Modular Laser and Pulsed-Light System for Treatment of Cutaneous Abnormalities
1 / 6Pages

Modular Laser and Pulsed-Light System for Treatment of Cutaneous Abnormalities Prof. Arie Orenstein, M.D., Sheba Medical Center, Tel Hashomer Hospital, Israel Ziv Kami, Ph.D., Jospeh Lepselter, Ph.D., Alma Lasers Ltd. One of the most striking advances in procedural dermatology in the past five years has been the proliferation of energy delivery devices, namely lasers and broadband light-sources. Yet, although lasers have become an important part of dermatology, their narrow electromagnetic spectrum limits their ability to treat a wide range of skin-related abnormalities. In addition, lasers are expensive, occupy large floor space and can be expensive to maintain. In the early 1990's, the advent of intense pulsed light (IPL) devices signaled a revolutionary change in the treatment of cutaneous abnormalities. No longer was it compulsory to use a laser of a specific wavelength and pulse duration to treat a particular skin abnormality. Rather, a variety of skin abnormalitities could be effectively treated with an intense, pulsed, broad spectrum non-coherent flashlamp. Consequently, as indications broadened and clinical experience was gained, new technologies responded to meet market demand. While the excitement of technological developments was certainly desirable, it became evident that stand-alone lasers or light-based systems were limited in their ability to cover the diverse therapeutic choices and clinical indications available to the clinician. Although individual laser and light-based systems provide much of the patient care in aesthetic medicine today, the market has been seeking a new, technological breakthrough that will give the practitioner and the patient the best therapeutic choices and, at the same time, the highest return on investment. The Harmony system from Alma Lasers, Inc. (Ft. Lauderdale, Florida) is the first multi-technology system that encompasses pulsed light, laser, UVB, and near-infrared technologies on one platform. This unique capability enables greater versatility and flexibility in regard to therapeutic choices for the clinician and patient alike. The Harmony platform signals a breakthrough in the way laser and light-based procedural dermatology will be performed in the future, since it provides complimentary technologies to enable combined therapeutic regimes. The Harmony system, which is a compact yet powerful system, eliminates the need for dedicated application systems, which may be bulky, have articulated arms, delicate fiber optics and high maintenance costs. ADVANCED FLUORESCENT TECHNOLOGY: PULSED LIGHT The Harmony platform (Fig. 1) incorporates six different light-based handpieces - five operating in the visible / near-infrared spectrum and one in the ultraviolet (UVB). The optical window of each handpiece has been designed in accordance with specific clinical indications and their unique endogenous, biological - Psoriasis and vitiligo (300-380 nm; proteins and - Acne clearance (420-950 nm; porphyrins, - Vascular and pigmented lesions (540-950 nm; oxy/deoxyhemoglobin, melanin) - Skin rejuvenation (570-950 nm; melanin, - Hair removal (650-950 nm; melanin) - Deep dermal heating (near-infrared; 780-1,000 nm; non-specific heating)

Different elements found in the skin absorb different wavelengths. Melanin has a wide absorption spectrum that slowly decreases from the ultraviolet to the near infrared (300-1,000 nm). Oxyhelpglobin strongly absorbs light in the yellow portion of the electromagnetic spectrum (550-600 nm). Before reaching a vascular target however, optical energy must pass through the melanin-laden epidermis. The competition of epidermal melanin may cause fewer photons to reach the intended chromophore, reducing efficacy and increasing epidermal heating. Epidermal melanin content varies by at least an order...

need for expensive, fragile fiber assemblies. The light- guide assemblies determine each spot size and ensure precise energy delivery to the treatment area. Fig. 4: Versatile Harmony laser modules MULTIPLE TECHNOLOGIES - The Harmony pulsed-light and laser system is compact computer-controlled system has a short learning curve and minimal maintenance. Harmony comprises a main console, a universal connector that receives each laser or light-based AFT handpiece, and a footswitch. In addition, there is a simple array of controls and indicators, including a main-power switch, a key switch, an...

CLINICAL EFFICACY Hair Removal The 650-950 nm (red-coded) AFT handpiece is indicated for the removal of unwanted hair for all skin phenotypes (I-VI), including permanent hair reduction. The hair removal process with AFT technology is based on selective photothermolysis, which combines selective absorption of the light energy by the melanin in the hair follicle with suitable pulse energy and widths (thermokinetic selectivity). The hair removal AFT handpiece provides equally distributed fluence in pulse durations of 30, 40, and 50 msec. In cases where prolonged coverage rate and higher...

AFT 540 VP Module after 5 Tx. 14-18 J/cm2@10 msec. Photos Courtesy: BCK Patel M.D. FRCS, Professor Chief, Divison of Facial, Orbital and Oculoplastic Surgery, University of Utah, Salt Lake City, Utah, USA AFT 420 Acne Module after 12 Tx. 7 J/cm2 @ 50 msec. Double pass 6 biweekly. Photos Courtesy: Prof. Arie Orenstien, M.D. Sheba Medical Center, Israel AFT 540 VP Module after 2 Tx. 16-17 J/cm2@10 msec. Photos Courtesy: BCK Patel M.D. FRCS, Professor Chief, Divison of Facial, Orbital and Oculoplastic Surgery, University of Utah, Salt Lake City, Utah, USA After Er YAG Module Tx 3Passes of...

540-950 nm AFT handpiece (short) and the long-pulse, Facial Wrinkles The 1320nmNd:YAG laser handpiece is indicated for the non-ablative treatment of facial wrinkles, improving the appearance of photo-aged skin. Such dermal remodeling is thought to occur through increased collagen I deposition with collagen reorganization into parallel arrays of compact fibrils. Patients are usually treated at 4-week intervals. Non- ablative or subsurface remodeling represents the newest approach to improving photo-damaged skin and is available as part of the Harmony platform. Skin Tightening The...