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 for anesthesia during pulsed dye laser treatment of port-wine stains.
Port-wine stains ( PWS ) are benign , congenital vascular malformations found in approximately 0.3 % of newborns . PWS may be effectively treated with the flashlamp pulsed dye laser ( FPDL ) at 585 nm . However , laser therapy of vascular lesions often produces pain . We performed a prospect i ve double-blind , placebo-controlled evaluation of the iontophoresis of lidocaine 5 % with epinephrine 1:50,000 and mepivacaine 2 % with epinephrine 1:50,000 .  Thirty-six patients with facial PWS were included in the study ; 13 of them were treated with lidocaine 5 % with epinephrine , another 13 were treated with mepivacaine 2 % with epinephrine , and the other 13 were treated with preservative-free 0.9 % NaCl . The pain was grade d by the patient on a visual analog scale from 0 to 10 , comparing the iontophoretically treated area with an adjacent area treated without anesthesia . Pain evaluation by patients demonstrated a significant decrease in the pain of pulsed dye laser impulses using the iontophoresis of lidocaine 5 % with epinephrine . No change in the efficacy of pulsed dye laser treatment of PWS or important side effects were observed in our patients . Iontophoresis of lidocaine 5 % with epinephrine is a safe and effective method of local anesthesia for pulsed dye laser and it is more effective than the iontophoresis of mepivacaine 2 % with epinephrine
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 .