Drug delivery anesthetic method with lidocaine for using fractional co2 laser on the face: Pilot Study

Introduction: The CO2 laser, widely used for rejuvenation and aesthetic treatments can cause intense discomfort, making it necessary to use anesthetics. Depending on its application, lidocaine is an effective resource for anesthesia before applicating fractional lasers. Microneedling has shown to be an extremely effective resource for the transdermal delivery of medications through the stratum corneum, including anesthetics. Objective: To collect preliminary results on the efficacy of microneedling associated with lidocaine drug delivery to the skin in order to enable appropriate anesthesia for the use of fractional CO2 laser on the face. Materials and methods: Twenty-one adult patients with mild to moderate facial sagging were selected for treatment with a fractional CO2 laser, excluding those with contraindications related to the technique. The split-face study compared the analgesia provided by lidocaine drug delivery before the application of fractional CO2 laser. The procedure involved microneedling with simultaneous infusion of lidocaine on one side of the face, while saline solution was infused on the other, followed by application of the fractional CO2 laser. Two brands of equipment were used (HYBRID® and YOULASER®). Thus, dosimetric parameters were standardized for both equipment utilized. After treatment, patients answered a questionnaire about their perception of pain and comfort during the procedure. Results: The analysis of comfort showed that most patients considered the procedure with fractional CO2 laser uncomfortable, with no statistically significant difference between the brands of equipment tested. The most sensitive areas varied between the groups, with emphasis on the eye and forehead regions. The comparison between hemifaces showed that analgesia with microneedling and lidocaine significantly reduced pain during laser treatment, confirming the effectiveness of drug delivery with lidocaine in enhancing the anesthetic effect necessary for performing the procedure. Conclusion: Anesthesia with lidocaine drug delivery associated with microneedling was effective in reducing discomfort and enabling the application of fractional CO2 laser. However, as this is a preliminary investigation, some factors may have influenced the results and should be considered for the continuation of this study.