Cutera will preview its Adjustable Depth Selectivity (ADS) Technology at the 67th Annual Meeting of the American Academy of Dermatology in San Francisco, March 6-10, 2009. ADS is the result of five years of clinical research conducted with in-vitro human fat cells at the Cell Culture Facility at the University of California Medical Center, San Francisco (UCSF).

The research determined fat cell survival rates following thermal exposures, which is necessary to establish treatment parameters and to make the next step in the development of new technologies for non-invasive body contouring. The two key features of this technology are the ability to selectively target and heat fat cells and to vary treatment depths within the fat.

The findings will help physicians develop new protocols for more efficacious treatment of a wide variety of patients and boost new device innovation.

Solta Medical, the manufacturer of Thermage and Fraxel systems today announced the opening of the Solta Medical Aesthetic Center “to advance the company’s new product development, facilitate research on the innovative Thermage(R) and Fraxel(R) product lines and serve as a destination where physicians can participate in research studies and training”.

This is a truly novel development in the industry as Solta is the first company in the aesthetic energy device space to open an in-house clinic and biomedical engineering lab.
The company claims that more than 4,500 physicians in nearly 80 countries perform Thermage and Fraxel treatments. The Solta Aesthetic Center will serve as a central research destination for physicians around the world to access the latest findings about Thermage and Fraxel treatments.
“The Solta Medical Aesthetic Center allows for a seamless transition from the research bench to the treatment room,” said Vic A. Narurkar, M.D., dermatologist and founder of the Bay Area Laser Institute in San Francisco, California. “Solta’s state-of-the-art clinic allows the company’s optics and biomedical engineers to share data and receive immediate clinical feedback about their work in new product development and existing product enhancement.”

Solta Medical has a history of leadership in R&D of the aesthetic devices. Current studies being conducted at the Aesthetic Center include the recently released Thermage Body Tip 16.0 and several advancements in skin tightening, resurfacing and other dermatological applications using new, breakthrough proprietary technology.

The grand opening of the Solta Medical Aesthetic Center occurs in conjunction with the 67th annual meeting of the AAD in San Francisco. Several physicians presenting at the AAD will discuss their clinical findings using Thermage and Fraxel systems and the effectiveness of skin tightening and skin resurfacing.

These presentations include:

• “Lasers, Non-Ablative Fractional Resurfacing,” by Elizabeth Tanzi, M.D., Washington Institute of Dermatologic Surgery, Washington, D.C.
• “Advanced Lasers, Fractional Resurfacing,” by Christopher Zachary, F.R.C.P., University of California, Irvine.
• “Skin Resurfacing & Rejuvenation, Carbon Dioxide Fractional Laser Rejuvenation,” by Christopher Zachary, F.R.C.P., University of California, Irvine.
• “Fractional Laser and Light-based Technologies,” by Vic A. Narurkar, M.D., founder of the Bay Area Laser Institute, San Francisco, CA.
• “Aesthetics and Cosmetic Surgical Procedures in Darker Racial Ethnic Groups, Fractional Photothermolysis & Radiofrequency Devices,” by Vic Narurkar, M.D., founder of the Bay Area Laser Institute, San Francisco, CA.

We receive many questions regarding the use of fractional lasers for treatment of non-facial areas such as the hand. Few clinical studies have been reported in the literature documenting the efficacy of non-ablative modalities in the treatment of hands with visible photoaging conditions (search in Research).

Laser treatment for photoaging of the hands should ideally address pigmentary alteration as well as associated skin roughness and wrinkling. Fractional non-ablative resurfacing has been previously shown to effectively treat facial rhytids and dyschromia and are currently widely used by medical practitioners and aesthetic clinics.

About fractional non-ablative resurfacing

Non-ablative fractional photothermolysis (nFP) produces specific thermal injury areas called microthermal treatment zones (MTZ) at specific depths in the skin. The surrounding tissue of the MTZ and the stratum corneum of the epidermis remain intact during treatment, leading to rapid healing of the injured tissue. Macroscopic wounding is not apparent. Mild to moderate erythema and edema are usually apparent for several days post-treatment, therefore there is only minimal downtime for the patient. Several treatment courses are required, which is typical of any other non-ablative laser procedures. The most commonly used is the 1,550-nm diode-pumped erbium fiber laser by Solta Medical, formerly Reliant Technologies.

About clinical trials

Trials are conducted by medical doctors, proficient in the laser photothermolysis field, and sponsored by grants by laser manufacturers, Solta Medical in the reviewed cases. Patients (Fitzpatrick skin phototypes I to IV) with with bilateral moderate hand photodamage were randomized to receive 5-6 treatments with the 1,550-nm diode erbium fiber laser on either the right or left hand. Treatments were performed at settings of 8 to 9 mJ/microscopic treatment zone (MTZ) and density of 2,500 microscopic treatment zones/cm2. Subjective assessments by the patients and investigator were performed for skin roughness, wrinkling, pigmentation, skin texture and overall photodamage using an improvement scale. Skin biopsies were taken at baseline and at 1 and 3 months. In addition, some histological analyses (H&E) were carried out on several individuals.

Reported results

The subjective assessment and physician clinical assessment at 1 and 3 months revealed a mean 51% to 75% improvement in skin pigmentation and 25% to 50% improvement in skin roughness and wrinkling. Biopsies of the skin showed increased density of dermal collagen. Patients experienced transient erythema and edema and none had scarring or other adverse effects. Histologic evaluation showed a reduction in atypical keratinocytes, improvement in rete ridge formations, increased collagen density and a reduction in solar elastosis at 6 months post-treatment.

Fractional non-ablative resurfacing appears to be an effective and safe treatment modality for correcting both the pigmentary and the textural aspects of photoaging of non-facial anatomic areas such as the dorsum of the hands.