In our present study we focus on two physical enhancement methods for transdermal drug delivery: ultrasound and electric pulses either alone or in combination. Great emphasis has been given on the design of the experimental system and protocols, so the results and the conclusions drawn from them would have greater relevance for in vivo use and later translation into clinical practice. Our results show a statistically significant enhancement of calcein delivery (after one hour of passive diffusion following treatment) already after 5 minutes of ultrasound application, or only 6 × 100 short high voltage electrical pulses. We also experimented with combinations of the two enhancement methods hoping for synergistic effects, however, the results showed no evident drastic improvement over single method. Looking closer at physics of both methods, this absence of synergy in our in vivo oriented experimental setting is not surprising. The mechanism of action of both methods is the creation of aqueous pathways in the stratum corneum leading to increased skin permeability. However, when used in combination (regardless of the order of methods), the second method was unsuccessful in adding many new aqueous pathways in the stratum corneum, as it acted preferentially near the sites of the existing ones.
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