Novel Cryotherapy Device for the Treatment of Itch in Atopic Dermatitis

The feasibility and safety of a novel cryotherapy device for the treatment of mild pruritis in patients with atopic dermatitis finds support in study data published in the Journal of Cosmetic Dermatology.

Chronic itch is common in atopic dermatitis, although treatment modalities are limited. Localized cooling therapies have shown efficacy in prior studies. Investigators sought to assess the efficacy of a new cryotherapy device with a temperature application range of -20℃ to 10℃. This split-body clinical trial enrolled adults with mild to moderate atopic dermatitis from dermatology clinics across South Korea. Eligible patients were not using any systemic steroids or antihistamines. Patients served as their own controls; 1 side of the body was treated with the novel cryotherapy device, and the other side received standard treatment. Cryotherapy was applied at −5℃ for 5 seconds once per week for a total of 8 weeks. Visual analogue scale (VAS) scores for itch at 10, 30, and 60 minutes post-therapy were captured. Scores were also recorded at 1, 2, and 8 weeks. Patient satisfaction was assessed by self-report and adverse events were monitored throughout the trial duration.

The study cohort comprised 28 patients aged 19 to 62 years, of whom 22 (78.6%) were men. Mean age was 29.0 ± 9.0 years at enrollment. On the first day of treatment, the VAS score for itch at 10, 30, and 60 minutes post-treatment was substantially greater in the control-side group compared with the treated-side group. On the treated side, VAS scores decreased rapidly after cryotherapy administration, from 5.86 ±1.80 at baseline to 3.18 ± 2.53 points at 60 minutes post-therapy. This decline was sustained during follow-up, with mean VAS scores of 3.18 ± 1.88 points, 3.50 ± 1.78 points, and 2.92 ± 1.51 for the treated side at 1, 2, and 8 weeks post-treatment, respectively. No serious adverse events were recorded, although 1 patient reported a dry and tingling sensation after cryotherapy application. The percentage of patients reporting good or excellent satisfaction with treatment was 14.3%. Overall, 53.2% and 14.3% of patients reported poor and moderate satisfaction, respectively.

These data suggest that a novel cryotherapy device may improve itch in patients with mild to moderate atopic dermatitis. Data generalizability are limited by the small study cohort; 28 patients were enrolled, and only 12 patients completed all follow-up visits. Just more than half of patients reported poor satisfaction, although a small group of patients noted substantial improvement.

“[T]he novel device for cryotherapy assessed herein is a safe and effective antipruritic therapeutic remedy, although the mechanisms of its cooling effect on pruritus remain elusive,” investigators concluded.

Reference

Lee EH, Lee HJ, Park KD, Lee WJ. Effect of a new cryotherapy device on an itchy sensation in patients with mild atopic dermatitis. . J Cosmet Dermatol. Published online February 3, 2021. doi: 10.1111/jocd.13975