Use of the Tixel drug delivery system (Novoxel, Israel) combined with topical rapamycin may improve the results of pulsed dye laser (PDL) application for port wine stains and can reduce the total number of necessary PDL sessions, according to study research published in Dermatologic Therapy.
Port wine stains can have a substantial effect on quality of life, and although PDL is considered to be the gold standard for treatment, only 10% to 20% of patients obtain full clearance of their port wine stains, even after many PDL treatments. Recently, oral sirolimus (rapamycin) has been shown to improve treatment outcome by minimizing postlaser revascularization, one of the main causes of incomplete regression and recurrence, but topical rapamycin has shown contradicting results. Tixel technology, a painless, nonlaser thermal resurfacing system that significantly increases skin permeability, enhances drug delivery.
Researchers assessed the added value of the Tixel drug delivery system to PDL and topical rapamycin in 3 teenage patients with port wine stain previously treated with PDL. They observed clinically significant differences in blanching responses favoring port wine stain receiving PDL plus Tixel plus rapamycin compared with PDL plus rapamycin alone. Transient hyperpigmentation was noted in 1 patient, and 2 patients developed mild transient irritation and dermatitis after treatment.
Study limitations include the small sample size, as well as the comparatively advanced age range of the patient population,
The study suggests that “the use of drug delivery system and topical rapamycin has no remarkable adverse effects, and the addition of Tixel allowed for improved response of PDL and topical rapamycin for port wine stains, that may be related to increased penetration of rapamycin,” stated the investigators.
Artzi O, Mehrabi JN, Heyman L, Friedman O, Mashiah J. Treatment of port wine stain with Tixel-induced rapamycin delivery following pulsed dye laser application [published online November 20, 2019]. Dermatol Ther. doi:10.1111/dth.13172