Aug 28, 2006. Steven L. Jacques

The concept of using a pulsed laser to perforate the superficial skin layer to allow delivery or collection of compounds across the skin or to enable sampling of blood, has been around for awhile. The idea has also been called laser venipuncture and laser assisted drug delivery (LAD). Laser-assisted percutaneous transport includes:

  1. Laser assisted drug delivery (LAD) and biomaterial collection A pulsed laser removes micrometers (µm) of the stratum corneum per pulse, removing the protective barrier of the skin. The laser can stop at the start of wet viable epidermis and not violate the skin's blood vessels, so there is no bleeding. The hole created in the stratum corneum can now facilitate delivery of drugs or collection of biochemical from the skin site.

  2. Laser assisted biomaterial collectionThe same as LAD, but now biomaterial such as biochemicals (such as glucose), circulating drugs, and extracellular fluid can be collected.

  3. Blood sampling (venipuncture) A strong laser pulse can penetrate the ~100 µm required to reach the superficial venous plexus of the skin and create a hole down to disrupted blood vessels. This is comparable to a pinprick. Now, the blood can now be sampled. This is a type of biomaterial collection, but deserves special emphasis since blood sampling is such a common task in medicine.

The history of laser enhanced percutaneous transport is briefly summarized:

The development of laser-assisted perforation of the stratum corneum for drug delivery and blood sampling continues.

References

1. S. L. Jacques, D. J. McAuliffe, I. H. Blank, J. A. Parrish, "Controlled removal of human stratum corneum by pulsed laser," Journal of Investigative Dermatology,88, 88- 93 (1987).

2. Steven L. Jacques, Daniel J. McAuliffe, Irvin H. Blank, John A. Parrish. Controlled removal of human stratum corneum by pulsed laser to enhance percutaneous transport. United States Patent 4775361, ISSUED: Oct. 4, 1988, FILED: Apr. 10, 1986.

3. S. L. Jacques, F. E. Ejeckam, F. K. Tittel, "How micro is microdissection? Laser removal of stratum corneum of skin to expose the epidermal battery," SPIE Proceedings of Laser- Tissue Interaction IV, edited by S. L. Jacques, A. Katzir, 1882, 23-33 (1993)

4. Nelson JS, McCullough JL, Glenn TC, Wright WH, Liaw LH, Jacques SL. Mid-infrared laser ablation of stratum corneum enhances in vitro percutaneous transport of drugs. J Invest Dermatol. 1991 Nov;97(5):874-9.

5. Milton Waner, Stephen T. Flock, Charles H. Vestal, Laser perforator. United States Patent 5643252, ISSUED: July 1, 1997,FILED: Sep. 24, 1993.

6. Flock S, Stern T, Lehman P, et al. Er:YAG laser-induced changed in skin in vivo and transdermal drug delivery. In: Anderson R, et al, eds. Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems VII, Proc. SPIE. 1997;2970:374-379. http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ija/vol6n2/laser.xml

7. http://www.norwoodabbey.com/research.htm

8. Jeffrey L Koh, Dale R Harrison, Stephen Flock, Kevin Marchitto, Timothy W Martin: Local Anesthesia by Topical Application of Lidocaine After Stratum Corneum Ablation with an Er:YAG Laser . The Internet Journal of Anesthesiology. 2003. Volume 6 Number 2