accolade qs alexandrite 755 nm benign pigmented lesions and tattoo removal
TRANSCRIPT
AccoladeAccolade
QS Alexandrite 755 nmBenign Pigmented Lesions and Tattoo Removal
2
Market Size and Incidence
• Epidermal Lesions- Superficial
• 30% of population has solar lentigines
• 10% of population has café-aulait
• 60% have freckles• Dermal Lesions
• Nevus of Ota and Ito (Acquired Dermal Melanocytosis)
– 0.014%-0.034% of Asian population
– 0.4-0.8% of people of Japanese and Korean descent • Cosmetic, Medical, Body Art Tattoo
• Permanent makeup tattoos
• Reconstructive medical tattoos after mastectomy and surgery
• Cosmetic tattoos to cover up scars and other skin imperfections
• Body Art Tattoos
3
Treatment Market Size
• Benign Pigmented Lesion Removal• Global treatment size $2.50 Billion to $6.48 Billion
• 2008 expected US market size $38 M at CAGR 12%*
• Tattoo Removal• 2008 expected US market size $120 M at CAGR 17%*
• International market estimated $45 M
*Source: Millennium Research Group
4
Nano vs microsecondPulse Width
Time
Power
Equal amounts of energy
NanosecondPulse Width
MicrosecondPulse Width
Courtesy of:
Dr. Wang Hongwei
Peking Union Medical College Hospital
• Effectively destroys melanosomes and tattoo pigments
• Ultra-short pulse widths required to shatter melanosome/ pigments by photoacoustic effect
5
Benign Pigmented Lesions
• Discoloration caused by high concentration of melanocytes in a particular area
• Treatments include cover up with makeup, or painful removal by dermabrasion or cryosurgery
• Mostly for pediatric treatments or as an adjunct procedure in skin rejuvenation for adults
• Lasers remove pigmented lesions through photoaccoustic effects
• Melanin absorbs laser energy more intensely than the surrounding tissue which leads to fracturing of the pigment and melanocyte cell death
• Fractured melanin/melanocyte is removed by the immune system
6
Nevus of Ota
• First described in 1861• Bluish hyperpigmentation along the first or
second branches of trigeminal nerve• Most patients have no family history• Age of onset- perinatal period or puberty• Significant predominance among women
• Male to female ratio 1:4.8
• Female hormones suggested as potent stimuli
• Other stimuli include infection, trauma, or ultraviolet light exposure
Source: Chan and Kono et al Nevus of Ota: Clinical Aspects & Management, SKINmed, 2003
7
Nevus of Ito, Mongolian spots & Other conditions
Nevus of Ito • Variant of Nevus of Ota. • Skin pigmentation occurs is more diffuse and
less mottled in the acromioclavicular region
Mongolian spot • Sacrococcygeal region • Usually regresses and disappears during
childhood. • The spot is found in almost all newborn Chinese,
Japanese and Mongolian children, as well as some white and black children.
Becker Nevus and Henry Nevus
8
Treatment of Pigmented Lesions
9
Treatment of Pigmented Lesions
10
Incidence – Tattoos
• Sixth fastest-growing retail business in the United States in recent years
• 80% of tattoo customers are upper middle-class white suburban females
• 15-20% of US teens and young adults have tattoos (40M Americans)
• 23% of college students have tattoos
• 50% of everyone receiving a tattoo, wants it removed (ASDS)
“In the 90’s I did five laser treatments a month… now I do that in one day” Elizabeth McBurney, MD
Source: The Pulse, Hofstra University and ASDS- American Society of Dermatologic Surgery
11
Treatment of Tattoos
12
Treatment of Tattoos
13
The Accolade
• Q-Switched Alexandrite Laser
• The Speed of Alex
• The Spot Size of Ruby
• Removes Pigmented Lesions
• Removes Black, Blue, Brown
and Green Tattoos
14
Correct Wavelength for Specific Treatment
Alexandrite 755 nm
15
Effective Wavelengths
Accolade• 755nm
• Absorbed by most pigments
• Greater depth of penetration for treating deeper structures
• 50-70 ns pulse width• Disrupts
melansomes and tattoo pigments
1320nm Nd:YAG
16
Accolade Specs
Wavelength 755 nm
Spot Size
2.0 mm(Max Fluence 18 J/cm2)
3.0 mm (Max Fluence 10 J/cm2)4.0 mm(Max Fluence 5 J/cm2)
5.0 mm (Max Fluence 2.8 J/cm2)
Pulse WidthShort Pulse: Min 50 nsec Long Pulse: 150 μsec
Pulse Rate 1, 2, 5, 10 Hz
Beam Delivery Optical Fiber
17
