Rieko Verhagen

Minimally invasive non-thermal laser technology using laser-induced optical breakdown for skin rejuvenation

We describe a novel, minimally invasive laser technology for skin rejuvenation by creating isolated microscopic lesions within tissue below the epidermis using laser induced optical breakdown. Using an in-house built prototype device, tightly focused near-infrared laser pulses are used to create optical breakdown in the dermis while leaving the epidermis intact, resulting in lesions due to cavitation and plasma explosion. This stimulates a healing response and consequently skin remodelling, resulting in skin rejuvenation effects. Analysis of ex-vivo and in-vivo treated human skin samples successfully demonstrated the safety and effectiveness of the microscopic lesion creation inside the dermis. Treatments led to mild side effects that can be controlled by small optimizations of the optical skin contact and treatment depth within the skin. The histological results from a limited panel test performed on five test volunteers show evidence of microscopic lesion creation and new collagen formation at the sites of the optical breakdown. This potentially introduces a safe, breakthrough treatment procedure for skin rejuvenation without damaging the epidermis with no or little social down-time and with efficacy comparable to conventional fractional ablative techniques. (© 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim)

Efficacy of minimally invasive nonthermal laser-induced optical breakdown technology for skin rejuvenation.

We demonstrate the efficacy of a novel minimally invasive nonthermal skin rejuvenation technique for wrinkle and fine-line reduction based on laser-induced optical breakdown. The optical breakdown caused by tightly focused near-infrared laser pulses creates a grid of intradermal lesions without affecting the epidermis, leading to skin rejuvenation. The pilot in vivo efficacy test performed on five subjects successfully demonstrates wrinkle and fine‐line reduction, and improvement of other skin features without pain or any other unpleasant sensations or any social downtime associated with the treatment. The efficacy is evaluated objectively and subjectively by assessing the improvement of wrinkles and/or fine lines or skin texture after the treatment. The treatment is safe without side effects or social downtime, and all test subjects reported that the treatment is “perceptible but not painful.” Four out of the five subjects who participated in this pilot study were assessed to have “minor” to “significant” improvements of wrinkles and fine lines by the professional panels. The results of this clinical study are expected to bring a paradigm shift in the present laser- and light-based skin rejuvenation methods by introducing a safe treatment procedure without damaging the epidermis, with no or little social downtime and with an efficacy that might be comparable to ablative techniques.

Optical properties of the medulla and the cortex of human scalp hair

An increasing number of applications, including non- or minimally invasive diagnostics and treatment as well as various cosmetic procedures, has resulted in a need to determine the optical properties of hair and its structures. We report on the measurement of the total attenuation coefficient of the cortex and the medulla of blond, gray, and Asian black human scalp hair at a 633-nm wavelength. Our results show that for blond and gray hair the total attenuation coefficient of the medulla is more than 200 times higher compared to that of the cortex. This difference is only 1.5 times for Asian black hair. Furthermore, we present the total attenuation coefficient of the cortex of blond, gray, light brown, and Asian black hair measured at wavelengths of 409, 532, 633, 800, and 1064 nm. The total attenuation coefficient consistently decreases with an increase in wavelength, as well as with a decrease in hair pigmentation. Additionally, we demonstrate the dependence of the total attenuation coefficient of the cortex and the medulla of Asian black hair on the polarization of incident light. A similar dependence is observed for the cortex of blond and gray hair but not for the medulla of these hair types.

Contrast improvement in scattered light confocal imaging of skin birefringent structures by depolarization detection

Here we describe a method for enhancing the contrast in imaging skin birefringent structures. The method relies on polarization-dependent optical properties and is implemented using cross polarized confocal microscopy. The experimental data obtained using ex-vivo and in-vivo measurements on human scalp hairs and human skin demonstrate a significant dependence of the change in polarization of light that interacted with the birefringent hair on the orientation of the incident polarization. The polarization dependent contrast, defined as the ratio of intensity measured for different orientations of the incident polarization when observed using cross polarized confocal microscopy furthermore depends on the hair type/degree of pigmentation and on the focusing depth inside the hair. No such dependence was observed for the upper skin layers, including the stratum corneum and epidermis. We propose a new method for enhancing the contrast between the skin and the birefringent hair by the use of cross polarized confocal microscopy combined with the variation of the polarization of the incoming light. Potential applications of this method include imaging of hairs for assessing the efficacy of hair removal methods and measurement of skin birefringence. The underestimation of the birefringence content resulting from the orientation related effects associated with the use of linearly polarized light for imaging tissues containing wavy birefringent structures could be minimized by this method.

Effects of polarization and apodization on laser induced optical breakdown threshold.

We investigated the influence of polarization and apodization on laser induced optical breakdown threshold in transparent and diffuse media using linearly and radially polarized light. We demonstrate a lower irradiance threshold for optical breakdown using radially polarized light. The dominance of radial polarization in higher-order multiphoton ionization has important medical applications where a lower irradiance threshold may allow reaching deeper layers inside the skin with less risk of collateral damage and thereby improving safety and efficacy of treatment.

Highlighting the nuances behind interaction of picosecond pulses with human skin: Relating distinct laser-tissue interactions to their potential in cutaneous interventions

In recent years, several commercial systems relying on picosecond pulses have been introduced into the field of cutaneous interventions. In parallel with this development, a somewhat distinct research prototype also operating in the picosecond regime was described in literature. Albeit both market-available products and the investigational device employ laser beams of nearly the same pulse duration and were reported to cause laser-induced optical breakdown (LIOB), they are different in terms of wavelength, applied fluence, laser beam quality, optical architecture and related focusing optics, resulting in different histomorphological features (such as e.g. lesion size, location, expression of collagen). Understanding the differences between these systems in relation to implications for clinical results raises a need in highlighting the nuances behind interaction of picosecond pulses with biological tissue. To achieve this, we accentuate the interplay of irradiance levels of picosecond pulses in W/cm2 , absorption properties of a target tissue at a wavelength of a light source and resulting interaction mechanisms with biological object. We also relate these nuances to potential consequences for cutaneous interventions.

Effects of polarization and absorption on laser induced optical breakdown threshold for skin rejuvenation

Laser induced optical breakdown (LIOB) is a non-linear absorption process leading to plasma formation at locations where the threshold irradiance for breakdown is surpassed. In this paper we experimentally demonstrate the influence of polarization and absorption on laser induced breakdown threshold in transparent, absorbing and scattering phantoms made from water suspensions of polystyrene microspheres. We demonstrate that radially polarized light yields a lower irradiance threshold for creating optical breakdown compared to linearly polarized light. We also demonstrate that the thermal initiation pathway used for generating seed electrons results in a lower irradiance threshold compared to multiphoton initiation pathway used for optical breakdown.