Trish: Okay, welcome back, everyone. I’m here today at Cosmeticon 2018 with Professor Glen Calderhead and he’s from Dermatology, which is based in South Korea. They are the Lutronic group of devices, for want of a better word. Today, we’re going to have a chat about the new PicoPlus, which is actually a device that treats pigment, and whether that be tattoo or melasma, or even skin rejuvenation, so we’re going to have a chat about that device. Welcome. Thank you so much for joining us today.

Prof. Glen C.: Lovely to be here again.

Trish: Lovely. Lovely. I bet you’d be sit of talking to me by now. (laughs)

Prof. Glen C.: Not at all.

Trish: So tell us, the PicoPlus, there’s a bit of a buzz happening in the industry about it. What actually is the wonderful thing about this device?

Prof. Glen C.: Okay.

Trish: And what does it treat?

Prof. Glen C.: Well the name, pico, you’ll find in all similar systems, denotes the fact that the pulse width of the laser is incredibly short, in the picosecond range. If you come down from a second, you have seconds, then you have milliseconds, which is a thousandth of a second, then you have nanoseconds, which are one billionth of a second, and then you have picoseconds, which are one trillionth of a second.

Trish: Wow.

Prof. Glen C.: So ultimate, really really short. Now the shorter the pulse width for the same energy delivered, the higher the peak power in the tissue. The higher the peak power, the more efficient is pigment removal. This is what made the pico systems such a big magic when they arrived. But when I talk about picosecond lasers, my first question always is “is the picosecond laser a magic wand?” And the answer is “no it’s not.” Not yet. Because at the moment, pico lasers range from 350 picoseconds up to 750 picoseconds. And when you think about that, that’s only 0.35 up to 0.7 and a nanosecond. So it’s not yet that terribly much faster than the nanosecond lasers, which are tried and tested.

The big disadvantage of the pico lasers is that they are horrendously expensive. However, there is no doubt that they are more effective than nanosecond laser. However they are not the automatic answer to all the problems. There are two major problems with existing pico lasers, the majority of them. They only have two wavelengths, which is 1064 nanometers in the near infrared and 532 green. They have low energy levels. As we develop, so we’re developing more wavelengths. And why do we need more wavelengths?

Well, because we are still not at non-selectivity. The higher, the shorter the pico we can get, the less we’ll depend on colour selectivity and any pigment can be removed with the one wavelength. At the moment we really need four. We need the 1064 and green 532, and we need yellow wavelength of some kind and we need a red wavelength of some kind. We need the yellow wavelengths for vascular genic treatment, such a rosacea. Anything that’s got flushing. For post acne redness, for post laser redness. We need the 660, or red, to treat skin lesions. How can I say … melanin lesions that are clearly visible, with borders like freckles for example. With these four wavelengths, then we can deal with almost any pigmentation, including multi coloured tattoos.

And high energy levels? Well the higher the energy level, the higher the peak irradiance, the peak power in the tissue and the more efficient is the clearing of tattoos, or the clearing of pigmented lesions. I’m happy to say that the PicoPlus can fulfil the four wavelength criteria and it can also fulfil the high energy criteria. It’s got the highest range of energies on the market. It has four different handpieces to treat almost any kind of lesion. Including our new focus dots handpiece and that’s the one we can use for skin rejuvenation. And for tattoo … not for tattoo, sorry. For scar revision. Which really takes the picosecond laser away from the pigmented lesion market into another market allowing practitioners to offer better services to their patients.

Trish: And with the scars, is that like all scars? Like hypertrophic or the red scar?

Prof. Glen C.: Yes. This will deal with hypertrophic scars very nicely.

Trish: So I wanted to ask you about rosacea.

Prof. Glen C.: Yes.

Trish: So how does it … can it really help with rosacea?

Prof. Glen C.: Yes.

Trish: Wow. That a big pool.

Prof. Glen C.: It’s a big pool.

Trish: Okay.

Prof. Glen C.: Rosacea is basically an inflammatory disorder of the blood vessels in the very superficial dermis. The micro vessels. Their walls, their endophilia, become active and release signalling compounds, which create this vicious circle that creates more redness, more signalling compounds, more redness and there is crosstalk between the blood vessels and fibroblasts.

So until we can break that crosstalk, we cannot get rid of rosacea. However, by using the yellow handpiece, which we gold toning plus handpiece. At 595 nanometers, we can attack and selectively, not disable, but, how can I say, normalise these abnormal blood vessels.

Trish: Right.

Prof. Glen C.: The other thing that this is interesting for is in melasma. One of the major causes of melasma that is now coming out is vascular genic activity in the dermis. This is not new, it was published back in 2007. But it’s only recently that people have suddenly realised that it exists. And if we examine most cases of melasma, in more cases than not we will find these little blood vessels which are activating the keratinocytes to activate the melanocytes to produce more melanin.

Trish: Right.

Prof. Glen C.: And by breaking the vicious circle, we can remove the melasma.

Trish: Okay so … because I noticed basically you’ve got the device and so for a practitioner who offers the PicoPlus they can … there’s five different handpieces. Is that right?

Prof. Glen C.: That’s correct.

Trish: So you’ve got one different handpiece that treats one particular thing and that’s why it treats so many different options.

Prof. Glen C.: That’s right.

Trish: Okay.

Prof. Glen C.: And I say one particular handpiece that treats one particular thing, one handpiece can actually treat several things. So you’re right, it extends the scope for the surgeon.

Trish: Okay.

Prof. Glen C.: And for the patient.

Trish: Yes. And I believe it’s a lot quicker, in the treatment.

Prof. Glen C.: It’s quicker, treatments are quicker. Side effects are less. Downtime is therefore less.

Trish: Yes.

Prof. Glen C.: Pain is less.

Trish: That’s the one I was waiting for. So less pain?

Prof. Glen C.: Yes.

Trish: Okay. Less pain more gain.

Prof. Glen C.: Less pain more gain.

Trish: Perfect (laughs).

Alright, I reckon that’s probably covered everything I want to ask on that. I’m really … I look forward to following some real stories about the rosacea because I know that people have lots of problems trying to heal that one and the melasma one …

Prof. Glen C.: Yes.

Trish: As well because there’s a lot of treatments but it takes a lot of time and lot of downtime and pain.

Prof. Glen C.: The big problem with melasma is it’s always going to reoccur. Once somebody has melasma, they’re predisposed to it.

Trish: Yes.

Prof. Glen C.: And we may quieten down the melanocytes that are causing that particular patch of melasma, but other melanocytes may well get activated and start producing more melanin than they should. More melasma.

Trish: Yes. Awesome. Well thank you so much for that. That’s been really helpful.

For any of you out there that are into chemistry and physics and science, you’re going to love this podcast (laughs). You’ve taught me so much in this short time.

Well thank you so much.

Prof. Glen C.: My pleasure.

Trish: So ladies and guys, if you’re out there and you’re looking for someone to … who does have the PicoPlus in their practise, you can drop me an email to info@plasticurgeryhub.com.au and thank you so much for your time today.

Prof. Glen C.: Always my pleasure.

Trish: Thank you.

Prof. Glen C.: Thank you.

Trish

Trish is a plastic surgery blogger. She is passionate about wellbeing, health and beauty, and doesn't mind a little bit of 'help' from the amazing cosmetic and beauty procedures that are available today. Trish spends her days talking to women and men who are looking for suggestions and advice on procedures that are available to them. Cutting through the sales pitch and hype, a down-to-earth response on general information is what you will get.

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