ClearSkin Er:Glass 1540nm Laser Module Orly Baror Gal, Eng.BioMedical Clinical Applications Specialist
Acne - Introduction 2
Acne Vulgaris Very common Affects 80% of the population Almost every person experience some form of acne Long term scarring if not treated. Causes emotional/psychological effects 3
Acne - Definition A chronic inflammatory disease of the folliculo-sebaceous unit, characterized by a variety of lesions : comedones, papules, pustules, nodules, cysts. Although classically classified as a sebaceous gland disease, it is actually a process that involves the pilosebaceous unit. It involves the face, chest, upper back and arms 4
Causes for Acne Hormonal follicular keratinization sebum production Bacterial P. acnes inflammation 5
Acne Therapy 6
Pharmaceutical Solutions Topical Retinoids Topical Antibiotics Dapsone (Aczone) Oral (e.g. Accutane) Oral Antibiotics Oral contraceptives Anti-androgen agent Isotretinoin 7
Acne Solutions Photo Therapy Photo Thermal Therapy Electro Thermal Therapy (RF) LED UV PDT / ALA + IPL Mid infrared lasers (1540nm) 8
ClearSkin - Integrated Cooling-Vacuum-Assisted Er:Glass 1540-nm Laser 9
Suction port Inner Glass Cooled rod
Suction pores Contact Cooling +5ºC
ClearSkin Module Laser type = A flashlamp-pumped erbium:glass Wavelength =1,540-nm Spots = 4, 10mm tips Pulse width = 3msec Contact cooling + vacuum Energy = Up to 1000mJ/pulse PRR = 1-3 Hz Stack or No-stack 12
ClearSkin Protocol 13
Patient preparation Before treatment, the area is prepared with a skin cleanser only. The treatment can be performed without any anesthesia. 14
Suggested setup parameters for the standard 4 & 10 mm tips Skin Type Fluence (mj/p) 4mm tip Fluence (mj/p) 10mm tip PPR (Hz) Number of stacked pulses Number of passes I III 500-700 700-1000 2-3 3-4 2 IV VI 400-600 600-800 2-3 3-4 2 4 to 6 treatments at 2-3 weeks interval. 15
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Before Immediately After 19
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Mid Infrared chromophores absorption Er:Glass (1540) 25
Penetration Depth 26
Acne laser target 27
Treatment rational - Heat 1. Suppression of P. acnes by limiting its growth or by increasing the kill rate of the bacteria. 2. Reduction of sebum excretion rate by decreasing the proliferation, or by increasing the rate of sebum glands apoptosis or/and necrosis. Reduction of the inflammatory response in the dermis and epidermis surrounding the follicle affected by the acne. 28
Clinical Evidence 29
Clinical Study: ClearSkin Er:Glass 1540-nm Laser Dr. Yael Politi & Prof Moshe Lapidoth ẞ-Site Hertzlia, Israel Clinical Department July 2014 30
Methods A prospective study 12 volunteers ( 7 men, 5 women) with mild-to-moderate acne vulgaris. The midinfrared 1540-nm laser (Alma Lasers Ltd. Caesarea, Israel) is operated with combined cooling-vacuum-assisted technology. Acne lesion is initially manipulated upon contact by the vacuumcooling-assisted tip followed by 3-4 stacked laser pulses of 500-600mJ/Pulse (4mm spot size) given at 3Hz rate. Subjects underwent 4-6 treatments every 2 weeks with follow up at 1 & 3 months after the last treatment. 31
Methods Before and after photography were captured by high resolution digital camera. Clinical evaluation was performed by two independents physicians on a scale from -1 (exacerbation) to 4 (75%-99% improvement), satisfaction was evaluated both by practitioner and by patient. Pain perception and adverse/side effects were also evaluated. 32
Results All the subjects demonstrated a moderate to significant improvement (average 3.6 after one month and 2.8 after three months post last session). No any significant side effects were observed beside a transient erythema and mild focal transient blisters. 33
ER:GLASS- ACNE Before After 3 rd TXT 34
ER:GLASS- ACNE Before After 3 rd TXT 35
Er:Glass- Acne Before 1 month after 2 TXT 37
Er:Glass- Acne 38 Before After 5 th TXT
Er:Glass- Acne 39 Before 2 months follow up after 5th TXT
Er:Glass- Acne Before After 1 st txt 40
Er:Glass- Acne Before After 1 st txt 41
Er:Glass- Acne Before After 1 st txt 42
Er:Glass- Acne Before After 1 st txt 43
Conclusions The ClearSkin Er:Glass 1540-nm laser improve laser-skin interaction, reduce the pain sensation and increase overall safety and efficacy of the treatment of mild-to-moderate acne vulgaris. Based on clinical evidence, cooled-vacuum-assisted the ClearSkin Er:Glass 1540-nm laser is a safe and effective technology for the treatment of acne vulgaris. 44
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