Some call it a vanity tool. Others see it as a way to delay the aging process. Whatever the motivation, the application of intense light to skin for cosmetic purposes has become a booming business.
Such light-based procedures barely existed before 1997, when Palomar Medical Technologies, Burlington, MA, became the first company to get FDA clearance on a laser system for hair removal. Now, estimates CEO Joseph Caruso, consumers spend about $8 billion annually on such care, ranging from removing wrinkles, tattoos and sun spots to treating disfiguring acne and port wine stains.
Meanwhile, the worldwide market for the equipment that makes these procedures possible has jumped to about $600 million a year, while growing at an annual rate of more than 20 percent.
Behind this surge: better and more-cost effective devices, a sharp increase in the number of doctors trained in the procedures, and the greater willingness of the Baby Boom generation to correct conditions that their parents were content to live with.
Spotlight on Palomar
Few companies have prospered more from this trend than Palomar, which eight years ago shed other businesses to concentrate on the cosmetic laser market. In 2004, the company's sales hit $58.7 million, up 57 percent from 2003.
Transformation of the technology itself has been a big driver. "When cosmetic lasers were first introduced in the mid 90's, they were complex systems that weighed 800 lbs, cost $200,000 each and were used almost exclusively by plastic surgeons and dermatologists," notes Steve Armstrong, VP of operations for Palomar. "Now, systems weigh less than 50 lbs, cost $40,000 to $100,000, and the practitioners have expanded to include family-practice physicians and even spa personnel under physician supervision."
Over the last decade, Palomar has designed several light-based systems, often supported by joint research and clinical trials at Massachusetts General Hospital and Wellman Laboratories.
In a typical procedure, the laser system directs a beam of light at a type of tissue. When the beam of energy reaches its target, it is absorbed and converted into heat, destroying or stimulating cells in the target area. For hair removal, for example, the laser targets the melanin in the hair follicle. To treat acne scars, the device aims at cells near the surface of the skin to stimulate the production of collagen.
Although it still produces laser-based systems, Palomar since 2001 has introduced several platforms based on intense pulsed light (IPL), a technology that it believes is as effective as lasers, while being safer, easier to use, and less costly. IPL systems also tend to be more efficient in converting electrical energy into light energy. Such systems are typically evaluated in terms of the "fluence," or energy density delivered, typically measured in joules per square centimeter (J/cm²).
While lasers provide intense, single-wavelength beams of light, IPL systems typically use a Xenon lamp to deliver a broad spectrum of light--from Ultraviolet to Visible to Infrared—over a larger spot size for faster treatments. Depending on the condition to be treated, doctors can change hand pieces which are equipped with filters that apply different wavelengths of light to the patient's skin. They can also vary power settings, the duration of each energy pulse, and the time between pulses.
"The old laser systems commonly relied on 6 kW of power," notes Paul Dunleavy, manager of product development. "One of our biggest successes was moving to a desktop IPL system with 1.5 kW of power." The key to that transformation, explains Dunleavy, was in power electronics, where Palomar engineers shifted from a passive pulse forming network (PFN) to an active PFN that delivers continuous power to the flashlamp.
Palomar's patented power supply system uses high-speed semiconductor switches that control the discharge of energy from the capacitor through an inductor and flashlamp. Other key components within the handpiece include reflectors and an optical wave guide.
One System, Multiple Treatments
Palomar's special niche has been to design base platforms that can treat several different conditions, simply by changing handpieces. For example, the top-of-the line StarLux™, introduced in 2004, can power five different IPL handpieces, each with its own wavelength range, treatment spot sizes (up to 16×46 mm) and fluence range (up to 50 J/cm2). List price: About $83,000 for the StarLux and one handpiece, and about $10,000 to $35,000 for additional handpieces.
With pulsewidths ranging from 1 to 500 msec and operating at 2 Hz, the StarLux offers several innovations, including:
Smooth pulse technology. Rather than high-peak power spikes at the beginning of each light pulse, which can damage skin, the Palomar system delivers pulsed light with a constant controlled peak power over the pulse duration. This patented technology keeps the epidermal temperature lower, for more comfortable treatments. It also allows for the safe delivery of greater amounts of energy, which can be more effectively absorbed by the skin target.
Active contact cooling. Chilled water from a reservoir in the StarLux base unit moves through the handpiece down to the sapphire tip, which is cooled to as low as 4C. The result is continuous cooling of the patient's skin throughout treatment, particularly important when the target is hair follicles, which are generally several millimeters beneath the surface.
Photon Recycling. In most light-based treatments, up to 60 percent of the energy is reflected back off the skin surface, rather than being delivered to the treatment target. Palomar's patented design of reflectors and wave guide within the handpiece recaptures this scattered light and sends it back to the treatment area.
Ease of use is also a priority. The Palomar systems, which are plug-and-play out of the box, feature full-color touchscreeen controls and provide constant feedback on fluence, pulse width, shot count, and temperature.
Forming Strategic Alliances
All this technology has caught the attention of companies much bigger than this 180-employee firm. In 2003, Palomar announced a new joint development agreement with Gillette to design a home-use, light-based hair removal device. And last year, it launched a new research program with Johnson & Johnson to develop consumer devices for treating acne and reducing or reshaping body fat.
Besides these new forays into home-based applications, Palomar has received a $2.5 million contract from the U.S. Army to develop a light-based, self-treatment device for Pseudofolliculitis Barbae (PFB), often referred to as "razor bumps." This painful skin irritation develops after shaving when strands of hair curl back on themselves and grow into the skin.
Palomar is already at work on new handpieces to expand the range of treatments. "Laser and IPL treatments have become a major profit center for doctors," says Caruso. "An $80,000 system can easily generate $300,000 in revenue a year, and it is all cash, non-reimbursed, and private-pay."
Caruso estimates that only 1 percent of the potential population for cosmetic light treatment has been reached, a percentage that Palomar believes will expand significantly as the Baby Boom generation ages. Says Caruso: "Rather than save money and pass it on to the next generation as their parents did, more people today want to look and feel younger, and gain an edge in the workplace."