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 .
Iontophoresis of lidocaine for anesthesia during pulsed dye laser treatment of port-wine stains.
Port-wine stains may be effectively ablated using the pulsed dye laser emitting at a wavelength of 577 or 585 nm . However , the discomfort of this therapy may be severe enough to require reduction of treatment duration thereby increasing the need for repeat sessions . Currently available methods of anesthesia or sedation for pulsed dye laser therapy have drawbacks to their use . We performed a prospect i ve double-blind , placebo-controlled evaluation of the iontophoresis of lidocaine HCl 4 % and lidocaine HCl 4 % with epinephrine 1:50,000 for local anesthesia during pulsed dye laser ablation of port-wine stains . Eleven patients with port-wine stains completed the initial phase of the study .  Pain scale evaluation by patients demonstrated significant decreases in the discomfort of pulsed dye laser impulses by the iontophoresis of lidocaine HCl 4 % and lidocaine HCl 4 % with epinephrine 1:50,000 ( P less than .0001 ) , with no significant difference between these treatments . Follow-up evaluation suggests that iontophoresis has no detrimental effect on pulsed dye laser ablation of port-wine stains , despite significant decreases in perfusion , as measured by laser Doppler velocimetry , of port-wine stain areas receiving iontophoresis of lidocaine with epinephrine . Iontophoresis of lidocaine HCl 4 % with or without epinephrine is a safe and effective method of local anesthesia for pulsed dye laser therapy
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 .