Close Up with Eric F. Bernstein, MD

There’s lots of buzz about Acclaro’s UltraClear cold ablative fiber laser, and Eric F. Bernstein, MD, a dermatologic laser surgeon at Main Line Center for Laser Surgery in Ardmore, PA, recently presented histologic findings on photodamaged skin using the new laser at the American Society for Laser Medicine and Surgery (ASLMS) meeting in Phoenix, AZ. He chatted with Practical Dermatology® magazine about this study and the laser, which represents an entirely new approach to ablative and fractional laser resurfacing.

“Different from other devices in the market today, UltraClear uses cold fiber laser beams to precisely remove damaged cells at various depths from epidermal to deeper dermal cells to clear photodamage and other skin irregularities while minimizing thermal-induced side effects like PIH, as well as dramatically reducing pain,” he says. “It does this by delivering many low-energy pulses that combine to produce dramatic tissue effects, laying down over 5,000 pulses per second.”

Why is this topic important to study?

Eric F. Bernstein, MD: With the UltraClear MID-IR 2,910nm cold fiber laser, it’s important to demonstrate scientific validity and clinical efficacy. Looking at the histologic effects of laser treatment on the skin helps us to document the mechanisms by which the laser produces the clinical improvement we see. Investigating where ablation occurs, as well as residual thermal damage is evident, and following the inflammatory response helps show the mechanisms of action of this novel device. It also paves the way for future studies and uses of the UltraClear laser.

Describe the research and your findings.

Dr. Bernstein: The objective of this study was to demonstrate the histologic changes seen on photodamaged skin using the new UltraClear 2,910 nm fiber laser with its unique pulse characteristics. Three specimens were harvested after lower eyelid blepharoplasty surgery and treated with UltraClear to a depth of 300 micrometers (µm) using deep and superficial modes. Ablation pit depths and zones of thermal damage were measured. Our histology findings showed that the average pit depth was 378.9 µm from the top of the epidermis to the bottom of the pit, very close to the predicted depth of ablation, even on ex-vivo skin specimens. Pits averaged 54.7 µm wide on fixed tissue, the mean thickness of residual thermal damage was 43.3 + 5.6 µm, and zones were quite uniform throughout the specimens. These results successfully demonstrate the uniformity of UltraClear laser tissue effects and that the depth of injury correlates to predicted depths quite well.

What is the next step?

Dr. Bernstein: The next step is to advance these findings with varied parameters on in-vivo skin to further characterize UltraClear’s differentiated 3D IntelliPulse technology. We will be exploring the UltraClear for laser coring to address multiple signs of photoaging and chronological aging of the face, notably deep wrinkles and scars.