Cold plasma: controlled physics for skin, nails and microorganisms

Cold plasma: controlled physics for skin, nails and microorganisms

In podiatry, foot care and cosmetics, the demands placed on treatments are constantly increasing. In addition to effectiveness, aspects such as tolerability, hygiene, sustainability and reproducible results are becoming increasingly important. At the same time, chronic, microbial or regenerative issues are on the rise – from nail fungus and sensitive skin to stressed or inflamed skin conditions.

Cold plasma is a technology that addresses precisely this interface. Originally developed in medical research, it is now increasingly being used in podiatry and cosmetic practice. The reason: cold plasma does not act chemically or thermally, but via controlled physical stimuli that can be specifically adapted to different skin and nail conditions.

What is cold plasma?

Atmospheric cold plasma is an ionised gas with a temperature of around 38 °C. It is created when oxygen and nitrogen molecules from the ambient air are activated by electrical energy. This produces a mixture of various active components, in particular:

• reactive oxygen and nitrogen species (ROS/RNS)
• free electrons and other charged particles

These components are short-lived, highly reactive and take effect immediately upon contact with the skin surface – without heating or damaging it.

Cold plasma as a "controlled stimulus"

The key to understanding cold plasma is not the mere existence of these active particles, but their controlled dosage and composition. Cold plasma does not have a blanket effect, but rather a context-dependent one.

Single-celled microorganisms such as fungi or bacteria react to the oxidative stimulus with structural damage. Human skin cells, on the other hand, have complex protective and regulatory mechanisms. They use the same stimulus as a signal to initiate antioxidant, regenerative and stabilising processes.

This selective effect forms the basis for the versatile application of cold plasma in podiatry, foot care and cosmetics.

Further information

• Cold plasma in podiatry
  Antimicrobial mode of action, indications, case studies Nail fungus
• Cold plasma in foot care & cosmetics
  Skin protection, regeneration, cosmetic applications
• How cold plasma treatment with GEHWOL TECH works
  Technology, controllability, safety by design, application

Literature review

(A) Antifungal effects of cold plasma

[1] Gnat, S., Łagowski, D., Dyląg, M. et al. Cold atmospheric pressure plasma (CAPP) as a new alternative treatment method for onychomycosis caused by Trichophyton verrucosum: in vitro studies. Infection 49, 1233–1240 (2021). https://doi.org/10.1007/s15010-021-01691-w
[2] S. R. Lipner, G. Friedman, R. K. Scher, Pilot study to evaluate a plasma device for the treatment of onychomycosis, Clinical and Experimental Dermatology, Volume 42, Issue 3, 1 April 2017, Pages 295–298, https://doi.org/10.1111/ced.12973
[3] Xiong, Z., Roe, J., Grammer, T.C. and Graves, D.B. (2016), Plasma Treatment of Onychomycosis. Plasma Process. Polym., 13: 588-597. https://doi.org/10.1002/ppap.201600010

(B) Hormesis effects and regenerative effects of cold plasma

[4] Schmidt A, Dietrich S, Steuer A, Weltmann KD, von Woedtke T, Masur K, Wende K. Non-thermal plasma activates human keratinocytes by stimulation of antioxidant and phase II pathways. J Biol Chem. 2015 Mar 13;290(11):6731-50. https://doi.org/10.1074/jbc.M114.603555
[5] von Woedtke, T., Schmidt, A., Bekeschus, S., Wende, K., & Weltmann, K.-D. (2019). Plasma Medicine: A Field of Applied Redox Biology. In Vivo, 33(4), 1011–1026. https://doi.org/10.21873/invivo.11570
[6] Ahn, G. R., Park, H. J., Koh, Y. G., Shin, S. H., Kim, Y. J., Song, M. G., Lee, J. O., Hong, H. K., Lee, K. B., & Kim, B. J. (2022). Low-intensity cold atmospheric plasma reduces wrinkles on photoaged skin through hormetic induction of extracellular matrix protein expression in dermal fibroblasts. Lasers in Surgery and Medicine, 54(7), 978–993. https://doi.org/10.1002/lsm.23559
[7] Schmidt, A., Bekeschus, S., Wende, K., Vollmar, B., & von Woedtke, T. (2017). A cold plasma jet accelerates wound healing in a murine model of full-thickness skin wounds. Experimental Dermatology, 26(2), 156–162. https://doi.org/10.1111/exd.13156
[8] Jung, J. M., Yoon, H. K., Won, C. H., Seo, Y. K., & Park, Y. W. (2021). Cold Plasma Treatment Promotes Full-thickness Healing of Skin Wounds in Murine Models. Journal of Experimental & Clinical Medicine, 13(2), 456–467. https://doi.org/10.1177/15347346211002144
[9] von Woedtke, T., Schmidt, A., Bekeschus, S., Wende, K., & Weltmann, K.-D. (2019). Plasma Medicine: A Field of Applied Redox Biology. In Vivo, 33(4), 1011–1026. https://doi.org/10.21873/invivo.11570
[10] Tan, F., Wang, Y., Zhang, S., Shui, R., & Chen, J. (2022). Plasma Dermatology: Skin Therapy Using Cold Atmospheric Plasma. Frontiers in Oncology, 12, 918484. https://doi.org/10.3389/fonc.2022.918484
[11] Busco, G., Robert, E., Chettouh-Hammas, N., Pouvesle, J.-M., & Grillon, C. (2020). The emerging potential of cold atmospheric plasma in skin biology. Free Radical Biology and Medicine, 161, 290–304. https://doi.org/10.1016/j.freeradbiomed.2020.10.004
[12] Choi, J. H., Song, Y. S., Song, K., Lee, H. J., Hong, J. W., & Kim, G. C. (2016). Skin renewal activity of non-thermal plasma through the activation of β-catenin in keratinocytes. Scientific Reports, 6, 27376. https://doi.org/10.1038/srep27376
[13] Kisch, T., Schleusser, S., Limpert, R., Seuser, A., Mailänder, P., Kraemer, R., & Arnemann, J. (2016). Initiation of microcirculation by cold atmospheric plasma. Wound Repair and Regeneration, 24(6), 1023–1030. https://doi.org/10.1111/wrr.12479