Combination of Conducted RF and Optical

Energies in Aesthetic Medical Procedures

A new highly efficacious

treatment

Dr. P. Tracy

ELOSTM Technology in Aesthetics

The ELOS advantage• Synergy -

–electrical (Radio- Frequency) and–optical (Light) energy

• Two different energy sources -–selective mechanisms of action–optimal treatment synergy

• Active epidermal cooling• Active dermal monitoring TM

Syneron ELOS Technology

• Reduced optical energy – to a safe level for all skin types

• Electrical RF energy – Compensates for the reduction of optical

energy– RF that is not sensitive to skin or target colour

ELOS technology replaces up to 60% of the optical energy by the synergistic use of RF bi-polar current, maximising efficiency and

minimising unwanted effects.

RF energy properties

• Well known in medicine• No effect on melanin• All RF parameters (Voltage, Current, Impedence)

can be measured and controlled with high time resolution

• Skin impedence depends on temperature and can be used for skin temperature monitoring where impedance drop is about 2% per C

How does it work?Pre- Pulse

Test

Light Pulse

Target is Pre-heated

Impedence of target is

decreased

RF Pulse

Higher current in zone with low

impedence Target is heated More effectively

than skin

Contact test

Cooling test

Tissue pre-

Heating with RF

Pre-Pulse Test

If cooling temperature is too high → COOLING UP Message appears in the display and the pulse is not enabled.If contact is not good → BAD COUPLING Message appears in the display and the pulse is not enabled.

Pre- PulseTest

Light Pulse

Target is Pre-heated

Impedance of target is

decreased

RF Pulse

Higher current in zone with low

impedance

Target is heated More effectively

than skin

Contact test

Cooling test

Tissue pre-

Heating with RF

Light Pulse

• Light pulse pre-heats target (vascular or pigmented) lesion• Temperature of the target is higher than the temperature of the

surrounding tissue.• Impedance of the target is lower than the impedance of the

surrounding tissue• Cooling increases the impedance of the epidermis making it

resistant to RF heating.

Pre- PulseTest

Light Pulse

Target is Pre-heated

Impedance of target is

decreased

RF Pulse

Higher current in zone with low

impedance

Target is heated More effectively

than skin

Contact test

Cooling test

Tissue pre-

Heating with RF

RF Pulse

RF current distribution depends on the impedance distribution within tissue. Tissue with low impedance conducts higher RF current while zones with high impedance conduct lower RF current.

Cooled epidermis conducts low current and is heated less.

Pre-heated target conducts higher current and is heated more effectively by the RF current.

Pre- PulseTest

Light Pulse

Target is Pre-heated

Impedance of target is

decreased

RF Pulse

Higher current in zone with low

impedance

Target is heated More effectively

than skin

Contact test

Cooling test

Tissue pre-

Heating with RF

Aurora pulse sequence

RF energy

Light

Testing pre-pulse to ensure

coupling and skin calibration for RF

monitoring

Intense pulse

Fine heat adjustment

RF energy

p u r e s y n e r g y

wavelength [nm]

Abs

orpt

ions

koef

fizie

nt [1

/cm

]Optical Parameters

Hämoglobin

Melanin

DiodeAlex

Aurora

DYE DIODE-Laser for water absorption

RF Current Distribution

Cold epidermal layerCold epidermal layer

DermisDermis

Pre-heated targetPre-heated target

Spotsize and Penetration

Spotsize small large

Penetration Depth small deep

p u r e s y n e r g y

RF

Ene

rgy

p u r e s y n e r g y

RF – cond.Current

OpticalEnergy

Energy

Temperature

Impedance

Pre-Measuring

5 ms – 30 msOptical Pulse

7 - 12 ms

RF – Current post-heating150 ms-

200 ms

Pulse + Safety STOP

Impedance all 3 ms

Multi-target Effect in skin Renewal

Photo-facial RF

• Number Sessions: 4 - 6 • Session Interval : 2 - 3 weeks• Skin improvement continues for 3

months post last treatment.• Maintenance : 2-3 treatments per year.

Results – timescale

• Pigmented lesions : 3-5 days.• Telangiectasia : 3-4 weeks.• Haemangiomas : 10 mins.• Skin quality : 2 treatment sessions.

p u r e s y n e r g yDevelopment of Laser and Light Systems

Ener

gy

Skin Damage

History Present Future

Successful treatment of the target

Hair RemovalEfficacy/Risk Algorithm

-----------------Light skin Dark hair

Dark skin Dark hair

Light skin Light hair

Dark skin Light hair

EfficacyHighHighLowLow

Risk (Adverse Effects)

LowHighLowHigh

Light induced temperature distribution

• Light selectively heats hair shaft.

• Bulb and follicle are damaged by heat transfer from hair shaft

ShaftFollicle

RF selectivity - mechanismElectrodes

• Current density in the follicle is twice that of the surrounding tissues

• Heat generation is proportional to square of current density

RF induced temperature distribution

• RF creates heat in the 30 microns layer around the hair shaft

• Heated layer includes hair follicle and bulb

RF + Light induced temperature distribution

• Combination of two energy sources.

• Uniform heating of the shaft, follicle and bulb.

• Safety: –less optical energy used.–Lower incidence of side effects.

• Selective energy delivery to target.• Multiple skin/hair types effectively treated:

–Dark skin - treated without compromising efficacy or safety.–Lighter hairs – treated effectively

ELOSTM major advantages

Light brown hair (Aurora DS treatment)

Optical pulse at 20J/cm2 with no additional RF energy.

Optical pulse at 20J/cm2 and RF energy of 20J/cm3.

AfterBefore

White hair (Aurora DS Treatment)

Skin Renewal

Aurora SR treatment

Before 2 weeks after

Aurora SR treatment

Aurora SR TreatmentLentigines

Before

After

Aurora Photo-rejuvenation Treatment

Before

After

Aurora Photo-rejuvenation Treatment

Before

After

Aurora Photo-rejuvenation Treatment

Before After

Aurora Photo-rejuvenation Treatment

Before After

Before

22 weeks afterweeks after

Aurora SR treatmentAurora SR treatment

Age spots and fine Age spots and fine lineslines

p u r e s y n e r g y

TemperatureDistribution

Effect of conducted RF

• Conducted RF heats the tissue between the two electrodes only and directs the thermal effect on the target ( Bipolar System )

• No Radiance (No Microwave).• The penetration depth is depending on the distance of

the electrodes. • Controlled heating of the target structure.• Painless and no side effects.

p u r e s y n e r g y

SingleEnergySingle

Wavelength

Laser

IPL + long-pulsed +Multi-Wavelength Laser

SingleEnergy

Multiple Wavelength

MultipleWavelength

Multiple Energy ELOS

Technology - Positioning

1980-2000

1990-2000

2000-2010