Aesthetic laser devices are changing rapidly to improve efficacy and safety — some with features straight out of a sci-fi movie.
“We’re seeing a lot more tools that aid the physician to get better results; a lot more automation and more application-driven menus,” according to E. Victor Ross, M.D., skin laser surgery specialist at Scripps Clinic Carmel Valley in San Diego. “There are more navigational features in laser technology, where the end user is going to be able to do assessments based on monitoring of the device with built-in diagnostics.”
In essence, the devices are becoming more automated. Some examples: Sciton is using optical coherence tomography to “pre-look” at the skin from the inside out. The noninvasive imaging technology helps medical professionals assess the skin and provides feedback about what settings might be good for resurfacing. Cynosure has a pigment meter that gives providers proper guidelines for settings based on the color of the skin, according to Dr. Ross.
Laser Device Innovations
Laser technology advancements present the opportunity to improve nearly every skin aging concern.
The Dermastat handpiece (Cutera) is one such advance on Cutera’s excel V, a 532 nm and 1064 nm device to treat vascular and pigmented lesions. The excel V is a great time-tested technology — it’s been around for about a decade. The technology turned new again and has been made better, according to Dr. Ross.
“The company has done three things to make it better over the last year. They’ve increased the power, which means it has a larger spot size; they have a thicker cooling window, which means it’s more comfortable and safer; and they’ve added this small handpiece, the Dermastat handpiece, which was the handpiece available on the very first model of the Gemini, the precursor to the excel V,” Dr. Ross says.
Using the pencil-sized Dermastat handpiece, dermatologists can navigate easily around the nooks and cervices, like the corners of the nose or the corner of the eye.
For facial rejuvenation, dermatologic surgeon Suneel Chilukuri, M.D., of Refresh Dermatology in Houston, often turns to the 1927 nm thulium laser Lase MD by Lutronic.
“It’s remarkable in terms of what we can do with this laser because we can limit the downtime to a day or less and really see nice changes in terms of skin quality and fine lines. I call it kind of a ‘polisher’ with minimal to no downtime,” Dr. Chilukuri says.
The 1927 nm thulium is a strong contender for patients who aren’t willing to endure the downtime that comes with laser skin resurfacing with a carbon dioxide (CO2) or erbium YAG (er:YAG) laser, he says.
Dr. Chilukuri says that treatment with the Lase MD isn’t painful and there’s no numbing involved. Patients usually are red for about a day.
“Occasionally, if I’m going more aggressively with it, they’ll be a little bit more red and slightly swollen for about three days,” he says. “The Lase MD is not going to be for the deep rhytids or deep static lines that are on the face because it’s not powerful enough unless you do multiple treatments.”
Fat, Skin Tightening & Collagen
Dr. Chilukuri also has experience with the recently released Accutite (InMode), which he says is an upgrade from earlier radiofrequency (RF) devices.
Dr. Batra has worked as a consultant for Venus. Dr. Ross is a consultant with and has done research for Lutronic and has received honoraria from Candela. Dr. Chilukuri has worked as a consultant and speaker for Alastin, Aerolase, Allergan, BTL, Cynosure, Eurothread, Galderma, InMode, Lutronic, PCA Skin, Sinclair, Theravant, Under Skin and ZO Skin.