Laser-Assisted Drug Delivery: A Systematic Review of Safety and Adverse Events

Abstract

Laser-assisted drug delivery (LADD) is an increasingly studied and applied methodology for drug delivery. It has been used in a wide variety of clinical applications. Given the relatively low barrier to entry for clinicians as well as ongoing research in this area, the authors aimed to review outcomes relating to safety in laser-assisted drug delivery. A systematic review was conducted, with the databases PubMed, Medline and Embase searched in September 2022. Included articles were those that mentioned laser-assisted drug delivery in human subjects that also reported adverse effects or safety outcomes. There were no language-based exclusions. Conference abstracts and literature reviews were excluded. The results were then tabulated and categorized according to the application of LADD. In total, 501 articles were obtained. Following deduplication, screening, and full text review 70 articles of various study designs were included. Common findings were erythema, oedema, pain, and crusting following LADD. Several notably more severe adverse effects such as generalized urticaria, infection, scarring and dyspigmentation were noted. However, these events were varied depending on the clinical use of LADD. Relevant negatives were also noted whereby no studies reported life-threatening adverse effects. Limitations included limited details regarding the adverse effects within the full texts, lack of follow-up, and risk of bias. In conclusion, there were multiple adverse effects that clinicians should consider prior to carrying out LADD, where treatment goals and patient tolerability should be considered. Further evidence is needed to quantitatively determine these risks.

Principles and clinical applications of transcutaneous laser-assisted drug delivery: A narrative review

“…It can also be used for the treatment of hyperpigmentation conditions, such as melasma or post-inflammatory hyperpigmentation. 43 By delivering depigmenting agents, such as hydroquinone or kojic acid, directly to the affected skin, LADD can help reduce the appearance of dark spots or patches. Furthermore, it can aid in the treatment of nail fungal infections (onychomycosis) by enhancing the delivery of antifungal medications to the nail bed.…”

A Comprehensive Review of Non-Surgical Treatments for Hypertrophic and Keloid Scars in Skin of Color

“…LADD has been praised for its ability to overcome the selective permeability of the skin by allowing for topical absorption of various drugs. 79 The vertical microchannels introduced into the skin-most commonly by fractionally ablative lasers-are thought to facilitate such delivery. 79 Corticosteroids are frequently used during the employment of LADD.…”

“…79 The vertical microchannels introduced into the skin-most commonly by fractionally ablative lasers-are thought to facilitate such delivery. 79 Corticosteroids are frequently used during the employment of LADD. In one study, ablative fractional CO 2 laser was used in the successful topical delivery of 40 mg/mL TAC to HTS of pediatric burn patients (FSTs I-VI).…”

“… 79 The vertical microchannels introduced into the skin–most commonly by fractionally ablative lasers–are thought to facilitate such delivery. 79 …”

A Comprehensive Review on Laser-Assisted Drug Delivery

“…This approach has the potential to revolutionize drug delivery by improving the absorption and bioavailability of medications, leading to enhanced therapeutic outcomes for patients. [1] The use of laser technology in transdermal drug delivery has garnered significant attention due to its ability to overcome the limitations of traditional delivery methods. By precisely controlling the depth and density of the channels created in the skin, this system enables the delivery of a wide range of drug molecules, including large and hydrophilic compounds that may otherwise have difficulty permeating the skin barrier.…”