Topical Brimonidine as an Effective Adjuvant to Local Anesthetics for Post Treatment Erythema and Pain Reduction

Ann Dermatol. 2019 Jun;31(3):315-319. doi: 10.5021/ad.2019.31.3.315. Epub 2019 May 1.

Abstract

Background: There are few pharmacologic options to reduce laser-associated post treatment erythema and to extend topical anesthesia duration. To improve the tolerability of painful laser treatment, dermatologists should encourage development of a novel adjuvant agent to topical lidocaine cream.

Objective: To report the efficacy and safety of a combination of topical brimonidine and anesthetic cream as an aid for post treatment erythema and pain.

Methods: A total of 15 Korean subjects were randomized to receive a split-face application of a mixture of brimonidine and anesthetics on one side and only anesthetics on the other side of the face for anesthesia. After non-ablative fractional full-face skin resurfacing, Clinician's Erythema Assessment, erythema index, and visual analogue scale were assessed at four time points: immediately after resurfacing, 30 minutes after, 60 minutes after, and 1 day after.

Results: A combination of brimonidine and anesthetics significantly lowered post treatment erythema until 60 minutes after the laser procedure. Furthermore, patients reported significantly lower post-procedural pain from the side of their face that received the mixture of anesthetics and brimonidine than they did for the side that only received anesthetics.

Conclusion: Topical brimonidine can be used as an effective adjuvant agent to lidocaine-based topical anesthetics.

Keywords: Alpha-2-agonist; Anesthesia; Brimonidine tartrate; Erythema; Pain.