Thirty-minute application of the S-Caine Peel prior to nonablative laser treatment

BACKGROUND. Advancements in nonablative laser technology necessitate concurrent developments in topical anesthesia, as patients have reported varying degrees of discomfort during these procedures. Although topical anesthetics have proven efficacious, they possess inherent limitations related to ease of use. OBJECTIVE. To evaluate the efficacy of the S-Caine Peel (ZARS Inc., Salt Lake City, UT), a novel topical anesthetic that dries to form a flexible membrane, for induction of anesthesia after only a 30-minute application period. METHOD. Twenty patients received concurrent 30-minute applications of both the S-Caine Peel and a placebo cream randomized to the right and left cheeks in a double-blinded manner. After one pass of the 1450-nm diode laser (Smoothbeam, Candela Corp., Wayland, MA), patients' pain levels were recorded on a visual analog scale (VAS). Both the investigator and an independent observer rated perceived discomfort and immediate skin reaction based on a numerical scale. RESULTS. Differences in VAS scores between active sites (average rating of 15 mm) and placebo sites (average rating of 47 mm) were statistically significant (P < 0.001). A painless procedure was noted at 50% and 65% of active sites by the independent observer and investigator, respectively. This was statistically different (P < 0.001) from the independent observer and investigator perception of pain-free procedure at the placebo site, 0% and 5%, respectively. CONCLUSION. The S-Caine Peel provided effective and safe dermal anesthesia after only a 30-minute application period for nonablative laser treatment with the 1450-nm diode laser. The unique vehicle readily delivers anesthetic to contoured regions of the body and eliminates the need for occlusion.