Pixel Screen Technology and FRAC3 – A Full Spectrum of ... - Fotona

Journal of the Laser and Health AcademyVol. 2008; No.1/1; www.laserandhealth.comPixel Screen Technology and FRAC3 – A Full Spectrum of LaserSkin Rejuvenation TreatmentsMartin Gorjan 1 , Ladislav Grad 1 , Matjaž Lukač 21University of Ljubljana, Slovenia2Institute Josef Stefan, Ljubljana, SloveniaINTRODUCTIONFractional laser skin rejuvenation has recently gained a lotof interest due to the fact that the remaining healthytissue around the fractional damage spots can act ashealing centers. The approach, to date, has been formingthe fractional pattern as a two-dimensional matrix;resulting in the illuminated columns below the spotsbeing damaged uniformly (see Fig.1 b). For ablative andskin-surface treatments this approach is very effective asit allows a ‘lighter’ variant of the traditional ablativeprocedure to be completed, with a lower density effectand faster recovery times. However, for non-ablative,deeper, skin-volume treatments this technique is nonselectivewith regard to local skin imperfections, and istherefore less suited for these particular procedures.For this reason Fotona is also pioneering the novelFRAC3 laser treatment, based on their Nd:YAG Accelerapulse mode characteristics. The method produces a threedimensional,fractional pattern within the epidermis anddermis, with damage islands located predominantly at thesites of minute skin imperfections and/orinhomogeneities (See Fig.1c). This self-inducedfractionality has been found to be especially pronouncedin skin with a higher number of aging imperfections.FRACTIONAL TREATMENTS USING PIXELSCREEN TECHNOLOGYFotona Er:YAG lasers have always offered a range ofrejuvenation treatments with the ability to use Fotona’sVariable Square Pulse technology to control the balancebetween ablation and thermal effects on the treatedtissue. The spectrum of treatments possible ranges frompure cold ablation, through a balance of ablative andthermal effects, to solely thermal effects [1]. The PixelScreen Technology (PST) works in conjunction withFotona’s highly-effective Er:YAG lasers. The PixelScreen distributes the energy as an array of small pointbeams generating, very finely-focused, high-intensitytreatment columns.The treatment effect of the PST is to add a further levelof control to the procedures above, with a smallerproportion of the skin surface being treated, and with thecapability to fine-tune this further through the variationof the pixel density used. This less-invasive treatmentmodality significantly reduces downtime after theprocedure.Fig. 2: The laser intensity profile for a standard Er:YAGlaser beam (dotted line) and with Pixel Screen Technology(continuous line).NOVEL THREE DIMENSIONAL FRACTIONALTREATMENTSWhile the action of more-conventional fractionaltechniques, such as those provided by the Fotona PixelScreen, are well-known and have now been proven over anumber of years, the novel FRAC3 treatment beingpioneered by Fotona is not so widely known. Fotonautilize a special operating mode, Accelera, developed toenable short, sub-2ms pulses in their renowned highperformanceNd:YAG laser systems, to create selfselectivetreatment micro-zones within the skin [2]. Thelaser energy acts only on the minute skin imperfectionswithin the skin volume, thus reducing the collateraldamage and only creating localized ‘damage islands’. Withthis selective, very-localized and three-dimensionaldistribution of the treatment effects, ‘damage islands’ aresurrounded by unharmed healthy tissue which can thenpromote the speedy healing of the treated tissue.© 2008 Laser and Health Academy. All rights reserved. Printed in Europe. www.laserandhealth.com

Pixel Screen Technology and FRAC3 Treatmentsleading to better cost-effectiveness for the skinrejuvenation procedure as well.Fig. 1Laser induced damage islands as healing centers.Skin surface measurements of the temperaturedistribution following treatment with an Nd:YAG laser inAccelera mode were performed in-vivo on patients’hands. Figure 3a shows a typical skin temperature profilefollowing a standard 20 msec long Nd:YAG pulse, whileFig.3b shows the temperature profile following a shortdurationAccelera pulse. Self-induced temperaturefractionality can only be observed following illuminationwith the Accelera pulses, while with standard pulsedurations heat conduction from the skin inhomogeneitiesto the surrounding tissue prevents temperature build-up,and thus no hot islands are observed within the skin [2].Note, that the ‘temperature islands’ observed here werefound to be more prevalent in older patients than inyounger ones, meaning that this treatment modality isparticularly effective within anti-aging therapies.One feature of this treatment modality is its requirementfor relatively high energy and fluences at short pulsedurations, meaning it is difficult to achieve with largerspot sizes. Thus, for larger area coverage and ease andspeed of treatment, a scanner is the ideal beam deliverymethod. The Fotona S-11 scanner enables FRAC3treatments to be quickly and easily carried out withoptimal spot sizes, and an adjustable scan area of up to 42cm 2 .Fig. 3 Skin surface temperature profile.Self-induced temperature fractionality was also observeddeeper within the skin. Figures 4a & b show thetemperature distribution following Nd:YAG pulses asseen in-vitro on a skin cross-section from skin excisedfrom a female human belly. Figure 4a shows the typicalskin temperature profile following a standard 20 mseclong Nd:YAG pulse, and Fig. 4b shows the temperatureprofile following a short-duration Accelera pulse. Again,self-induced temperature fractionality can only beobserved following illumination with the Accelera pulses.Fig. 4 Skin cross-section temperature profile.Preliminary clinical results show the procedure to bemore effective with substantially reduced healing times.Furthermore, no special optical device is needed, thusFig. 5 Fotona SP Plus Er:YAG/Nd:YAG combination lasersystem.CONCLUSIONSWith the option of fractional treatments using bothEr:YAG and Nd:YAG laser sources, especially with thethree-dimensional, self-selective nature of Fotona’sFRAC3 technology, Fotona is poised to be able toprovide the most comprehensive range of anti-aging,rejuvenation and resurfacing treatments available.The new Fotona FRAC3 laser method, in combinationwith Fotona’s S-11 scanner, is promising to be the nextstep in improved laser skin rejuvenation procedures, withits efficacy, selectiveness, short healing time and costeffectivenessREFERENCES1. Matjaž Lukač Ph.D., Tom Sult M.D., Robin Sult R.N, NewOptions and Treatment Strategies with the VSP ErbiumYAG Aesthetics Lasers, Journal of the Laser and HealthAcademy Vol. 2007; No.1/1; www.laserandhealth.com.2. Martin Gorjan, Ladislav Grad Ph.D., Matjaž Lukač Ph.D.,Three Dimensional Fractional Laser Skin Rejuvenation,IMCAS 2008 Abstracts Booklet, Posters, P28.