What is Cold Atmospheric Plasma therapy?
Cold Atmospheric Plasma (CAP) therapy is a relatively recent addition to the array of treatments available for wound healing and skin conditions. CAP refers to a physical plasma primarily composed of ionized gas generated at normal atmospheric pressure and ambient temperature. It encompasses multiple synergistically-acting components such as charged particles, electric currents, and ultraviolet radiation (1). This innovative therapy has emerged as an emerging method in dermatology, offering an alternative to traditional methods like oral or topical drugs, which can come with with systemic side effects and disease recurrence (2).
ℹ️ Related: A Recent Visit to The CAP TSW Clinic in Bangkok
History of Cold Atmospheric Plasma
Irving Langmuir was an American chemist and physicist who significantly contributed to the field of surface chemistry, earning him the Nobel Prize in Chemistry in 1932. He is also known for his work in plasma science and introduced the term “plasma” in 1928 to describe an ionized gas, laying a foundation for the development of plasma physics. Through his research, Langmuir helped in elucidating the behavior of electrons in ionized gases, which is fundamental to the understanding and applications of plasma, including its use in various medical and industrial applications.
The antimicrobial effect of Cold Atmospheric Plasma, which paved the way for its application in medicine, was discovered in the 1990s. However, it wasn’t until 2007 that the initial clinical trial utilizing a plasma device for facial rejuvenation procedures was conducted. This trial marked the beginning of CAP’s use in regenerative medicine, targeting the acceleration of acute and chronic wound healing by alleviating bacterial infection (3).
The science behind CAP – How it improves skin conditions and wound healing
CAP therapy operates on a physicochemical approach based on ionized gases. This technology has already been employed in dermatology to foster wound healing, and it’s steadily gaining traction in the cosmetic field as well (4). Its mechanism of action includes the elimination of bacterial infection, which is often a significant hurdle in the wound healing process. CAP’s capacity to reduce bacterial load in a wound initiates the healing process, a feature that has been showcased in various clinical settings including a case report where active wound dressings with cold plasma significantly improved chronic wounds (5).
Moreover, the interaction of CAP with living tissues generates reactive species which have cytotoxic and bactericidal effects, promoting cell proliferation and exhibiting anti-inflammatory effects. These properties make CAP a promising treatment for diseases involving chronic inflammation and bacterial infections.
The effectiveness and safety of CAP in treating skin diseases and promoting wound healing have opened new horizons in dermatology, marking a step forward towards establishing novel, non-invasive therapeutic approaches for managing skin conditions and improving patients’ quality of life.
Dermatological benefits of Cold Atmospheric Plasma therapy
- Treatment of skin diseases
CAP can potentially provide effective therapy for numerous skin diseases, paving the way for innovative dermatological treatments(6). - Bacterial eradication
CAP has demonstrated substantial antibacterial properties, reducing bacterial load and thus aiding in the management of skin infections and inflammations. - Enhanced absorption
By creating minuscule openings between cells, CAP facilitates enhanced absorption, augmenting product efficacy and transdermal delivery. - Accelerated healing
CAP has shown to promote wound healing by reducing bacterial contamination, making it a viable option for managing acute and chronic wounds(7). - Skin regeneration
CAP activates angiogenesis-related molecules in skin keratinocytes, fibroblasts, and endothelial cells, leading to increased production of collagen and elastin, which are crucial for skin regeneration. - Microbial inactivation
CAP acts as an antimicrobial agent, aiding in microbial inactivation, which is particularly beneficial in dermatological contexts where infectious microorganisms and disease processes complicate wound healing (8). - Alopecia treatment
It has been utilised to treat alopecia areata, demonstrating its potential in addressing hair loss conditions. - Occlusion management
CAP has been effective in treating vascular occlusion post dermal filler complications. - Blood coagulation
CAP accelerates blood coagulation, which can be beneficial in certain dermatological procedures or conditions (9). - Technical versatility
The technical versatility of CAP, including direct irradiation and indirect aqueous treatment, expands the scope and efficacy of dermatological treatments, allowing for a more tailored approach to individual patient needs(10).
The rise of interest for CAP therapy for Topical Steroid Withdrawal
The emergence of Cold Atmospheric Plasma (CAP) therapy in treating patients suffering from Topical Steroid Withdrawal (TSW) is a beacon of hope for both sufferers and their caregivers. While there is no medical cure for Topical Steroid Withdrawal, novel specialist clinics are utilising CAP therapy to treat the wound healing associated with the TSW skin condition.
Social media, online forums, and support groups have facilitated the popularity and growth of interest of CAP therapy to treat topical steroid withdrawal over the past two years. But how did it come about?
Peerawat Jay is a Thai practitioner who has been treating patients with topical steroid withdrawal in Bangkok for 16 years. His unique CAP machines have gone through various iterations and calibrations to specifically treat TSW skin have resulted in successful patient care and outcomes. The specific CAP machines and their custom tailored approach for each individual patient has resulted in patient care and treatment outcomes over the past 16 years.
ℹ️ Related Post: A Recent Visit to The CAP TSW Clinic in Bangkok
Jay’s Ultra Pulse Contact CAP treatment is tailored for people battling Topical Steroid Withdrawal (TSW). It operates on three core principles to rejuvenate TSW-affected skin:
- Cellular regeneration
- It triggers growth factors in skin cells, enhancing their regeneration rate, especially when hindered by long-term medication use.
