International expert consensus on transdermal drug delivery technologies in dermatology

Background: Transdermal drug delivery technologies (TDDTs) enhance drug absorption and therapeutic outcomes in dermatology, yet standardized, evidence-based recommendations for their clinical application remain lacking. Objective: To provide expert consensus recommendations on the clinical application of TDDTs, with a focus on fractional lasers and microneedles. Methods: A multidisciplinary panel of 25 experts systematically reviewed current literature and clinical practices. The consensus was developed using the Grading of Recommendations Assessment, Development and Evaluation framework to assess evidence quality and recommendation strength and the modified Delphi method to achieve expert agreement. Results: Evidence-based recommendations were formulated for the use of TDDTs in a variety of dermatological conditions, including cutaneous malignancies and precancerous lesions, viral warts, inflammatory and autoimmune skin diseases, and cosmetic indications. Conclusion: Fractional lasers and microneedles are valuable transdermal delivery tools for dermatological therapy. This expert consensus provides practical, evidence-based guidance to support their safe and effective clinical use.