title: Transient Alterations of Cutaneous Sensory Nerve Function by Noninvasive Cryolipolysis.
abstract: Cryolipolysis is a noninvasive, skin cooling treatment for local fat reduction that causes prolonged hypoesthesia over the treated area. We tested the hypothesis that cryolipolysis can attenuate nociception of a range of sensory stimuli, including stimuli that evoke itch. The effects of cryolipolysis on sensory phenomena were evaluated by quantitative sensory testing (QST) in 11 healthy subjects over a period of 56 days. Mechanical and thermal pain thresholds were measured on treated and contralateral untreated (control) flanks. Itch duration was evaluated following histamine iontophoresis. Unmyelinated epidermal nerve fiber and myelinated dermal nerve fiber densities were quantified in skin biopsies from six subjects. Cryolipolysis produced a marked decrease in mechanical and thermal pain sensitivity. Hyposensitivity started between two to seven days after cryolipolysis and persisted for at least thirty-five days post treatment. Skin biopsies revealed that cryolipolysis decreased epidermal nerve fiber density, as well as dermal myelinated nerve fiber density, which persisted throughout the study. In conclusion, cryolipolysis causes significant and prolonged decreases in cutaneous sensitivity. Our data suggest that controlled skin cooling to specifically target cutaneous nerve fibers has the potential to be useful for prolonged relief of cutaneous pain and might have a use as a research tool to isolate and study cutaneous itch-sensing nerves in human skin.
authors.affiliation: Wellman Center for Photomedicine, Massachusetts General Hospital; Department of Dermatology, Harvard Medical School, Boston, USA. Electronic address: lgaribyan@partners.org.
authors.forename: Lilit
authors.initials: L
authors.lastname: Garibyan
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital; Department of Anesthesia, Harvard Medical School, Boston, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Cornelissen
authors.affiliation: Wellman Center for Photomedicine, Massachusetts General Hospital; Department of Dermatology, Harvard Medical School, Boston, USA.
authors.forename: William
authors.initials: W
authors.lastname: Sipprell
authors.affiliation: Wellman Center for Photomedicine, Massachusetts General Hospital; Department of Dermatology, Harvard Medical School, Boston, USA.
authors.forename: Joachim
authors.initials: J
authors.lastname: Pruessner
authors.affiliation: Cutaneous Biology Research Center, Massachusetts General Hospital; Department of Dermatology, Harvard Medical School, Boston, USA.
authors.forename: Sarina
authors.initials: S
authors.lastname: Elmariah
authors.affiliation: Cutaneous Biology Research Center, Massachusetts General Hospital; Department of Dermatology, Harvard Medical School, Boston, USA.
authors.forename: Tuan
authors.initials: T
authors.lastname: Luo
authors.affiliation: Cutaneous Biology Research Center, Massachusetts General Hospital; Department of Dermatology, Harvard Medical School, Boston, USA.
authors.forename: Ethan A
authors.initials: EA
authors.lastname: Lerner
authors.affiliation: Wellman Center for Photomedicine, Massachusetts General Hospital; Department of Dermatology, Harvard Medical School, Boston, USA.
authors.forename: Yookyung
authors.initials: Y
authors.lastname: Jung
authors.affiliation: Wellman Center for Photomedicine, Massachusetts General Hospital; Department of Dermatology, Harvard Medical School, Boston, USA.
authors.forename: Conor
authors.initials: C
authors.lastname: Evans
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital; Department of Anesthesia, Harvard Medical School, Boston, USA.
authors.forename: David
authors.initials: D
authors.lastname: Zurakowski
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital; Department of Anesthesia, Harvard Medical School, Boston, USA.
authors.forename: Charles B
authors.initials: CB
authors.lastname: Berde
authors.affiliation: Wellman Center for Photomedicine, Massachusetts General Hospital; Department of Dermatology, Harvard Medical School, Boston, USA.
authors.forename: R
authors.initials: R
authors.lastname: Rox Anderson
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism; D000328:Adult; D000704:Analysis of Variance; D015992:Body Mass Index; D017679:Cryotherapy / Q000379:methods*; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D007150:Immunohistochemistry; D008066:Lipolysis; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000502:physiology; D010147:Pain Measurement; D011984:Sensory Receptor Cells / Q000502:physiology*; D012684:Sensory Thresholds / Q000502:physiology*; D012867:Skin / Q000294:innervation*