PracticalDermatology

When asked to write an article on energy-based devices (EBDs) that dermatologists should have on their radars for 2022, the first thought was that this could be a whole book, not just a simple, short article. While I cannot cover every EBD in this article—and I apologize if I left an important one out—I will try to give an update on some of the newer and even older devices that I think will be important as we enter 2022.

Rapid acoustic pulse technology. One of the more exciting EBDs that is going to make waves in 2022 is called Resonic by Soliton. This acoustic wave device uses rapid pulsed acoustic wave technology and has an FDA clearance to treat cellulite in the thighs and buttocks in as little as one treatment. The clinical results showed very nice clearance in most patients with just one treatment and high patient satisfaction rates. Resonic has recently received FDA clearance for its 52-week efficacy time period—which adds to the excitement with the device. Whether a second treatment might be needed in some patients remains to be seen, but for those suffering from cellulite, this EBD may be a game changer. In addition, Resonic also has an FDA clearance to aide in the removal of tattoos with a Q-Switched Nd:YAG laser, with clearance noted in a significant amount in three treatments. Again, this is a major step forward, and we are awaiting even more data with this device and to see how well it can work with picosecond tattoo lasers. The Resonic Device is shown in Figure 1.

Figure 1 – Resonic by Soliton

Cryolipolysis. Next on my “hot” list is CoolSculpting Elite, by Allergan Aesthetics, an AbbVie Company. This may not be a true EBD, but as a device to remove unwanted fat, a new CoolSculpting device is an exciting addition to the fat reduction armamentarium. In summer of 2021, the device was stopped in its tracks due to a software issue that required re-submission to the FDA. The buzz that had been generated with CoolSculpting Elite prior to the stoppage was very exciting. The Elite was a faster, more comfortable treatment, and had dual applicators to make the whole process work more efficiently for our patients. It is now off FDA “hold,” and we are all excited to be offering this new device to our patients. CoolSculpting Elite is shown in Figure 2.

Figure 2 – CoolSculpting Elite by Allergan Aesthetics

Microneedling RF. Microneedling radiofrequency (RF) has been a big buzzword for the last several years, and there is no reason to suggest that 2022 will slow things down with these treatments. Many of the devices in this category continue to improve on their initial offerings, and we should continue to see more improvements in 2022. I like to divide this category into RF needling pins and RF needling needles. In the RF pin category, the Venus Concepts VivaMD has taken its scanning needling technology into a deeper penetrating pin that has allowed more impressive results in treating acne scars, traumatic scars, and skin rejuvenation. The VivaMD is shown in Figure 3.

Figure 3 – VivaMD by Venus Concepts

In the RF needling sector, the EndyMed Intensif has taken its depth to 5mm, an important milestone to allow even greater efficacy in how it treats acne scars, traumatic scars, in rejuvenating, and in lifting the skin. The Intesif is shown in Figure 4.

Figure 4 – Intensif by EndyMed

The InMode Morpheus8 continues to expand its offerings with new applications for using its RF needling on and off the face with some amazing results. The Morpheus8 is shown in Figure 5.

Figure 5 – Morpheus8 by InMode

Cynosure, with the Potenza, has shown its versatility in the RF needling world, also with an impressive device. The Potenza is shown in Figure 6.

AMP, the Aesthetic Management Partners, offers two RF needling devices: the Scarlett and the Agnes. The Agnes is unique with a variety of different tips available, giving us some amazing results. The Agnes is seen in Figure 7.

Figure 6 – Potenza by Cynosure

Figure 7 – Agnes by AMP

Again, all of these devices can enhance one’s offerings and will change all of your current concepts of the RF needling field.

Short-pulsed 1064nm. An oldie but goodie and an EBD that you may have heard of but never used is the Aerolase Neo. This short-pulsed 1064nm laser has been around for several years now but has seen its status rise over the past several years as more and more of you are realizing the versatility of this portable, contactless, and virtually painless EBD for our patients. The Neo can treat vascular concerns, pigment concerns, and due to being a short-pulsed 1064nm, is successful in treating unwanted hair. In addition, medical dermatology indications, which include successfully treating acne vuglaris and psoriasis, has also placed it high up on must-have devices for 2022. The Neo is shown in Figure 8.

Figure 8 – Neo by Aerolase

IPL. I will end this article discussing one of my favorite EBDs—the one that got me my start in the EBD market—and has seen some amazing changes and improvements that bode well for 2022. That is the Intense Pulsed Light (IPL) source, also known by some as the Broad Band Light (BBL) source. IPLs have been around since the mid-1990s, and with improvements over the years, they have become the staple for many clinics around the world. What has always separated IPLs from most other devices is that they can successfully treat vascular lesions, pigmentary concerns, and have an effect on collagen—a winning combination that still is exciting today for many of us.

Almost every EBD company makes an IPL, and I just want to highlight a few here that I think have once again changed the IPL landscape. The Stellar M22 IPL by Lumenis has added new cut-off filters, known as the acne notched filter, that targets inflammatory acne lesions at 400-600nm and 800-1200nm. The vascular notched filter targets vascular lesions at 530-650nm and 900-1200nm, allowing more stubborn vascular lesions to be successfully treated. The Stellar M22 is shown in Figure 9.

Figure 9 – Stellar M22 by Lumenis

The Sciton BBL Hero has also changed how we approach our patients, as it is an in-motion BBL that has shown amazing results not only on the face but for off-the-face photodamage; it can allow us to treat patients in a rapid time. The BBL Hero is shown in Figure 10.

Figure 10 – BBL Hero by Sciton

It is also important to note that with IPLs and BBLs, we have demonstrated that repeating treatments on a yearly basis can significantly reverse skin aging in many. These studies have been published and remain important for our patients in 2022 as they have been for the past several years.

More to Come

As stated, I could keep writing about EBDs that can change how we think and how we practice aesthetic medicine in 2022. I have attempted to choose those that I think will continue to impact my clinical practice and I hope yours. We will plan to bring you further updates as newer EBDs emerge and to cover others in future editions.