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Fractional laser‐assisted drug uptake: Impact of time‐related topical application to achieve enhanced delivery
Author(s) -
Banzhaf Christina A.,
ThaysenPetersen Daniel,
Bay Christiane,
Philipsen Peter A.,
Mogensen Mette,
Prow Tarl,
Haedersdal Merete
Publication year - 2017
Publication title -
lasers in surgery and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 112
eISSN - 1096-9101
pISSN - 0196-8092
DOI - 10.1002/lsm.22610
Subject(s) - transepidermal water loss , sodium fluorescein , laser , interquartile range , fluorescence , nuclear medicine , biomedical engineering , optical coherence tomography , chemistry , materials science , medicine , fluorescein , surgery , optics , ophthalmology , pathology , physics , stratum corneum
Background and Objective Ablative fractional laser (AFXL) is acknowledged to increase uptake of topically applied agents in skin. AFXL channels gradually close over time, which may impair this capability. The time frame for applying a drug after AFXL exposure remains to be established. The aim of this study, was to investigate the importance of time‐related topical application after AFXL exposure and to relate resultant uptake in skin with AFXL channel morphology and skin integrity. Study Design/Materials and Methods Buttock skin of healthy volunteers ( n = 11) was exposed to 10,600 nm fractional CO 2 laser using 5% density, 120 μm beam diameter, 15 mJ pulse energy. Sodium fluorescein (NaF) a small, hydrophilic molecule (370 MW, log P = −1.52) was applied under standardized conditions at specific time points after laser exposure (0, 2, 5, 10, 30, 60, 90 minutes, 6, 24, and 48 hours). Fluorescence photography collected fluorescence images up to 180 minutes after NaF application. Optical coherence tomography (OCT) assessed AFXL channel dimensions and transepidermal water loss (TEWL) estimated loss of skin integrity. Results Fluorescence intensities (FI) were significantly elevated when NaF was applied up to 6 hours after laser exposure compared to non‐laser‐processed skin (median FI 1947 arbitrary units [interquartile range 1,246–3,560] versus 1,004 [350–1,538], P < 0.02). The highest FI occurred when NaF was applied within 30 minutes after laser exposure and similar FI were reached for applications at 0, 2, 5, 10, and 30 minutes after AFXL exposure (0 minutes: 3,866 [3,526–4,575], 30 minutes: 3,775 AU [3,070–4,484], P > 0.1). NaF application later than 30 minutes after AFXL exposure resulted in gradually decreasing FI, becoming similar to intact skin when applied at 24–48 hours after AFXL exposure ( P > 0.2). OCT images demonstrated that AFXL channels closed over time (100% [100–100%] open up to 30 minutes, 75% [4–86%] at 6 hours and 3% [0–15%] at 24–48 hours after AFXL exposure). TEWL measurements proved loss of skin integrity up to 6 hours after AFXL exposure, while integrity was similar in laser‐exposed and non‐laser‐exposed skin at 24–48 hours. Conclusions The time frame to maintain enhanced drug delivery sustained for several hours after AFXL exposure, corresponding to channel morphology and loss of skin integrity. Lasers Surg. Med. 49:348–354, 2017. © 2016 Wiley Periodicals, Inc.