hospital Dermatology Laser Center, Boston, MA 02114, USA.
Tachihara
Rieko
R
Anderson
R Rox
RR
D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage*; D004817:Epidermis; D005260:Female; D006801:Humans; D053685:Laser Therapy; D007834:Lasers; D008012:Lidocaine / Q000008:administration & dosage*; D008875:Middle Aged; D010147:Pain Measurement; D011184:Postoperative Period; D015361:Rhytidoplasty
D000779:Anesthetics, Local; D008012:Lidocaine