Successful pain management is a significant factor in reducing patient anxiety and providing successful treatment outcomes. If pain is managed well, it can enhance patient satisfaction and reduce post-treatment complications1. Nowhere is this more relevant than in laser and energy-based treatments. The mode of action involves heat, and where there is heat some discomfort will inevitably be experienced by patients. However, these technologies have a wide intensity range, which means the pain experience will vary.
Pliaglis®: providing patient comfort
Pliaglis is the first, self-occluding topical anaesthetic cream for a wide range of dermatological procedures2, 3, and is part of the Galderma product portfolio. Pliaglis has well established safety and efficacy2, 3, and meets many physicians’ and patients’ needs for fast, sufficient pain relief when undergoing a range of dermatologic procedures. It combines a high concentration of lidocaine 7% and tetracaine 7% to provide rapid onset, within 30 or 60 minutes, and long-lasting effect2, 3 (mean duration of 9 hours).
Pliaglis should be applied 30 minutes before pulsed dye laser (PDL) therapy, laser-assisted hair removal, non-ablative laser facial resurfacing, dermal filler injections and vascular access, and 60 minutes before laser-assisted tattoo removal and laser leg vein ablation.
Long-lasting pain relief
Plastic surgeon, Dr Matteo Tretti Clementoni, has been working with lasers since 1996 and is a member of the European Society of Laser Dermatology (ESLD). He views Pliaglis as an important advance in topical anaesthesia:
‘One of the unique features of Pliaglis is the self-occluding delivery system. This ensures rapid onset and lasting duration, which effectively deals with both immediate intraoperative pain and delayed postoperative pain associated with the more painful laser ablation treatments.’
Pliaglis delivers a treatment experience that patients prefer, plus post-procedure pain relief. Dr Tretti Clementoni explains:
‘Tattoo removal is in increasing demand by younger patients; they are very worried about pain. Providing effective pain relief extending into the postoperative period with Pliaglis enables me to provide the reassurance they seek, and I find that patient compliance is improved.’
Breaking the pain barrier
Max Murison, consultant plastic surgeon at the Swansea Laser Clinic, believes that Pliaglis has an important role to play in ensuring treatment strategies are based on achieving the best outcomes, not guided by the patient’s pain threshold. He says:
‘In the case of fractional ablative procedures I believe that Pliaglis will facilitate more intense treatments, which overall, will improve patient compliance, optimal treatment results and increase patient satisfaction.’
Pliaglis is easy to use
Pliaglis is applied as a cream using a spatula and dries to a pliable membrane when exposed to air. The unique formulation allows for easy application and removal, while covering other areas, such as skin folds, considered difficult for other topical anaesthetics4. Dr Tretti Clementoni adds:
‘In a busy clinic Pliaglis is easier to manage and less messy than other topical anaesthetic creams; when exposed to air it forms an occlusive barrier which is simply peeled away prior to treatment. I have also discovered another advantage when using Pliaglis; surgical markings remain intact after it is peeled away, which is helpful and time saving.’
Quality and reliability
Standardisation of compounded topical anaesthetic products proves difficult because of the differing protocols and mix of ingredients used by individual pharmacies, making accurate dosing complicated4. Pliaglis is the only FDA approved self-occluding topical anaesthetic cream. Dr Robert A. Weiss, Director, MD Laser Skin and Vein Institute, and Associate Professor of Dermatology, Johns Hopkins, considers that the predictability and reduced risk of toxicity of Pliaglis are its key strengths:
‘Patient safety is paramount. I feel more secure in using a pharmaceutical grade product because the FDA scrutinises the manufacturing site for quality control measures for product consistency as part of its approval process.’