Laser-Assisted Drug Delivery

Nonsurgical aesthetic providers face rising patient expectations in today’s environment: better results, fewer treatments, and less downtime. In the pursuit of meeting those demands, laser-assisted drug delivery (LADD) has become one of the most valuable tools at our disposal. Whether for optimizing pigmentation protocols or accelerating recovery, LADD offers a targeted and efficient way to deliver active ingredients deep into the skin. Although clinical research is still emerging, the anecdotal and early data are promising and worth our collective attention.

WHAT IS LASER-ASSISTED DRUG DELIVERY?

LADD is the process of using ablative or non-ablative lasers to create controlled microchannels in the skin, allowing for enhanced penetration of topical or injectable agents. The laser disrupts the stratum corneum and facilitates deeper delivery into the epidermis or dermis, bypassing the natural skin barrier. This method is not new, but we are now beginning to harness it in more meaningful, targeted ways with newer technologies and a growing library of biocompatible topicals.

COMMON AND EMERGING COMPOUNDS

A wide variety of active ingredients can be paired with LADD. Some that I use include:

• Antioxidants: vitamin C, glutathione, and niacinamide
• Depigmenting agents: tranexamic acid (TA)
• Growth factors: Platelet-derived growth factor (PDGF), platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and some newer commercial solutions
• Exosomes: including sterile vesicular products
• Hydrating agents: low, medium, and high molecular weight hyaluronic acid
• Anti-inflammatories: for post-laser healing and barrier repair
• Polynucleotides: including polydeoxyribonucleotide (PDRN, or salmon sperm DNA) for rejuvenation
• Neuromodulators: for scar remodeling, applied into deep ablative channels

Additionally, non-ablative treatments can be used on the scalp to prevent hair shaft damage while stimulating follicular rejuvenation with compounded topicals.

LADD VS MICRONEEDLING

Microneedling has limitations, especially when used without energy. Studies have shown that drug penetration with microneedling alone is limited. Many practitioners attempt to microneedle products such as poly-L-lactic acid (PLLA) into skin, despite its molecule being too large to pass through needle-created channels. LADD allows for calculated precision based on drug size and targeted depth, offering an unmatched ability to customize therapy.

CLINICAL APPLICATIONS

In my practice, I use a fiber laser (UltraClear, Acclaro) that minimizes thermal damage and offers customizable depth and density, allowing me to fine-tune treatments for each drug’s molecular characteristics. Its coagulation zone of approximately 10 μm is ideal for precision-based delivery. For instance, larger molecules require wider or deeper channels to reach therapeutic targets within the skin, a consideration that is often misunderstood in microneedling practices.

LADD can be used to treat melasma and dyschromia when TA is delivered both intradermally and via laser channels, followed by topical agents. When paired with non-ablative laser settings, this can achieve significant pigment reduction with less rebound compared to oral or topical-only approaches.

For skin rejuvenation and texture, using LADD with vitamin C, PDGF, and niacinamide combinations post-laser promotes collagenesis, hydration, and antioxidant repair. Histological evidence supports that combining CO₂ or Er:YAG lasers with these compounds results in enhanced wound healing and reduced wrinkle depth.

LADD also can be used for scar remodeling and post-procedure healing. Neuromodulators can be layered into deep coring (up to 1000 μm) to target fibrotic scars, showing promising remodeling over multiple sessions. Immediate post-laser application of PDGF dramatically reduces swelling and erythema.

Additionally, for hair restoration, using sterile peptides and growth factors with non-ablative delivery has allowed for hair regeneration without follicular damage.

There are very few high-quality studies on LADD in aesthetic settings, but what we do have is a growing consensus that drug-specific pairing with controlled energy delivery can optimize outcomes.

DELIVERING ON OUR PROMISE

Patients today want what we all want: faster, safer, smarter outcomes. LAAD is not magic; it is methodical science, and it is emerging as a cornerstone of modern aesthetic treatment strategies. The challenge ahead is to validate it with data and refine it through clinical precision.

As aesthetic providers, it is time we move beyond “off-label curiosity” and start building an evidence-based standard. When we get LADD right, we meet patients where they are—demanding more, with less. 

Editor’s note: This article is based on a presentation delivered at the 2025 Tell-All Tribune: An Aesthetic Think Tank.