Evaluation of Device-Based Cutaneous Channels Using Optical Coherence Tomography: Impact for Topical Drug Delivery

Abstract

BACKGROUND Topical medications play a large role in the management of cutaneous diseases, but penetration is limited. Device-assisted drug delivery using mechanical destruction, lasers, and other energy-based modalities can increase penetration and absorption through creation of transcutaneous channels. OBJECTIVE To examine real-time, in vivo cutaneous changes in response to various devices used to improve topical drug delivery through optical coherence tomography (OCT) imaging. METHODS AND MATERIALS Treatment was performed with 8 medical devices, including mechanical destruction, lasers, and other energy-based modalities. Optical coherence tomography was used for real-time, noninvasive, in vivo imaging. RESULTS Using OCT, microneedling and radiofrequency microneedling demonstrated no cutaneous channels. Both lowenergy, low-density, fractional nonablative lasers produced transient channels, which closed within hours. The fractional nonablative 1,927-nm thulium fiber and 1,550-nm erbium fiber lasers created channels with epidermal debris within, which were still closing at 24 hours. The fractional thermomechanical ablative device and the fractional ablative CO2 laser produced channels that were still open at 24 hours. CO2 laser channels had thick rims of coagulated tissue and remained open for longer. CONCLUSION Demonstrable differences among the devices were seen, and only some can produce observable channels, the characteristics of which vary with each technology.

Natural Ingredients of Transdermal Drug Delivery Systems as Permeation Enhancers of Active Substances through the Stratum Corneum

“…The use of this oil formulation allowed the API to be delivered to the skin at a higher concentration (222. 19 ] are effective when used alone in facilitating the penetration of ibuprofen. The main constituents of these oils included ligustilide (79.32%), ligustilide (41.00%), (E)-cinnamaldehyde (83.30%), and eugenol (80.22%), respectively.…”

“…Moreover, active and passive methods are used to facilitate TDD. Active methods involve the use of external energy to increase the penetration of active pharmaceutical ingredients (APIs) through the skin by using electrical energy (iontophoresis, electroporation), ultrasound (sonophoresis), radiofrequency electromagnetic waves (radiofrequency), and laser energy. − These methods include mechanical techniques such as micropuncture to create pores in the SC for APIs. − Passive methods involve the interactions between the drug, vehicle, and SC layer. They aim to modify the API physicochemical properties, e.g., by changing its solubility or ionization and/or leading to an increase in skin permeability.…”

Evidence-Based Clinical Practice Guidelines for Laser-Assisted Drug Delivery

“…Microneedles can be of various bores and lengths, with or without insulation or radiofrequency energy, and hence, may behave differently. Although a recent study using optical coherence tomography found that microneedling and radiofrequency microneedling did not create observable cutaneous channels, other recent research suggests that in some cases microneedling may facilitate increased penetration and greater lateral extension of the drug as compared with AF laser …”

Prospective Evaluation of the Safety and Efficacy of Thermomechanical Fractional Injury for Perioral Rhytides

“…7 Their patterns of thermal injury are different. 13 Greater contact duration and protrusion distance with this particular device can create larger effects. This has benefits for fibroblast proliferation and collagen production, and unlike fractional CO2 laser, the craters associated with fractional thermomechanical injury are clean of necrotic tissue or charring.…”