VBeam,Photoderm, Epilight Differences

[Guest guest]

Re-post of message, 2/11/01 from laserdocnyc@.... This might

answer some of the questions being asked recently ...

I have read with great interest many of the messages posted on

this wonderful web site. As a physician and laser specialist, I have

treated many patients with cea. For this reason, I understand to

some degree what many of the members of this group are experiencing.

I feel an obligation to try to make clear some of the mysteries of

laser/pulsed light device treatements. I am not identifying myself

as this is not a solicitation for patients. I will try to explain the

lasers and light devices in a simple manner as it is a bit more

complicated than what I will describe below. Please forgive me in

advance for this long narrative.

First, lasers are devices that emit a particular singular

wavelength of light. This wavelength will determine a specific

target. With respect to cea, the wavelength should be partial to

absorption by hemoglobin ( i.e red blood cells ). There are many

wavelengths of light that meet this criteria. Many laser systems

were developed to capitilize on these absorption points. The pulsed

dye lasers which have wavelengths of 577nm (earliest), 585nm

(standard for years), and 595nm (newest- includes the Sclerolaser and

the V-Beam; the KTP lasers at wavelengths of 532nm ( classically the

Versapulse, Aura, or Nd:YAG lasers); and now the longer wavelength

Nd:YAG lasers at 1064 nm. The photolight devices such as Photoderm

and Epilight are machines that produce a flash of intense light of

many wavelengths. For this reason they are not considered lasers.

The particular filter ( 515nm,550nm,570nm,590nm,615nm,etc..) will cut

off wavelengths of light below the number stated. [For example, with

a 570nm filter wavelengths less than 570nm do not reach the skin.

This prevents unwanted absorption of energy by other targets such as

pigment. With shorter filters, a darker skin individual could

blister or burn due to this undesired absorption.] The main

difference between Photoderm and Epilight are the filters. Epilight

was developed as a system for hair removal and uses higher filters to

try to concentrate the light energy on pigmented structures above the

absorption peaks for blood vessels. However, one can use the

Epilight machine like a photderm machine by utilizing lower filters.

To be fair, the Epilight is the second generation of the Photderm but

it is very much similar. A new attachment on these machines is a

Nd:YAG laser (1064nm) which has a variable pulse duration (see below)

that works best for deep and large blood vessels - specifically leg

veins.

Second, beyond the selection of a wavelength or filter, the ability

of the laser/light device to work effeciently to destroy vessels also

has a lot to do with the duration of laser/light exposure. This is

often measured in millisecond pulses or ms for short. The optimum

pulse duration varies depending on the blood vessel size. This is

where the difficulty in treatment lies. cea is a complex

vascular disorder with vessels of variable sizes. One laser or light

device alone may not meet the needs of the whole process without

manipulating pulse duration and energy.

One should not necessarily think that one system, laser or pulsed

light device, is better than the other. Both can be good for any

given person. The main reason that some doctors have only one

particular laser or a pulsed light device for treating cea is

that these machines cost up to and over $100,000. The maintenace

alone on a machine can be $10,000 - $20,000 a year. The more

important fact about the treatments given is what experience the

doctor has with his/her system. When the photoderm first came out

over 5 years ago, nobody really knew what were the best parameters.

There are several parameters to manipulate: filter, fluence (measured

in J/cm2 - the energy directed in a given area per second), # of

pulses, delay between multiple pulses and very importantly, the pulse

durations. Early on in photoderms history, people were learning what

parameters to use. Now several years later the parameters are better

known.

I have read in these posted messages the varied experiences of

many people with both lasers and photoderm units. These different

experiences may be related to the experience of the doctor performing

the treatment. With the rise in desire for cosmetic procedures in

the U.S., the number of doctors buying machines without formal

training in lasers is skyrocketing. It should take more than a

weekend course to really understand what one is doing with these

systems. A curious fact is that you have to be a phsyician to buy a

laser but not to buy a pulsed light device. In addition, you don't

have to be a physician to treat someone with these devices. In fact,

in most offices, nurses or technicians are performing these

treatments. You should know who is treating you. Also, and just as

important, one must consider that every person with cea is

different and what works well for one may not work for another. I

know that people in this support group are trying to get a set of

parameters to send around to each other. Remember, each machine is

slightly different and each machine may vary compared to itself over

time as the lamps get older. Speaking as a doctor and a laser

specialist, there are constant attempts to produce better systems.

In fact, a new laser is developed almost annually for the treatment

of vascular disorders.

One last comment about terminology. Photoderm and Epilight are

intense pulsed light devices. The terms photofacial, epifacial and

fotofacial are not really applying to roscea directly. These

procedures are treatments with the intense pulse light devices to

stimulate collagen growth in the skin and reduce wrinkles. In the

process of doing a treatment, small vessels and some brown spots

(lentigines or sun spots) may also be eliminated giving a freshened

look to the skin. Severe cea would best be treated with higher

energies and different settings as stated above.

I hope that this message helps you and didn't confuse the matter

too much. Please pardon any spelling errors as I am writing fairly

quickly. Good luck to everyone with their treatments.

[Guest guest]

Thank you. I finally understand the difference between laser and

Photoderm,etc. Your message was very informative.

VBeam,Photoderm, Epilight Differences

>Re-post of message, 2/11/01 from laserdocnyc@.... This might

>answer some of the questions being asked recently ...

