Surgery – Instruments – Light application
Reexamination Certificate
1998-05-13
2001-08-14
Gibson, Roy (Department: 3739)
Surgery
Instruments
Light application
C606S002000, C606S023000
Reexamination Certificate
active
06273884
ABSTRACT:
FIELD OF THE INVENTION
This invention relates to methods and apparatus for using optical radiation to treat dermatological problems and, more particular, to such methods and apparatus which require reduced energy and/or a lower cost radiation source by the use of continuous wave (CW) radiation (as this term is hereinafter defined), heating of the treatment area prior to irradiation and/or techniques for enhanced radiation utilization.
BACKGROUND OF THE INVENTION
Lasers, lamps, and other sources of electromagnetic radiation, particularly in the optical wavebands, are being increasingly utilized for various dermatological treatments and, in particular, for the removal of unwanted hair, spider veins, leg veins, other veins or other blood vessels which are visible through the patient's skin, lesions, port-wine stains, tattoos, and the like. In performing such treatments, it is desirable that the cost for the treatment be kept as low as possible, consistent with achieving desired results, and that risk of injury to the patient be minimized.
Since continuous wave (CW) lasers and other CW radiation sources are typically substantially less expensive than pulsed sources of comparable wavelength and energy, for cost reasons, it would be preferable to use CW sources rather than pulsed sources for such dermatological treatments. However, in order to avoid injury to the patient, the duration of energy application to a given area of the patient's skin must be controlled, this generally resulting in the more expensive pulsed light sources being used for the various dermatological treatments.
Further, since the only way to get radiation to areas where treatment is desired, which areas are normally in the dermis, is to transmit the radiation to such area through the overlying epidermis, some portion of incident radiation is absorbed in the epidermis creating the potential for damage thereto. This is a particular problem where melanin is being targeted in the dermis, as is for example the case for various hair removal treatments, since there is a substantial concentration of melanin in the lower portion of the epidermis at the dermal/epidermal (DE) junction. Further, the deeper in the dermis that treatment is desired, and/or the larger the element being treated, the more energy must be used, this generally involving the use of a more powerful laser or other radiation source and/or operating such source for longer time durations. This further increases the potential for epidermal damage.
Some attempts have been made in the past to scan a CW radiation source, such as the laser, over a treatment area, which has been done with the radiation source spaced from the skin in order to facilitate movement of the source. However, techniques currently utilized for protecting the epidermis frequently involve contact cooling of the epidermis and, for certain treatments such as hair removal, performing the treatment with pressure applied to the patient's skin is also desirable. Irradiation by use of a head in contact with the skin also permits more efficient transfer of energy into the patient's skin, thereby reducing the size of the source required for a given treatment energy density and, therefore, reducing the cost of such source. This cost could be further reduced if the radiation source is not the only source being utilized to heat the area under treatment.
Another problem in performing laser dermatology treatments, particularly when such treatment is to be performed over an area larger than the optical aperture of the applicator being utilized, is to obtain substantially uniform irradiation over the area so that sufficient radiation is applied to all portions of the area to achieve the desired treatment, while no portion of the area has so much radiation applied thereto as to cause thermal damage to the skin. Such uniform irradiation is very difficult with a pulsed source which typically utilize a circular aperture. Typically, the procedure followed is to irradiate a spot with a given pulse and to then reposition the head to an adjacent spot for irradiation. If the spots do not overlap, there will be portions of the area under treatment which do not receive radiation and, unfortunately, the radiation output is frequently not uniform over the entire optical aperture, being greater near the center, and less at the edges. Therefore, there is generally some overlap between adjacent spots. However, this results in some portions of the area under treatment receiving at least a double dose of radiation, which poses a potential danger of thermal damage in these overlap areas. Substantially uniform irradiation of a treatment area is therefore virtually impossible with a pulsed radiation source utilizing existing techniques.
Another problem which increases the energy required from the radiation source utilized is that, for existing systems, heating of the target to achieve the desired therapeutic effect is accomplished solely by radiation from the radiation source. If the temperature of the target could be increased by some type of preheating of the target volume, the amount of energy required from the radiation source to complete the job would be substantially reduced. However, such preheating must be achieved in a way such that the cost of such preheating is not greater than the savings achieved by reduced requirements on the radiation source.
A need therefore exists for an improved method and apparatus for utilizing radiation, and in particular optical radiation, to treat various dermatological conditions, which technique reduces costs and enhances safety by permitting a CW rather than pulsed sources to be utilized, by providing substantially uniform irradiation of an area under treatment, which area is larger than the optical aperture of the radiation applicator being utilized, by providing a means other than the radiation source to at least partially heat the area under treatment so as reduce the energy required from the radiation source to achieve the desired treatment, and/or by permitting contact cooling/preheating for both enhanced epidermal protection and enhanced energy transfer to further reduce source costs.
SUMMARY OF INVENTION
In accordance with the above, this invention provides a method and apparatus for effecting a selected dermatological treatment in an area of a patient's skin which involves placing a head having at least one optically transparent channel formed therethrough in contact with the patient's skin in the area under treatment. The at least one channel has a distal end in contact with a segment of the patient's skin, which segment is smaller than the area under treatment. The head is moved at a selected rate over the treatment area, which rate is preferably substantially uniform, while remaining in contact with the patient's skin and CW radiation of a wavelength appropriate for the selected dermatologic treatment is applied through the at least one channel to the patient's skin as the head moves thereover.
For preferred embodiments, at least the portion of the head in contact with the patient's skin is of a thermally conductive material and the head is utilized to control the temperature of the patient's skin in the area to be treated prior to treatment, during treatment and/or after treatment. In particular, the portion of the head which passes over the treatment area prior to irradiation may be heated so as to heat the segment of the area under treatment prior to treatment to a temperature below that at which thermal damage to the skin occurs. Alternatively, this portion of the head may be cooled to cool the segment to be treated, or at least the epidermal layer thereof, so as to protect this layer from damage. For one embodiment of the invention, the portion of the head in front of the at least one channel through which radiation is applied to the treatment area is divided into a first portion and a second portion which are thermally insulated from each other, with the first portion being heated by a first component and the
Altshuler Gregory B.
Anderson R. Rox
Gibson Roy
Palomar Medical Technologies, Inc.
Wolf Greenfield & Sacks P.C.
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