Harnessing cold atmospheric plasma for skin cancer: a non-invasive breakthrough in plasma medicine.

Skin cancer, including melanoma and non-melanoma, is a major global health concern as a result of rapid metastasis and recurrence. Key causes include ultraviolet (UV) radiation, aging, and genetic predisposition. Current treatments face challenges such as drug resistance, side effects, and relapse, prompting interest in novel therapies. Cold atmospheric plasma (CAP) is a promising alternative, producing reactive oxygen (ROS) and nitrogen species (RNS) that trigger oxidative stress-induced cell death of cancer cells. CAP also regulates signaling pathways linked to proliferation, apoptosis, and immunity, induces immunogenic cell death, and modulates calcium signaling. Preclinical and clinical studies revealed enhanced efficacy for its application in combination with chemotherapy and photodynamic therapy. In this review, we examine the mechanisms of action, combination strategies, clinical applications of CAP, as well as its potential in skin cancer treatment.