>

>

>I have read with great interest many of the messages posted on

>this wonderful web site. As a physician and laser specialist, I have

>treated many patients with cea. For this reason, I understand to

>some degree what many of the members of this group are experiencing.

>I feel an obligation to try to make clear some of the mysteries of

>laser/pulsed light device treatements. I am not identifying myself

>as this is not a solicitation for patients. I will try to explain the

>lasers and light devices in a simple manner as it is a bit more

>complicated than what I will describe below. Please forgive me in

>advance for this long narrative.

> First, lasers are devices that emit a particular singular

>wavelength of light. This wavelength will determine a specific

>target. With respect to cea, the wavelength should be partial to

>absorption by hemoglobin ( i.e red blood cells ). There are many

>wavelengths of light that meet this criteria. Many laser systems

>were developed to capitilize on these absorption points. The pulsed

>dye lasers which have wavelengths of 577nm (earliest), 585nm

>(standard for years), and 595nm (newest- includes the Sclerolaser and

>the V-Beam; the KTP lasers at wavelengths of 532nm ( classically the

>Versapulse, Aura, or Nd:YAG lasers); and now the longer wavelength

>Nd:YAG lasers at 1064 nm. The photolight devices such as Photoderm

>and Epilight are machines that produce a flash of intense light of

>many wavelengths. For this reason they are not considered lasers.

>The particular filter ( 515nm,550nm,570nm,590nm,615nm,etc..) will cut

>off wavelengths of light below the number stated. [For example, with

>a 570nm filter wavelengths less than 570nm do not reach the skin.

>This prevents unwanted absorption of energy by other targets such as

>pigment. With shorter filters, a darker skin individual could

>blister or burn due to this undesired absorption.] The main

>difference between Photoderm and Epilight are the filters. Epilight

>was developed as a system for hair removal and uses higher filters to

>try to concentrate the light energy on pigmented structures above the

>absorption peaks for blood vessels. However, one can use the

>Epilight machine like a photderm machine by utilizing lower filters.

>To be fair, the Epilight is the second generation of the Photderm but

>it is very much similar. A new attachment on these machines is a

>Nd:YAG laser (1064nm) which has a variable pulse duration (see below)

>that works best for deep and large blood vessels - specifically leg

>veins.

>

> Second, beyond the selection of a wavelength or filter, the ability

>of the laser/light device to work effeciently to destroy vessels also

>has a lot to do with the duration of laser/light exposure. This is

>often measured in millisecond pulses or ms for short. The optimum

>pulse duration varies depending on the blood vessel size. This is

>where the difficulty in treatment lies. cea is a complex

>vascular disorder with vessels of variable sizes. One laser or light

>device alone may not meet the needs of the whole process without

>manipulating pulse duration and energy.

>

> One should not necessarily think that one system, laser or pulsed

>light device, is better than the other. Both can be good for any

>given person. The main reason that some doctors have only one

>particular laser or a pulsed light device for treating cea is

>that these machines cost up to and over $100,000. The maintenace

>alone on a machine can be $10,000 - $20,000 a year. The more

>important fact about the treatments given is what experience the

>doctor has with his/her system. When the photoderm first came out

>over 5 years ago, nobody really knew what were the best parameters.

>There are several parameters to manipulate: filter, fluence (measured

>in J/cm2 - the energy directed in a given area per second), # of

>pulses, delay between multiple pulses and very importantly, the pulse

>durations. Early on in photoderms history, people were learning what

>parameters to use. Now several years later the parameters are better

>known.

> I have read in these posted messages the varied experiences of

>many people with both lasers and photoderm units. These different

>experiences may be related to the experience of the doctor performing

>the treatment. With the rise in desire for cosmetic procedures in

>the U.S., the number of doctors buying machines without formal

>training in lasers is skyrocketing. It should take more than a

>weekend course to really understand what one is doing with these

>systems. A curious fact is that you have to be a phsyician to buy a

>laser but not to buy a pulsed light device. In addition, you don't

>have to be a physician to treat someone with these devices. In fact,

>in most offices, nurses or technicians are performing these

>treatments. You should know who is treating you. Also, and just as

>important, one must consider that every person with cea is

>different and what works well for one may not work for another. I

>know that people in this support group are trying to get a set of

>parameters to send around to each other. Remember, each machine is

>slightly different and each machine may vary compared to itself over

>time as the lamps get older. Speaking as a doctor and a laser

>specialist, there are constant attempts to produce better systems.

>In fact, a new laser is developed almost annually for the treatment

>of vascular disorders.

> One last comment about terminology. Photoderm and Epilight are

>intense pulsed light devices. The terms photofacial, epifacial and

>fotofacial are not really applying to roscea directly. These

>procedures are treatments with the intense pulse light devices to

>stimulate collagen growth in the skin and reduce wrinkles. In the

>process of doing a treatment, small vessels and some brown spots

>(lentigines or sun spots) may also be eliminated giving a freshened

>look to the skin. Severe cea would best be treated with higher

>energies and different settings as stated above.

> I hope that this message helps you and didn't confuse the matter

>too much. Please pardon any spelling errors as I am writing fairly

>quickly. Good luck to everyone with their treatments.

>

>

>

>-----------------------------------------------------------------

>Please read the list highlights thoroughly before posting to the whole

group. See http://rosacea.ii.net/toc.html

>

>When replying, please delete all text at the end of your email that isn't

necessary for your message.

>

>To leave the list send an email to

rosacea-support-unsubscribe

>

>