title: Efficacy of erbium:yttrium-aluminum-garnet laser-assisted delivery of topical anesthetic.
abstract: 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.
authors.affiliation: Wellman Laboratory of Photomedicine and Massachusetts General Hospital Dermatology Laser Center, Boston, MA 02114, USA.
authors.forename: Patricia Lee
authors.initials: PL
authors.lastname: Yun
authors.forename: Rieko
authors.initials: R
authors.lastname: Tachihara
authors.forename: R Rox
authors.initials: RR
authors.lastname: Anderson
mesh_terms: 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
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine