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 .
Reduction of pain and side effects in the treatment of solar lentigines with pneumatic skin flattening (PSF)
Background : Energy densities utilized in the treatment of pigmented lesions such as solar lentigines with intense pulsed light systems are often limited by pain and post‐treatment erythema and edema . The sensation of pain associated with the treatment is immediate and acute . Application of topical anesthesia is time‐consuming , with only very moderate pain relief . Objective : ( a ) To test pain reduction as well as the reduction of post‐treatment erythema and edema when using pneumatic skin flattening ( PSF ) . This new technology utilizes an evacuation chamber to generate skin compression and activates tactile neural receptors in the skin . The result is an afferent inhibition of pain transmission in the dorsal horn ( the ‘ gate theory ’ ) . ( b ) To test the efficacy of PSF . Methods : Twenty patients were treated for solar lentigines . The patients were treated by three different IPLs . The evaluation of acute pain and post‐treatment erythema and edema was performed on all 20 patients : one to three sites per patient treated with PSF and the same number of control sites without PSF . Identical energies and IPL were applied to both sites on each patient . The pain evaluation was performed on a 10‐level scale modified McGill Pain Question naire . The clinical response to treatment was also evaluated . Results : All 20 patients completed the study and preferred the PSF treatment side over the non‐PSF side . Substantial pain reduction was observed in 19/20 patients ( 95 % ) . The average reduction of pain was by two levels , from very painful to very mild pain . Erythema reductions were observed on 14/18 ( 77 % ) patients and edema reduction on 8/9 ( 88 % ) patients . Treatment efficacy on PSF sites was identical to that of non‐PSF sites . Conclusion : The pneumatic skin flattening ( PSF ) technology considerably reduces pain , erythema and edema in the treatment of solar lentigines by IPLs . Treatment efficacy is preserved . The enhanced safety of PSF enables the increase of energy density and the acceleration of results
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 .