PracticalDermatology

He needs no introduction, but…

R. Rox Anderson, MD, currently the Lancer Endowed Chair in Dermatology at Massachusetts General Hospital in Boston, is named on more than 80 patents, and the laser and light technologies he helped develop have changed the way vascular malformations, tattoo regret, unwanted hair, excess pockets of fat, and more conditions are treated in practice. Dr. Anderson also co-founded several companies including Cytrellis, Follica, Olivo Labs, R2 Dermatology, Seven Oaks Biosystems, and Seventh Sense Biosystems. He’s a legend in dermatology and recently talked to Practical Dermatology® magazine.

You were recently inducted into the National Inventors Hall of Fame, how did it feel?

Rox Anderson, MD: It was a surprise, in part, because I don’t think of myself as an inventor. These kinds of awards are great to get, but I always tell myself they are not for me, but to inspire young people. [The induction] was a wonderful event and the only time I visited the United States Patent and Trademark Office when it hasn’t been to argue.

What motivates you to roll up your sleeves?

Dr. Anderson: I care a lot about children, which is why I started on port wine stains, vascular malformations, and pigmented lesions.

Do you any favorites among your inventions?

Dr. Anderson: Inventing things and getting them to work is a lot like having children. There are no two alike, and you love them all. I prefer therapeutic inventions where you directly help someone.

Selective photothermolysis or the concept of using lasers and pulses of light as a means of selectively targeting microscopic things inside the skin—boy did that invention have legs! Selective photothermolysis led to tattoo removal, laser hair removal, and treating vascular malformations and rosacea. It also has a role to play in early-stage glaucoma. Intense pulsed light (IPL) therapy flowed from this work too. (Dr. Anderson developed selective photothermolysis with John Parrish, MD, and then worked with Candela to produce the first commercialized pulsed-dye laser.)

I am also very enamored of the use of cold, which paved the way for CoolSculpting or cryolipolysis. My background in physics makes me enjoy energy or heat exchange and electrical fields of a physical nature.

What may be the next big thing?

Dr. Anderson: Cryolipolysis with injectable ice slurries or the injection of sterile ice into the body is evolving, and a couple of companies have started to go after it for different medical applications. I am excited about what we can do with ice slurries. It may even help treat some cases of sleep apnea.

What inventions didn’t make the cut over the years?

Dr. Anderson: I am an incurable optimist, but not everything we try works. We tried to make removable tattoos 15 years ago. There are hundreds of different inks, and the chemical composition of inks is not controlled by the FDA. People with no medical training are tattooing millions with potentially allergic or carcinogenic ink and bad art. There is a lot of tattoo regret, and we don’t have great ability to remove tattoos. We succeed 75-80% of the time. If the FDA did regulate tattoos and they were made of safe materials, sterile, well tolerated by the skin, and could be removed, it would be a game-changer. It failed because we ended up coming up with a really expensive tattoo ink in 2008 during the economic recession. I still love the idea of a safe removable tattoo. What I learned from this is that when you come up with an idea make sure you understand the ecosystem that the invention has to fit into. The cost of tattoo ink is less than $10.00. Removable ink that costs $300 is not tolerated.

What else can we expect to see out of your lab?

Dr. Anderson: We are working on ways to treat Neurofibromatosis type 1 (NF1), the most common human genetic disease that causes tumors to form on nerve tissue. A colleague in neurology approached me and said, ‘let’s do something about these tumors that people with NF1 get.’ In dermatology, we don’t do anything for them and in neurology, we don’t do anything either, so we got very motivated to come up with something non-invasive, well tolerated, that inhibits the growth of NF1 tumors before they get large and disfiguring. I am confident that we will be able to change the way we treat patients with NF1.