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  • Presentation

What's the Truth in Laser-Assisted Delivery in Dermatology?

Description

The presentation discusses laser-assisted drug delivery in dermatology, highlighting its effectiveness and growing practice due to advancements over the past decade. The approach involves pre-treating the skin with fractional lasers to create channels that enhance the uptake of topical medications. Supported by over 200 publications, the method shows promise in various applications including photodynamic therapy for premalignant lesions and scarring, with a significant increase in drug delivery efficiency. The key to success in this technique lies in adjusting laser settings like density and pulse energy according to the specific skin condition being treated. The use of ablative fractional lasers has been particularly effective, allowing drugs to be delivered through the created microchannels without significant tissue damage. Clinical evidence suggests that combining lasers with topical agents can yield effective treatments for conditions such as actinic keratosis, scars, and potentially even skin cancers. The coagulation zone formed by laser treatment also facilitates drug uptake, acting as a reservoir for hydrophilic substances. The speaker emphasizes a collaborative effort in advancing this field and mentions ongoing research into new drug applications, including immune therapy for skin cancer. Overall, the presentation advocates for the integration of laser-assisted delivery into clinical practices to enhance patient care in dermatology.

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Conclusions

  • Laser-assisted drug delivery enhances the penetration and effectiveness of various topical medications applied to the skin.
  • The combination of fractional lasers and drug delivery has been established as a powerful tool in dermatology with over 200 publications supporting its efficacy.
  • Customizing laser settings, such as laser type and density, is vital for optimizing drug uptake in specific skin conditions.
  • Ablative fractional lasers provide superior drug uptake compared to non-ablative lasers and microneedling techniques.
  • The coagulation zone created by laser treatment acts as a reservoir that enhances the absorption of hydrophilic drugs.
  • Clinical indications for laser-assisted drug delivery include actinic keratosis, scars, melasma, and other skin disorders, supported by systematic reviews and controlled trials.
  • Laser-assisted photodynamic therapy (PDT) significantly increases efficacy compared to PDT alone in treating actinic keratosis.
  • The drug delivered through laser channels includes a wide variety of substances from small molecules to larger biologics, affirming its versatility in skin treatment.
  • Ongoing research is probing into innovative uses of laser-assisted delivery, such as combining with PD-1 inhibitors for skin cancer treatment.
  • Overall, the technique holds promise for advancing patient care in dermatology by improving drug delivery and therapeutic outcomes.
  • Steeb T, Schlager JG, Kohl C, Ruzicka T, Heppt MV, Berking C. Laser-assisted photodynamic therapy for actinic keratosis: A systematic review and meta-analysis. J Am Acad Dermatol. 2019;80:947-56.
  • Bay C, Haedersdal M et al. Las Surg Med 2017.
  • Labadie J et al. Evidence-Based Clinical Practice Guidelines for Laser-Assisted Drug Delivery. JAMA Dermatol. 2022;158(10):1193-1201.
  • Seago M et al. Laser Treatment of Traumatic Scars and Contractures: 2020 International Consensus Recommendations. Lasers Surg Med 2020; 52: 96-116.
  • Erlendsson AM, et al. A one-time pneumatic jet-injection of 5-fluorouracil and triamcinolone acetonide for treatment of hypertrophic scars-A blinded randomized controlled trial. Lasers Surg Med. 2022 Jul;54(5):663-671. doi: 10.1002/lsm.23529.
  • Rkein A, Ozog D, Waibel JS. Treatment of atrophic scars with fractionated CO2 laser facilitating delivery of topically applied poly-L-lactic acid. Dermatol Surg. 2014;40(6):624-31.