Insights Into Energy-Based Devices
Clinical Summary
Energy-Based Devices in Dermatology: Core Principles for Safety and Efficacy
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Foundational concepts: Effective use of energy-based devices relies on the principles of selective photothermolysis—understanding wavelength, power, spot size, and pulse duration/time for each indication and device platform.
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Treatment optimization & risk reduction: Outcomes depend on matching the target chromophore while avoiding injury to surrounding tissue; ablative procedures carry greater complication risk due to wound creation and post-procedure healing needs.
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Common technical errors: Overcompensating with higher energy is a frequent mistake; pulse duration/time is often the most critical parameter, as correct timing allows effective treatment with lower energy and fewer complications.
Reviewed by Riya Gandhi, MA, Associate Editor of Immunology Group
Patrick Clark, PhD, CMLSO, reviews the foundational principles behind safe and effective use of energy-based devices in dermatology, including wavelength, pulse duration, power, spot size, and target chromophore selection. Learn how understanding selective photothermolysis and treatment timing can improve clinical outcomes, reduce complications, and optimize both ablative and non-ablative procedures.
Transcript
Hi, I'm Patrick Clark. I've been in the industry for 38 years. I'm honored to be with the SCALE meeting for the last 21 years. My background is in education and energy-based devices.
What are the most important principles clinicians should understand to safely and effectively use energy-based devices across different indications?
Dr Clark: 1983, Rox Anderson came up with the concept of selective photothermolysis. Go back to those core things: wavelength, power, spot size, and time. And, if you take yourself back to those core competencies, you can always find the best way to use a new or existing technology probably to its highest function.
How do factors like wavelength, pulse duration, and target chromophore influence treatment outcomes and complication risk?
Dr Clark: When you go back and look at the different components of how a procedure is done, of course, the first thing we need to break it down to either an ablative or non-ablative procedure. Clearly, risks are higher with an ablative procedure where you have a potential for wound and wound care post-procedure. But, you know, the chromophore that you're looking for, more importantly, not the target you're looking for, but the target you're trying to avoid is the best way to control complications and find successes with procedures.
What common mistakes do you see in device use, and what simple adjustments can improve both safety and clinical results?
Dr Clark: Most of the time people think that if something's not working correctly, they simply need to apply more energy. Probably just takes more energy to make something happen. The critical thing with the processes of using energy on tissue is the time in which you deliver energy, and very few people focus on that. That's the most important thing. If you can find the right time to match the dynamics of the target, then it will take very little energy to accomplish what you're trying to do.
What are some key clinical takeaways for dermatologists working with energy-based devices?
Dr Clark: The key clinical things: know your core competencies, know those 4 common things, wavelength, power, spot size, and time and how they fit into your technology. And also go back and look at the history, the expectation, and the nature of your patient or client to make sure that you can match your device properly to the needs of that patient or client.
