Transdermal delivery of topical lidocaine in a mouse model is enhanced by treatment with cold atmospheric plasma

Abstract

Background Topical anesthetics are widely used in dermatology and cosmetology to alleviate the pain from nonsurgical cosmetic procedures, while the transdermal drug delivery is limited by the skin barrier. Cold atmospheric plasma (CAP) is a potential approach used for skin pretreatment to enhance transdermal delivery of topical medications. Aims To assess the efficacy of CAP as a pretreatment to improve the transdermal delivery of topical anesthetic. Methods First, we conducted ex vivo permeation studies on 30 mice with a Franz cell diffusion experiment. CAP irradiations of different intensity and duration were pretreated on the epidermal layer of mice before topical lidocaine applied, with the control group received no pretreatment. The amount of drug penetrated through the skin and drug flux were determined by high‐performance liquid chromatography. Then, we treated 3 living mice with CAP followed by application of methylene blue cream (MB) and used skin biopsies to measure penetration depth by microscope. Last, we measured the transepidermal water loss (TEWL) of mouse skin in vivo before and after CAP treatment to observe its effect on the skin barrier function. Results In the permeation study, the transdermal flux of lidocaine was enhanced to 1.97 times of the control samples by CAP pretreatment. We also observed that the accumulative amount of lidocaine varied with the duration of the CAP treatment in a biphasic manner. In the MB penetration study, significant amount of MB deposition was observed under the epidermis and deeper parts of the skin after CAP pretreatment compared with the control sample. A sharp increase in TEWL value was observed directly after the CAP treatment, but 30 minutes later, it began to decrease and recovered to baseline in the next 3 hours, indicating that the skin barrier property had been changed reversibly. Conclusions Our studies suggested that the transdermal absorption of topical lidocaine can be efficiently and safely enhanced by pretreatment of the skin with CAP. We believe that CAP could be used as an assistance to improve analgesia in dermatology.

Analgesic effect of topical lidocaine is enhanced by cold atmospheric plasma pretreatment in facial CO2 laser treatments

“…Recently, we have conducted permeation experiments with CAP and topical lidocaine cream on ex vivo skin samples of mice and found that CAP pretreatment raised the cumulative amount of lidocaine penetration to 1.97 times of the control samples 27 . In this study, we found that the analgesic effect of topically applied anesthetic cream was improved by CAP pretreatment, which was in accordance with the ex vivo experiment and further verified its feasibility in clinical practice.…”

The efficacy and safety of the innovative cold atmospheric‐pressure plasma technology in the treatment of striae distensae: A randomized controlled trial

“…40 Recent studies in a mouse model demonstrated CAP as transdermal delivery of topical lidocaine. 59 The analgesic effect of topical lidocaine can also be enhanced by pretreatment CO 2 laser area with CAP. 60 In this case, a mild steroid was prescribed for a few days with white petrolatum ointment.…”

Plasma Dermatology: Skin Therapy Using Cold Atmospheric Plasma

“…In another consecutive studies by Xin et al., transdermal delivery of a local anaesthetic drug, lidocaine, was enhanced by CAP pre-treatment ( 122 , 123 ). Using a mouse model, the authors found that the transdermal flux of lidocaine was nearly doubled, and the drug penetration reached deeper parts of skin.…”