From the January 2015 issue of HealthCare Business News magazine

In addition, a number of alternate energy- based devices are finding uses in the cosmetic field, including focused ultrasound and radio frequency. Like non-ablative lasers, these methods do not disrupt the top layer of skin, but work by creating thermal injury underneath the skin.

Skin rejuvenation
For photoaging and pigmentation, an emerging application is the use of Qswitched non-ablative lasers that fire in nanoseconds (also used for tattoo removal). The newest and most promising are the picoseconds domain lasers which fire in trillionths of a second. “This is the hot new area, trying to understand all the benefits and to harness the advantages of such a short pulse duration,” says Weiss. “There is also investigation into lens arrays to break up the beam into tinier beams, which creates more intensity in little spots. The picosecond laser just received clearance from the FDA for wrinkles and acne scars, which helps expand the range of treatments and justify the investment. “
Fractional infrared non-ablative lasers, the latest based on thulium lasers, have been working very well for textural improvement of the skin and for the pigment component of aging.

The FDA has also cleared these lasers for safety and efficacy on actinic keratosis, which are pre-cancerous cells. “We have the capability to treat the pigment and kill the pre-cancers before they turn into cancers,” said Weiss.

The standard for really severe sun-damaged skin and scarring is the more invasive ablative fractional CO2 laser. The treatment provides greater improvement of the damage, but has a trade-off because it produces more redness and requires more pain control and downtime.

A new approach is the combination of devices at the same treatment session, such as a combination of ablative and non-ablative fractional laser resurfacing or two wavelength levels of non-ablative at the same treatment to achieve a better patient experience with less pain.

For complete patient satisfaction, many of the device treatments are part of a total rejuvenation program, which typically includes hyaluronic acid and other fillers to lift the face and neuromodulators to help with dynamic wrinkles — those created by muscle movement. “Even with the best laser, those dynamic wrinkles will return, because the muscle movement is constantly reinforcing those lines,” said Weiss. “We try to explain to the patient that with the laser, you are undergoing demolition of the old collagen and then reconstruction of the new collagen, which takes several months. Using these injectables in combination with the device treatment will provide a more satisfying and immediate result during the laser remodeling process.”

January 2015 Magazine

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