Laser-assisted drug delivery for wound healing

Laser-assisted drug delivery (LADD) for wound healing refers to the use of laser equipment to optimize drug penetration across biological barriers. There are several LADD techniques that can be used, completely or fractionally, with different types of lasers. The most used techniques include: the CO2 laser, the Er: YAG laser, the diode laser, the Nd: YAG laser, and the excimer laser. The main objective is faster and more effective absorption of medicines, with better localization in the target areas, allowing the doses necessary to be reduced to obtain the best effect. However, it is important to consider some challenges and risks to avoid harm and optimize medication delivery. Fractional lasers offer advantages such as greater fluence, permeation and depth of topical agents, as well as faster healing time. They can also be used combined with corticosteroids to improve tissue recovery. However, there are potential side effects, such as lower topical dosages and fewer cutaneous side effects without compromising efficacy. Furthermore, increased local drug accumulation may result in increased adverse reactions, especially for agents known to cause cutaneous side effects. Systemic absorption and excessive local accumulation in the skin can also lead to systemic toxicity. Pain during treatment is another concern, with superficial ablation at low fluences being relatively painless. Lasers have been shown to improve transcutaneous drug delivery by reducing the need for topical dosing and allowing deeper drug penetration with minimal tissue damage, especially for fractional lasers. However, more clinical studies are needed to determine optimal treatment parameters, including fluence, treatment density, and drug concentration. It is also crucial to determine which drugs are compatible with this delivery route and which vehicles are best for skin permeation.