The subtly profound outcomes achieved with Clear + Brilliant (C+B) from Solta Medical, a division of Bausch Health Companies, Inc. (Bothell, Wash.), are a testament to the versatility and wide appeal of this multi-wavelength laser system. Among its many benefits and uses as a preventative therapy, it can usher in a younger patient base, exposing them to the offerings and capabilities of your practice, and allowing the natural allure of successful outcomes to drive new business.
Founder and director of Van Dyke Aesthetics in Scottsdale, Ariz., veteran dermatologist Susan Van Dyke, M.D., is a true believer in Clear + Brilliant. As the first physician in the Southwestern U.S. to offer the technology to patients, she has enjoyed much success with it in her practice.
“Clear + Brilliant utilizes the 1440 nm fractional diode laser to provide lighter treatment, or as maintenance after more aggressive therapies, in either case staving off the need for additional intervention and keeping skin looking youthful and healthy,” she said. About four to six sessions will refresh skin and stimulate neocollagenesis.
“We recommend it because it is the kind of thing patients don’t always know they need until they’ve had it and seen the result,” Dr. Van Dyke shared. “It is an ideal avenue into aesthetic medicine, even before turning to injectables, or it may be used in conjunction with them.
“I got my first device in 2011 when microdermabrasion was all the rage,” she continued. “Within a few months we got rid of our microdermabrasion machines and converted patients to Clear + Brilliant. It’s a great first-line light treatment for texture, color or pigmentation, pore size and more, and it has proven itself as a great introductory treatment for anyone.
“Over the years we found out that it can be useful for any age of patient, especially as a ‘starter’ laser,” Dr. Van Dyke pointed out. “Currently our patient base for Clear + Brilliant ranges from ages 18 to 80 years.
“Half of my practice is laser-based so this provides a nice experience with lasers that allows patients to become comfortable with them, and often leads to more aggressive therapies in time, as appropriate,” she added.
The addition of the Perméa handpiece to the Clear + Brilliant armamentarium takes the technology to the next level, providing another dimension to C+B therapy, Dr. Van Dyke highlighted.
Using the 1927 nm wavelength (which has a higher absorption coefficient) at a fixed depth of 170 μm, Perméa does not penetrate the stratum corneum, thus preserving barrier function. This wavelength has an affinity for water rather than melanin, making it safe for darker skin types, and the fractional delivery pattern of holes may be suitable for facilitating topical delivery of therapeutic compounds.
Furthermore, because it is gentle, superficial, and the wavelength is not pigment-specific, Clear + Brilliant Perméa may be ideal for melasma, especially when used in a multi-vector protocol.
“When treating melasma with a laser you run the risk of exacerbating the condition, but much less so with Perméa because of the nature of the wavelength and depth of delivery,” explained Dr. Van Dyke. “This is now my go-to treatment for melasma, precisely because we don’t see that rebound pigmentation. I often use this with hydroquinone therapy.”
In fact, Clear + Brilliant is great for combatting pigmentation in general. “I practice in Arizona so everybody has some level of sun-induced pigmentation, and Clear + Brilliant is a great option for this indication in patients of any age,” she said.
As a preventative treatment, Clear + Brilliant appeals strongly to the younger patient base. “Aesthetic medicine is much more accessible than it once was, due to changes in cultural attitude, information availability, and the rise of effective but low-hassle and more affordable options, so our potential patient population is getting younger and younger,” Dr. Van Dyke stated.
“Clear + Brilliant is an excellent option for the younger patient,” she expressed. “Sessions take maybe 20 minutes. It is not very aggressive so treatment is comfortable without anesthesia, and downtime is non-existent. This group of patients doesn’t usually need much, but their skin is ripe for refreshing because they’re still young. With regular treatment and good self-care, regular sunscreen use, etc., such a patient may maintain a healthy, youthful glow for quite a long time.
“If younger patients come in with textural issues and pigment, I go with the Clear + Brilliant Perméa – the 1927 nm wavelength,” Dr. Van Dyke advised. “If there is some acne scarring or superficial dermal issues, I’ll go with the 1440 nm because I can go deeper.”
For darker skin types, Perméa may be better. “It treats superficially and doesn’t target melanin, so it is safer for that patient group,” she noted. “However, if their issues require a more aggressive approach, I will do six sessions over six months using the 1440 nm wavelength. For post-pregnancy or for melasma in darker-skinned patients I will often do Perméa plus topical lightening or brightening agents, same number of sessions and interval.”
Although the outcomes are more subtle than what is seen with more aggressive treatments, patient satisfaction is still excellent – high enough to turn otherwise skeptical or hesitant patients into believers in aesthetic medicine, Dr. Van Dyke stated. “This technology has been a true gateway treatment, opening doors for patients since we brought it into our practice. Once people have experienced Clear + Brilliant, they’re often eager to try something else.”
That said, the gateway potential for Clear + Brilliant is crystal clear. According to Dr. Van Dyke, “A typical scenario is this: A 30-something-year-old patient comes in wanting a more aggressive treatment, but that may not be appropriate, or they may still be a little uncomfortable with the idea. We give them a Clear + Brilliant treatment and they get comfortable with the experience, then later we move them to something like Fraxel Laser (Solta Medical), then back to Clear + Brilliant every three or four months as a maintenance treatment.
“Or, if downtime is an issue and they want to go a bit more aggressive but aren’t entirely comfortable, we may do one session of Fraxel and then a few months of Clear + Brilliant, and see where we go with minimal lifestyle impact. Fraxel and Clear + Brilliant work extraordinarily well together.”
Dr. Van Dyke added that Clear + Brilliant also works well with injectables and/or skincare regimens. “That’s how Clear + Brilliant is so versatile, you can do much with it as a stand-alone, but use it with other things as well.”
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