Topical Anesthetic Does Not Interfere With PDL Efficacy on Erythema

A tube of hydrocortisone cream on a white surface.
This study is among the first to evaluate the influence of the topical anesthetics (23% lidocaine/7% tetracaine and 7% lidocaine/7% tetracaine ointment) on the efficacy and safety of the treatment of non‐port-wine stain erythema by pulsed dye laser .

The efficacy of pulsed dye laser (PDL) treatment for erythema is not affected by pretreatment with topical anesthetics, according to study data published in Lasers in Surgery and Medicine.

To assess whether topical anesthetics reduce the efficacy of PDL in the treatment of erythema, researchers conducted a retrospective single-site study of 69 patients with erythema on the face, neck, chest, and extremities. Thirty-one of the patients had been treated with topical anesthetics (23% lidocaine/7% tetracaine ointment or 7% lidocaine/7% tetracaine ointment) before PDL therapy. Blinded dermatologists evaluated pre- and posttreatment photographs for the improvement of erythema.

The researchers evaluated the overall improvement using a noninferiority test. Mean improvement of the patients who received a topical anesthetic pretreatment was 2.2581, and mean improvement of the patients who did not receive a topical anesthetic pretreatment was 2.2632. The analysis of these results reflected no significant difference in improvement scores between the two groups of the study, supporting the study premise that the efficacy of PDL therapy is not affected by the addition of a topical anesthetic pretreatment.

Related Articles

The main limitations of the study were its heterogeneous conditions, which included variation in treatment settings, number of treatments, and time between follow-up appointments. Also, the researchers noted an inability to standardize the “number of treatment sessions delivered, and the heterogeneity of lesions,” as a result of the retrospective study design.

The researchers concluded that topical anesthetics “do not interfere with the efficacy of PDL” and “the application of a local anesthetic will enhance patient comfort and satisfaction during treatment with PDL.”

Follow @DermAdvisor


Chunharas C, Boen M, Alhaddad M, Wu DC. The efficacy of pulsed dye laser pretreated with or without local anesthetic on patients presenting with erythema of face, neck, chest, and extremities [published online August 22, 2019]. Lasers Surg Med. doi: 10.1002/lsm.23146