Accolade Improved Design
• Faster than other competing systems• 2x spot size of other Alex
• More than 10x the speed of Ruby
• Faster Treatments and Faster Clearance• Larger Spot and Higher Repetition rate
give the fastest treatment possible• Larger Spot means deeper penetration for
faster clearance
18
Accolade Treatments Characteristics
• Accolade treatments are gentler
• Less painful especially for the face
• Greater specificity towards target chromophore
• Reduces damage to peripheral tissue
• Minimum pinpoint bleeding
• Decreases incidence of scarring
19
AccoladeFeatures and Benefits
Features Benefits Wavelength: 755 nm Target absorption by tattoo pigments
Treats Black, Blue, Green colors Target absorption by melanin Reduces damage to surrounding tissues
Short pulse: minimum 50 ns Intense high peak energy targeting: Tattoo pigments Melanosomes (cell structures with melanin) No cooling needed (optional)
Long pulse: 150 μs Superficial vascular lesions Persistent epidermal lesions
Spot/ Fluence: 2 mm; min10 to max18 J/cm2 Short Pulse; treats deeper skin levels 3 mm; min5 to max10 J/cm2 Short Pulse; most commonly used; deeper 4 mm; min3 to max5 J/cm2 Short Pulse; treats large areas faster 5 mm; min1.6 to max2.8 J/cm2 Short Pulse; treats larger areas faster Rep Rates: 1, 2, 5, 10 Hz Better treatment control
Faster treatment with higher rep rates Lower rep rates prevent treatment overlap
20
Weakness of Other Lasers
Other Suppliers Features Weakness Supplier C QS Alexandrite
QS Alexandrite 755 nm with QS 1064nm & 532nm
Laser Pump Laser Low QS 1064/532 Fluence Max 5 Hz Rep Rate
Highly unstable Internal machine is the QS Alexandrite laser 1064/532 driven by handpiececs Inadequate energy for any treatment with 1064/532 Slower treatment
Supplier H QS ND:YAG
QS ND:YAG 1064 nm & 532 nm Two hand pieces- 585 nm &
650 nm (dye polymer) Claims to do a lot of functions
with one box
More side effects from pinpoint bleeding due to non-specific absorption by hemoglobin & water
Low energy hand pieces not effective Expensive hand pieces More painful treatments than the Alexandrite laser
Other Nd YAG Low price Small size
Unstable pulse width High variability & quality
21
Comparison of Different Lasers
Affinity AccoladeSystem TypeWavelength 532nm 532 585 650 532 1064Pulse Width 150 µsec 140 µsec*Max Fluence per Spot Size 8 mm * * * 8 mm 2 J/cm2 * * *
6mm 3 J/cm2 1.5 J/cm2 5mm 6mm 3.0 1.4 J/cm2 * * 5mm 4 J/cm2 1 J/cm2 2 J/cm24 mm 7.0 3.0 4mm 4 mm 6.0 3.0 * * 4mm 6 J/cm23mm 12.0 6.0 3mm 3 mm 12.0 4.0 3.5 J/cm2 2.1 J/cm2 3mm 11 J/cm2 3 J/cm2 6 J/cm22mm 28.0 14.0 2mm 2 mm * 5.0 8.0 4.5 2mm 25 J/cm2 6 J/cm2 13 J/cm2
Max Rep RateAiming BeamElectrical RequirmentsSize (HxWxD)
Price
MedLiteTM C6 AlexTriVantageNd:YAG QS QS Alexandrite Nd:YAG & Dye Impregnated Polymers QS Alex & QS nd: YAG
755nm6 nsec min 50 ns 5–20 ns 50 nsec
1064nm 755nm 1064
*
2.8 J/cm25 J/cm2
10 J/cm218 J/cm2
1, 2, 5, 10 Hz 10 Hz 1, 2, 5 &10 1, 2, 3, 5 HzRed LED Red Diode Laser Red aiming beam Ring Style
32"x10" X 27" 41"x15"x25" 28.5" X 12" X 31.8" 43"x16"x30"200/220 VAC/15A 220 Vac/20A, 50/60Hz, single 220 V, Single Phase, 8 Amps or 110 V, 15 Amps
(109cmx40cmX76cm)$95,500 $95,500 $85,000
(81cmx26cmx69cm) (104cmx38cm64cm) (81cmX30.5cmX72.5cm)
22
Clinical Results: Nevus of Ota
BEFORE AFTER
23
Nevus of Ota Before & After
Courtesy of:
Dr. Wang Hongwei
Peking Union Medical College Hospital
4 treatments
BEFORE AFTER
24
Nevus of Ota Before & After
7 treatments
BEFORE AFTER
Courtesy of:
Dr. Wang Hongwei
Peking Union Medical College Hospital
25
Pigmented Lesion Before & After
3 treatments
BEFORE AFTER
Courtesy of:
Dr. Wang Hongwei
Peking Union Medical College Hospital
26
Freckles Before & After
1 treatment
BEFORE AFTER
Courtesy of:
Dr. Wang Hongwei
Peking Union Medical College Hospital
27
Tattoo Treatment Before & After
After 2 treatments (5.8-8.6 J/cm2)
Eyebrow Tattoo
Caution: Spot test first. Tattoo pigments with iron may turn jet black with laser; continue treatment for black
Courtesy of:
Dr. Lu Zhong Huashan Hospital
BEFORE AFTER
28
Tattoo Treatment Before & After
Courtesy of:
Dr. Lu Zhong Huashan Hospital
After 3 treatments (5.8-8.6 J/cm2)
BEFORE AFTER