psd-502 and glycolic-acid

EMLA has a slow onset due to its limited percutaneous absorption into an intact skin, while Glycolic acid (GA) has been known to have the capability of disrupting the skin barrier function. To the best of our knowledge, the effect of 50% GA on the percutaneous absorption of EMLA has not been studied previously.. The study used a two-step randomized double blind controlled trial involving 20 healthy subjects each. The first step compared the pain intensity upon applying GA and placebo for 4 minutes prior to EMLA occlusive application over time. Based on findings made in the first step, second step observation focused on the effect of occlusion on EMLA percutaneous absorption after GA application in minute 30 and 45. A second of 20 mA electrofulguration induced the pain, while modified Verbal Rating Scale (VRS) measured the pain intensity.. Significant VRS difference (P < 0.05) between GA and placebo group was found in minute 15, 20, 30 and 45. However, no significant VRS difference was found after minute 60 (P = 0.420). Adequate cutaneous analgesia was achieved in minute 30 in the treatment (GA) group and in minute 45 in the placebo. There was no significant VRS difference between the occlusive and non-occlusive group in minute 30 (P = 0.214) and minute 45 (P = 0.309).. Administering 50% GA prior to EMLA application enhances percutaneous absorption of EMLA, which accelerates the onset of adequate cutaneous analgesia, even without using an occlusive dressing.

Topics: Adolescent; Adult; Anesthetics, Local; Double-Blind Method; Drug Synergism; Drug Therapy, Combination; Electric Stimulation; Female; Glycolates; Humans; Keratolytic Agents; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Occlusive Dressings; Pain; Pain Measurement; Prilocaine; Skin; Skin Absorption; Statistics, Nonparametric; Time Factors

Medium-depth chemical peels are an effective and popular treatment for actinic damage, fine wrinkles, and pigmentary dyschromias. However, they are also uncomfortable. A previous attempt to study the effectiveness of a topical anesthetic gel in 35% trichloroacetic acid (TCA) peeling found a reduction in discomfort but an increased depth of penetration and delayed healing.. To evaluate both the efficacy of two topical anesthetic agents in medium-depth combination peeling as well as the histologic result from chemical peeling combined with topical anesthesia.. Seventy percent glycolic acid (GA) was applied to the entire face of 10 patients and diluted with water after 2 minutes. This was followed by the sequential application of EMLA cream (lidocaine 2.5% and prilocaine 2.5%), ELA-Max cream (lidocaine 4%), and placebo to selected areas on the face for 30 minutes without occlusion. These agents were then removed and 35% TCA was applied to the entire face. The level of discomfort felt by the patients during the TCA peel was recorded, clinical photographs were taken, and bilateral preauricular biopsies were performed at baseline, 48 hours, and 90 days postoperatively.. Clinically there was a statistically significant decrease in pain felt during the 70% GA-35% TCA peel with topical anesthesia when compared to the control. There was no statistically significant difference in efficacy between EMLA and ELA-Max. There was also no difference in either the clinical or the histopathologic appearance between the medium-depth peel combined with topical anesthesia and the medium-depth peel with control.. Both EMLA and ELA-Max decrease the discomfort felt during medium-depth combination chemical peeling without influencing either the clinical or the histopathologic result.

Topics: Anesthetics, Combined; Anesthetics, Local; Biopsy, Needle; Chemexfoliation; Female; Glycolates; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Pain; Prilocaine; Skin; Trichloroacetic Acid