Plasma Medicine: Applications of Cold Atmospheric Pressure Plasma in Dermatology

Abstract

The ability to produce cold plasma at atmospheric pressure conditions was the basis for the rapid growth of plasma-related application areas in biomedicine. Plasma comprises a multitude of active components such as charged particles, electric current, UV radiation, and reactive gas species which can act synergistically. Anti-itch, antimicrobial, anti-inflammatory, tissue-stimulating, blood flow-enhancing, and proapoptotic effects were demonstrated in in vivo and in vitro experiments, and until now, no resistance of pathogens against plasma treatment was observed. The combination of the different active agents and their broad range of positive effects on various diseases, especially easily accessible skin diseases, renders plasma quite attractive for applications in medicine. For medical applications, two different types of cold plasma appear suitable: indirect (plasma jet) and direct (dielectric barrier discharge—DBD) plasma sources. The DBD device PlasmaDerm® VU-2010 (CINOGY Technologies GmbH), the atmospheric pressure plasma jet (APPJ) kINPen® MED (INP Greifswald/neoplas tools GmbH), and the SteriPlas (Adtec Ltd., London, United Kingdom) are CE-certified as a medical product to treat chronic wounds in humans and showed efficacy and a good tolerability. Recently, the use of plasma in cancer research and oncology is of particular interest. Plasma has been shown to induce proapoptotic effects more efficiently in tumor cells compared with the benign counterparts, leads to cellular senescence, and—as shown in vivo—reduces skin tumors. To this end, a world-wide first Leibniz professorship for plasmabiotechnology in dermatology has been introduced to establish a scientific network for the investigation of the efficacy and safety of cold atmospheric plasma in dermatooncology. Hence, plasma medicine especially in dermatology holds great promise.

Cold Atmospheric Plasma: A Powerful Tool for Modern Medicine

“…Moreover, it cannot be hypothetically excluded that CAP application does not have some minimal negative effects at the molecular level. All these findings and possibilities are subject to ongoing analysis, but current results suggest that the unproven adverse effects are outweighed by CAP's many benefits [3,4,12]. Finally, it is likely that more possibilities and greater benefits for CAP use in clinical practice will be demonstrated in the future, because most CAP studies have just taken place in the last 15 years [3,4,12].…”

“…All these findings and possibilities are subject to ongoing analysis, but current results suggest that the unproven adverse effects are outweighed by CAP's many benefits [3,4,12]. Finally, it is likely that more possibilities and greater benefits for CAP use in clinical practice will be demonstrated in the future, because most CAP studies have just taken place in the last 15 years [3,4,12]. While CAP can be employed in aesthetic procedures [30][31][32], herein we summarise CAP use in more serious medical conditions.…”

“…The current plasma term was then initiated almost fifty years later in 1927 by Irvin Langmuir [1]. Plasma has since been applied in many spheres over the past few decades, including medicine [2][3][4]. Plasma is often defined as an ionised gas produced by disintegration of polyatomic gas molecules or the removal of electrons from monatomic gas shells [5].…”

“…Plasma devices used in clinical practice are designed to avoid danger to healthy cells. They undergo multistep testing and are not currently associated with significant side effects [4,27,28]. However, the appropriate CAP dosage in clinical practice must be closely controlled, and this control depends on treatment type.…”

“…They can also generate plasma solely in air without the need for carrier gases. The discharge area, however, is relatively limited because it must lie between two electrodes, and a constant distance must be maintained; this demands a smooth, flat surface [4,33,34].…”