It has been demonstrated that ethanol (EtOH) can enhance skin permeation of drugs when simultaneously applied with drugs. However, only a few studies have reported on the pretreatment effect of EtOH on skin permeations. In this study, the pretreatment effects of EtOH on skin permeation of drugs were investigated by measuring changes in skin permeation and electrical skin resistance. Permeabilities of deuterium oxide (D 2 O), isosorbide mononitrate (ISMN), isosorbide dinitrate (ISDN), calcein sodium (CA-Na), and fluorescein isothiocyanate-dextran 4 kDa (FD-4, 3.3-4.4 kDa) were evaluated through Yucatan micropig skin pretreated with different concentrations of EtOH solution. From the results, almost constant skin permeabilities of D 2 O and ISDN were observed independent of EtOH concentration. Skin permeabilities of ISMN, CA, and FD-4 increased with low concentrations of EtOH, but decreased with high concentrations of EtOH. At 99.5% EtOH pretreatment, skin permeabilities of hydrophilic compounds (ISMN, CA, and FD-4) decreased to non-detectable levels. In addition, low molecular ion transports were almost constant at any EtOH concentration. Since molecular (ion) sizes of ISMN, CA, and FD-4 are larger than Na , Cl , and D 2 O, permeation pathway sizes for hydrophilic compounds in the skin barrier may be remarkably decreased by pretreatment with high concentrations of EtOH. However, the permeability coefficient of ISDN was not influenced by any EtOH concentration, since ISDN is a lipophilic, low-molecular compound that permeated through the lipophilic stratum corneum pathway. The present results show useful information for repeatedly and topically applied formulations containing EtOH, and also contribute to the effective use of alcohol formulations.Key words skin permeation; ethanol; pretreatment; electrical skin resistance; enhancer; permeation route Ethanol (EtOH) is well known as an ingredient of alcoholic beverages and has been utilized as a medicine for humans with different efficacies since ancient times. Currently, several skin disinfectants containing EtOH are frequently utilized in hospitals and public facilities for preventive purposes against viral infections. EtOH is a commonly used solvent just like water in pharmaceutical formulations, and is applied as a skin permeation enhancer, a skin disinfectant, and a solubilizer for poorly-soluble drugs. Tinctures, lotions, gels and liniments are dosage forms containing EtOH. Transdermal drug delivery systems and topical formulations often have the problem of low skin permeation of active ingredients. The skin barrier is mainly constituted by the outermost layer of skin, the stratum corneum, which dramatically restricts skin permeability of drugs. EtOH in topical formulations greatly enhances skin permeation of drugs. Estradiol and fentanyl dermal patches are typical examples developed using EtOH to enhance their transdermal deliveries.1-3) It has been proposed that the mechanisms of EtOH effects on the stratum corneum are extraction of lipids, increases in lipid...