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Surface a 'peel': Novel peel-away topical anesthetic offers quick onset, convenience

Article-Surface a 'peel': Novel peel-away topical anesthetic offers quick onset, convenience

Key iconKey Points

  • Clinical data are available for a new anesthetic cream for laser treatment-related pain
  • According to the study, 95 percent of patients had significantly less pain with the new cream compared with only 20 percent with the comparator cream
  • AEs were reported to be minimal

Dr. Alster
WASHINGTON D.C. — Although several topical anesthetics for laser treatments are available to reduce treatment-related pain, according to one expert, a new peel-away topical local anesthetic called Pliaglis (Galderma; Ft. Worth, Tex.) offers increased anesthetic effectiveness, a higher level of comfort and tolerance and convenience to patients.

QUICK AND EASY "...One of the major benefits of this new topical anesthetic is in its convenience," says Tina S. Alster, M.D., director of the Washington Institute of Dermatologic Laser Surgery and clinical professor of Dermatology at Georgetown University Medical Center, Washington D.C. "Approximately 20 to 30 minutes following its application, the cream dries and forms an easy-to-peel-away self-occlusive film membrane. Other local anesthetics are messy in their application and removal as well as inferior in their anesthesia, especially at the peripheral skin margins."

PROOF IS IN THE...CREAM Dr. Alster conducted a study comparing Pliaglis cream (seven percent lidocaine and seven percent tetracaine) with EMLA cream (AstraZeneca; Wilmington, Del.) (2.5 percent lidocaine and 2.5 percent prilocaine) in 20 patients (17 men and three women) who underwent CO2 laser resurfacing treatment.1 Patients were randomized to receive Pliaglis on one cheek and EMLA on the other. Each cream was allowed to work for 30 minutes prior to the first pass of the laser.

Results showed that 95 percent of the patients reported significantly less pain on the cheek on which the Pliaglis peel was used compared with only 20 percent where the EMLA cream was used. These significant results were matched by the observations made by a blinded investigator as well as an independent observer.

According to Dr. Alster, 75 percent of patients reported erythema at the application site where the Pliaglis peel was used, compared with only 10 percent of patients on whom the EMLA cream was used. However, the transient erythema reported for both treatments was generally mild. Less frequently reported adverse events associated with the application of both topical anesthetic creams were also mild, such as edema and skin blanching.

ANESTHETIC EFFICACY According to Dr. Alster, for the past decade practicing dermatologists have most frequently used creams for topical anesthesia. "We have several topical anesthetic agents at our disposal today including a eutectic mixture of lidocaine derivatives such as EMLA cream as well as other lidocaine-containing formulations," she explains. "To be effective, the EMLA cream needs to be applied to the desired area for at least one hour under occlusive dressing. Pliaglis, on the other hand, has a quicker anesthetic effect and does not require any messy occlusive dressings."

Dr. Alster adds that a multitude of research has already been performed with Pliaglis. The product is FDA approved and has been shown to be safe and effective in adults, though, she notes, additional studies may be required in children.

"This clearly opens the door for other topical anesthetics that can impart a faster onset as well as an easier, more user-friendly application," Dr. Alster says. "In my opinion, Pliaglis definitely raises the bar in terms of anesthetic efficacy for many dermatologic procedures."


1 Alster TS, Lupton JR. Evaluation of a novel topical anesthetic agent for cutaneous laser resurfacing: a randomized comparison study. Dermatol Surg. 2002; 28:1004-1006.


Dr. Alster has received study support from Zars Corporation (original developers of the product).

For more information
Tina S. Alster, M.D.
[email protected]

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