A Review of Technology Discusses Broadening Horizons of Clinical Applications
Research conducted by Lindsay R. Sklar, M.D., Christopher T. Burnett, M.D., F.A.A.D., Jill S. Waibel, M.D., F.A.A.D., Ronald L. Moy, M.D., F.A.A.D., and David M. Ozog, M.D., F.A.A.D., was selected as Editor’s Choice for the April 2014 issue of Lasers in Surgery and Medicine (LSM).
The manuscript titled “Laser Assisted Drug Delivery: A Review of An Evolving Technology” was published in LSM, the official journal of the American Society for Laser Medicine and Surgery, Inc. (ASLMS).
Fractional laser predictably disrupts the barrier of the skin creating deep channels that allow the delivery of drug and cellular materials. This technology is emerging as a new delivery system of drugs versus oral, intravenous or transdermal routes. Laser assisted delivery is potentially safer, faster, has less adverse events and cost effective for the health care system. The laser is powerful because it enables the physician to uniformly distribute drug in microscopic channels to depth to desired level in cutaneous tissue. The research by Sklar, et al., highlights this growing arena and shows the diverse use of this technology with multiple different drugs and applications.
“We are just now at the forefront of understanding the uses and methods of using lasers and other devices to disrupt our skin surfaces, allowing the penetration of various medications. It is conceivable that one day your arthritis medication could come with a small device that creates microscopic pores in your skin to allow an anti-inflammatory drug applied topically over an arthritic joint to penetrate directly to the targeted area. By skipping the traditional routes such as oral delivery, many side effects may be avoided. These new methods may be combined with nano-technology and delayed release drugs to maximize effects,” said Dr. Ozog.
Dr. David M. Ozog is Director of Cosmetic Dermatology for the Division of Mohs and Dermatological Surgery and Vice-Chair of the Department of Dermatology at Henry Ford Hospital in Detroit, MI. He received his M.D. from University of Rochester Medical School in Rochester, NY. He completed his dermatology residency at Henry Ford Hospital, and his Mohs, cosmetic and procedural fellowship at UCLA Medical Center and the Moy-Fincher Medical Group in Beverly Hills, CA.
"Laser assisted drug delivery is an exciting area of research which is summarized in our manuscript. The current evidence suggests a wide variety of potential clinical uses, including the enhancement of topical drug delivery, the delivery of systemic medications, scar reduction, and even the delivery of stem cells.
Further studies are needed to validate the existing research and explore the many additional potential clinical applications," commented Dr. Burnett.
Dr. Burnett, a general Dermatologist at Henry Ford Hospital on the study publication date, is now completing a procedural dermatology fellowship at The University of Texas-Southwestern. He earned his medical degree at The Medical College of Wisconsin in Milwaukee, WI.
The existing literature discussed in the manuscript suggests that lasers are a safe and effective means of enhancing the delivery of topically applied agents through the skin. According to the manuscript, “The types of lasers most commonly studied in regards to drug delivery are the carbon dioxide (CO2) and erbium:yttrium-aluminum-garnet (Er:YAG) lasers.” The study summarized the usage of both conventional ablative and fractional ablative modalities.
“At the Miami Dermatology and Laser Institute we have done laser assisted delivery clinical studies on corticosteroids, 5-Fluorouracil, Poly-L-lactic Acid, Hyaluronic Acid, Bimatoprost, Timolol and Antibiotics. At the University of Miami my colleagues Dr. Evangelos Badiavas and Professor Stephen Davis have a Department of Defense Grant studying the basic science of laser assisted delivery of stem cells on acute burns in a 3rd degree burn porcine model. Our grant is “Scars through Laser Assisted Delivery of Stem Cells, Care for the Critically Injured Burn Patient” and we are studying putting Fat Stem Cells, Autologous Stem Cells and Allogeneic Stem Cells down the laser channels to heal skin with very promising results. In addition, we are studying techniques to optimize laser assisted drug delivery by using accessories such as the Impact Acoustic wave device, matrices and occlusion,” said Dr. Waibel.
Dr. Waibel practices as a board certified dermatologist specializing in cutaneous laser surgery and the dermatologic care of patients. She is currently the medical director and owner of Miami Dermatology and Laser Institute in Miami, FL. Dr. Waibel's undergraduate degree is from Indiana University. She completed medical school and her dermatology residency at the Wright State School of Medicine.
The Editor-in-Chief of LSM, J. Stuart Nelson, M.D., Ph.D. commented on the study, “The use of lasers to assist in drug delivery is a rapidly evolving therapeutic modality with the potential for wide ranging clinical applications. The authors of this paper provide a comprehensive summary of the existing literature on the topic."