Safety of Ablative Fractional Laser- Assisted Drug Delivery

Summary: Topical drug delivery’s bioavailability is relatively low with 1-5% being absorbed into the skin. Lasers can ablatively and non-ablatively create microchannels within the stratum corneum allowing for increased penetration of topical drugs and enhancing bioavailability. The erbium: yttrium-aluminum-garnet (Er:YAG) laser and CO2 laser are used commonly with laser assisted drug delivery (LADD). Advantages of LADD include a reduction in the topical drug concentration and a reduction in the duration of topical treatment needed for therapeutic benefit. Adverse effects reported in our analysis include erythema, edema, burning, pruritus, and hypopigmentation. Systemic toxicity is exceedingly rare, reported in only one case with LADD. A history of poor wound healing, keloids, easy tanning, and hypertrophic scarring may increase risk of adverse effects including infections. Our results suggest that LADD is a safe modality as it did not have an increased risk of adverse effects.