- Bacterial and fungal eradication
- By interacting with pathogens on the skin, it eradicates harmful bacteria and fungus, aiding in skin recovery.
- Micro-exfoliation
- It performs a gentle micro-exfoliation to manage hardened skin, making it suitable even for sensitive and damaged skin,
This treatment method that incorporates CAP technology as the primary driving force, has expanded into the creation of Skin Solace, a UK based Skin Clinic. Skin Solace was founded in 2020 by Louise King and Jing Rui who were previous patients of Peerawat Jay and long term sufferers of topical steroid withdrawal. The entrepreneurial pair had been influential advocates for topical steroid withdrawal awareness for many years and have evolved from advocacy to treatment.
Online testimonials and videos from patients of these two skin clinics have gone viral across Instagram, Tiktok, and Facebook groups.
Considerations for Eczema
It is important to note the initial underlying conditions that was previously being treated by topical steroids, such as atopic dermatitis (eczema), a chronic inflammatory skin condition. CAP’s potential as a treatment for AD has been explored, with positive implications for treating TSW as well. By addressing microbial infections, immune system dysfunction, and skin barrier deficits – central events in AD pathogenesis – CAP therapy could offer a broader spectrum of treatment options for individuals suffering from various skin conditions including TSW (11)(12).
Receiving CAP therapy can be beneficial for improving skin that has atrophied from long-term steroid use, focusing primarily on the skin cell regeneration, bacterial eradication, and micro-exfoliation. However, the underlying original skin conditions that were previously treated by topical steroids, such as eczema—which is often linked to genetic and environmental factors—may be untreated once CAP therapy ceases.
ℹ️ Related: Initial Skin Conditions Before Using Topical Steroids
Are there other CAP clinics for TSW around the world?
CAP machines have been around for many years and lower strength machines are commonly found in cosmetic and skin aesthetic clinics around the world. These CAP machines are different in calibration and technology to the specific machines used in the two clinics mentioned above. This does not devalue their efficacy, but it should be informed that the machines were not intended originally for patients with topical steroid withdrawal.
The emergence of the beneficial outcomes of Ultra Pulse CAP technology from Skin Solace and Bangkok clinic for treating Topical Steroid Withdrawal skin is opening up a new door for new technological advancements, research, customisations into treatment opportunities that utilize Cold Atmospheric Plasma for wound healing.
Recently, there has been an increasing adoption of skin aesthetic clinics around the world promoting treatments for TSW using their own CAP machines. These machines may be calibrated differently than Peerawat’s CAP machines, and the difference of established treatment protocols or trained personnel could potentially result in different outcomes. Nonetheless, there is optimism toward the future advancements in this technology and its potential to benefit more people in need.
Over the next few years, we expect to see various Cold Atmospheric Plasma machines and brands enter the skin treatment market, treating a wide range of medical and dermatological conditions.
The dawn of specialised CAP clinics for TSW
The advent of clinics specializing in CAP treatment for Topical steroid withdrawal reflects a growing recognition of the therapy’s potential.
New clinics utilising CAP for TSW are marking a significant stride towards tailored care for TSW patients with more specialised clinics soon to emerge to facilitate this demand.
The interest and ongoing research in CAP therapy could potentially lead to more refined treatment protocols, better understanding of its mechanisms, and broader application in treating a variety of skin conditions. As more clinics adopt this therapy, the wider population could gain access to this innovative treatment, improving the quality of life for individuals afflicted with TSW and other related skin conditions.
Through the combination of evidence-based science and clinical practice, CAP therapy could become a cornerstone in the management and treatment of TSW, offering hope for countless sufferers and their families.
References
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9576403/#:~:text=Cold%20atmospheric%20plasma%20,electric%20currents%2C%20ultraviolet%20radiation
- https://www.frontiersin.org/articles/10.3389/fimmu.2022.868386/full#:~:text=The%20traditional%20therapies%20for%20skin,and%20effective%20functions%20in%20dermatology
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7215620/
- https://www.sciencedirect.com/science/article/pii/S0891584920312776#:~:text=Currently%2C%20a%20physicochemical%20approach%2C%20based,thus%20providing%20a%20new%20challenge
- https://journals.lww.com/aswcjournal/Fulltext/2022/12000/Use_of_Cold_Plasma_in_Wound_Healing__A_Case_Report.12.aspx#:~:text=The%20concept%20of%20the%20fully,S%2C%20Helmke%20A%2C%20et%20al
- https://onlinelibrary.wiley.com/doi/10.1002/jbio.202000415#:~:text=Cold%20atmospheric%20plasma%20,use%20of%20CAP%20in%20dermatology
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10219374/#:~:text=Cold%20atmospheric%20plasma%20,contamination%20and%20promote%20wound%20healing
- https://link.springer.com/chapter/10.1007/978-3-030-49966-2_12#:~:text=The%20understanding%20that%20cold%20atmospheric,1%2C%2024
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7949367/#:~:text=1,accelerating%20blood%20coagulation%2C%20killing
- https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.918484/full#:~:text=Cold%20atmospheric%20plasma,and%20practical
- https://www.medicalnewstoday.com/articles/using-coldwater-atmospheric-plasma-to-treat-atopic-dermatitis#:~:text=Researchers%20from%20the%20Institute%20of,a%20potential%20treatment%20for%20atopic
- https://karger.com/iaa/article/doi/10.1159/000531967/862369/Cold-Atmospheric-Plasma-A-Promising-and-Safe
