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

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.