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From fine lines and wrinkles to uneven pigment and unwanted tattoos, enlighten by Cutera (Brisbane, California, U.S.) offers treatment versatility. Its 532 nm and 1064 nm wavelengths operate at pulse durations of 2 ns or 750 ps; while its 670 nm wavelength delivers energy at 660 picoseconds.
“I chose enlighten because of its solid technology,” said Tingsong Lim, M.D., L.C.P. (Aesthetics), who practices in Kuala Lumpur and Petaling Jaya, Malaysia. “Having instant and continuous calibrating capability enables constant and stable energy output.”
“I also appreciate the ability to switch between nano- and picosecond technology to tackle pigmentary disorders,” Dr. Lim continued. “And the Micro Lens Array (MLA) fractional handpiece allows us to increase the power and depth of both the 532 nm and 1064 nm lasers with minimal downtime or complications.”
Dr. Lim uses enlighten mainly for pigmentary disorders and the enlighten MLA for rejuvenation and scars. The handpiece attachment facilitates skin remodeling deep within the dermis. In his experience, “Picosecond treatments seem to yield faster and more visible results, and the MLA is great for targeting acne scars that have been previously treated with traditional ablative lasers, and no longer responding to treatment.”
For rejuvenation with the MLA (PICO Genesis FX treatment), Dr. Lim first uses the 1064 nm wavelength at 0.8 to 1.1 J/cm2 with a 10 Hz repetition rate and an 8 mm spot for full-face toning.
“For any visible dark spots that seem slightly superficial, the 1064 nm laser is employed with a 6 mm spot size at 1.2 to 2.0 J/cm2 until a slight change of color or mild erythema occurs at the darker spots,” he shared. “Skin rejuvenation appears following the first session, which creates a frosted, powder-like skin texture not seen with other devices.”
Newer, sub-nanosecond laser technologies using shorter pulse durations and higher intensity have shifted laser-tissue interaction from photo-thermal to photoacoustic, which is less chromophoredependent, Dr. Lim expressed. This mechanism, called laser-induced optical breakdown (LIOB), combines high-intensity light with ultra-short pulses to cause a photomechanical disruption that fragments target tissues with a laser-induced shockwave.
“The optical breakdown creates a grid of intradermal micro-lesions without affecting the epidermis, leading to skin rejuvenation and scar remodeling,” he explained.
Furthermore, the PICO Genesis treatment, performed without the MLA handpiece, provides another option for skin rejuvenation. The combination of wavelengths, pulse durations and selectable fluences available in enlighten, streamlines global skin revitalization treatments on all skin types by addressing tone and textural concerns.
Unlike competitors’ devices, the MLA is not an ongoing consumable, Dr. Lim reported. It allows physicians to perform 1 million shots without requiring replacement. “Therefore, rejuvenation and scar treatments can be customized based on the needs of an individual patient rather than a preset, limited number of shots.”
