Muskat Ahava, Kost Yana, Balazic Eliza, Cohen Joel L, Kobets Kseniya
Albert Einstein College of Medicine, Division of Dermatology, Bronx, NY, USA.
Montefiore Einstein Advanced Care Center, Division of Dermatology, Bronx, NY, USA.
Aesthet Surg J. 2023 Feb 21;43(3):NP181-NP198. doi: 10.1093/asj/sjac286.
Although broad reviews on laser-assisted drug delivery (LADD) have been published in the past, an updated focused examination of its utility in the context of common, treatment-resistant, dermatologic conditions has not been published. This article reports a comprehensive scoping review of the potential benefits of LADD compared to laser or drug monotherapy for the treatment of 3 such conditions: scars, rhytids, and melasma. A PubMed (National Institutes of Health; Bethesda, MD) search was conducted for keywords including "laser-assisted drug delivery," "scar," "rhytid," and "melasma." Out-of-scope studies were excluded. To evaluate the efficacy of LADD for the treatment of scars, relevant articles were categorized by scar type: hypertrophic/keloid, atrophic, and hypopigmented. LADD, with both ablative and nonablative laser types, was studied in combination with corticosteroids, botulinum toxin-A (BTX-A), 5-fluorouracil, 5-aminolevulinic acid photodynamic therapy, stem cells, platelet-rich plasma, and prostaglandin analogs for the treatment of scars. Some randomized controlled trials demonstrated the efficacy of LADD, whereas others showed no significant differences in clinical outcomes but demonstrated reduced adverse effects. Regarding rhytids, laser treatment has been combined with various cosmeceuticals, including poly-L-lactic acid, topical retinaldehyde, and topical BTX-A. The studies reviewed supported the use of LADD with these drugs over monotherapy. Some studies showed that LADD was effective for the absorption of drugs such as poly-L-lactic acid and BTX-A which are often not effective topically. For melasma treatment, LADD with tranexamic acid and hydroquinone was superior in some studies, but not significantly different than monotherapy in other studies. LADD with certain drugs could be considered to treat scars, rhytids, and melasma.
尽管过去已经发表了关于激光辅助药物递送(LADD)的广泛综述,但尚未发表在常见的、难治性皮肤病背景下对其效用的最新重点研究。本文报告了一项全面的范围综述,比较了LADD与激光或药物单一疗法治疗三种此类疾病(瘢痕、皱纹和黄褐斑)的潜在益处。在PubMed(美国国立卫生研究院;马里兰州贝塞斯达)上进行了搜索,关键词包括“激光辅助药物递送”、“瘢痕”、“皱纹”和“黄褐斑”。排除了范围外的研究。为了评估LADD治疗瘢痕的疗效,相关文章按瘢痕类型分类:增生性/瘢痕疙瘩性、萎缩性和色素减退性。研究了剥脱性和非剥脱性激光类型的LADD与皮质类固醇、肉毒杆菌毒素A(BTX-A)、5-氟尿嘧啶、5-氨基酮戊酸光动力疗法、干细胞、富血小板血浆和前列腺素类似物联合用于治疗瘢痕。一些随机对照试验证明了LADD的疗效,而另一些试验则显示临床结果无显著差异,但不良反应减少。关于皱纹,激光治疗已与各种美容药物联合使用,包括聚-L-乳酸、局部视黄醛和局部BTX-A。所综述的研究支持LADD与这些药物联合使用优于单一疗法。一些研究表明,LADD对聚-L-乳酸和BTX-A等通常局部无效的药物的吸收有效。对于黄褐斑治疗,在一些研究中,氨甲环酸和氢醌联合LADD效果更佳,但在其他研究中与单一疗法无显著差异。LADD与某些药物联合可用于治疗瘢痕、皱纹和黄褐斑。