In general , active non-invasive anaesthetic methods seemed to provide favourable results compared to placebo or no anaesthesia , and topical anaesthetic drugs and PSF seemed to result in a better pain reduction than skin cooling .
However , the current evidence is insufficient to provide recommendations for daily clinical practice .
Future studies should also evaluate sex differences in pain perception , have uniformity with regard to vali date d pain measurement scales and address clinical ly significant differences in pain reduction besides statistically significant differences
Pain is a common side-effect of dermatological laser procedures .
Non-invasive anaesthetic drugs and anaesthetic procedures can be used to provide pain relief and increase patient satisfaction and treatment efficacy .
However , it remains unclear which method provides the best pain relief .
The objective of this systematic review was therefore to assess the efficacy and safety of non-invasive anaesthetic methods during dermatological laser procedures .
Evaluation of different temperatures in cold air cooling with pulsed-dye laser treatment of facial telangiectasia.
BACKGROUND AND OBJECTIVES Cold air cooling is widely used in dermatological laser therapy . We investigated the influence of cold air cooling at different skin temperatures on therapeutic outcome and side effects of pulsed dye laser treatment of facial telangiectasia . STUDY DESIGN / MATERIAL S AND METHODS From September 2002 to February 2003 , 17 patients with previously untreated facial telangiectasia underwent a single treatment session with flash-lamp pulsed dye laser  ( 3.5 J/cm(2 ) , 585 nm , 0.45 milliseconds pulse length , 10 mm beam diameter , Cynosure V ) . The treatment area was divided into three sub- areas : no cooling , cold air cooling to 20 degrees C and to 17 degrees C skin temperature . The skin temperature was monitored by a prototype infrared sensor system which controlled the temperature of the cold air stream ( Cryo5 ) . In a prospect i ve study , we collected data on purpura , pain , clearance , and patient satisfaction on numerical analog scales ( NAS ) from 0 ( meaning " no " ) to 3 ( meaning " high " ) . RESULTS Without cooling , purpura ( 2.53 ) , pain ( 2.41 ) , and clearance ( 2.35 ) were rated medium to high . Cooling to 20 degrees C reduced purpura ( 1.12 ) and pain ( 1.06 ) , whereas the clearance ( 2.12 ) was only slightly affected . Cooling to 17 degrees C reduced purpura ( 0.88 ) and pain ( 0.76 ) even more , the clearance ( 2.06 ) was lowered marginally . Most patients preferred cooling to 20 degrees C skin temperature . CONCLUSION In dermatological laser therapy of facial telangiectasia , the use of cold air cooling can significantly reduce side effects and increase patient satisfaction while only slightly affecting clearance . Cooling to 20 degrees C skin temperature proved to be a well-balanced middle course . For the practical use of cold air cooling , we thus recommend cooling to a level which the patient can tolerate without problems and to try to increase the energy densities
In general , active non-invasive anaesthetic methods seemed to provide favourable results compared to placebo or no anaesthesia , and topical anaesthetic drugs and PSF seemed to result in a better pain reduction than skin cooling .
However , the current evidence is insufficient to provide recommendations for daily clinical practice .
Future studies should also evaluate sex differences in pain perception , have uniformity with regard to vali date d pain measurement scales and address clinical ly significant differences in pain reduction besides statistically significant differences
Pain is a common side-effect of dermatological laser procedures .
Non-invasive anaesthetic drugs and anaesthetic procedures can be used to provide pain relief and increase patient satisfaction and treatment efficacy .
However , it remains unclear which method provides the best pain relief .
The objective of this systematic review was therefore to assess the efficacy and safety of non-invasive anaesthetic methods during dermatological laser procedures .