Cooling system for a photocosmetic device

^ϋηυψιυΐΰ ρηπ> ητρ rmyo

COOLING SYSTEM FOR PHOTOCOSMETIC DEVICE PALOMAR MEDICAL TECHNOLOGIES INC C: 73377 211859 COOLING SYSTEM ΓΟΠ A PHOTOCOSMETieT>E^TGg-

BACKGROUND OF THE INVENTION

Related Applications / \This application claims priority to provisional application serial number 60/363^8, filed Marek 12,2002. This application is also a continuation-in-part of application serial number 10/05^474, filed January 18,2002, which application is a continuation^! application serial number 09/493,910, filed December 28,1999, which application clainaspriority to provisional applicatioKserial number 60/115,447, filed January 8,1999/6laims priority from provisional application serial number 60/164,492, filed November 9/1999, and is a continuation-in-part of application serial number 09/078,055, fi^u May 13, 1998, now U. S. Patent No. 6,273,884, which application claims priority to provisional application serial number 60/046,542, filed May 15, Γ997 andprovisionaj/iipplication serial number 60/077,726, filed March 12,1998. This application's also a continuation-in-part of application serial number 09/268,433, filed March 12,1999\hicj/application claims priority to provisional application serial number 60/115,447, filed &mhary 8,1999 and provisional application serial number 60/077,794, filed January 8,199/and is a oontinuation-in-part of application serial number 08/759,036, filed December^1996, now U. SsPatent No. 6,015,404, and is a continuation-in-part of application serial number 08/759,1^6, filed December 2,1996, now abandoned, and is a continuation-in-part of application serianrumber 09/078,055, filed May 13,1998, now U. S. PatentJMo. 6,273,884, which application claims priority to provisional application serial numbe/60/046,542, filed May 15,1997 and provisional application serial number 60/077,726, fiied March 12,1998. This application is also a oontinuation-in-part of application serial mmiber 09/634,981, filed August 9,2000, which application is a continuation of application sejfial number 09/078,055, filed May 13,1998, now U. S. Patent No. 6,273,884, which application claims priority to provisional application serial number 60/046,542, filed May 15,199/ and provisional application serial number 60/077,726, filed Marcrkl2,1998. I .f* \

This application is also a continuation-in-part of application serial number 09/847,043, filed April 30/2001, which claims priority to provisional application serial number 60/20(M31, filed April 28,2000. This application also claims priority to provisional application serial number 60/2^2,827, filed May 23,2001. This application also claims priority to provisional \ apjflication serial number 60/363,871, filed March 12,2OO2.The contents of all of these prion, application specifications are incorporated herein by reference. '

Vvi) t'ViiWj Ί (, IV,ri /1 WlVW 3.-

Thcre emsuavuneiy of' conditions tTcataoie using priowcivnienc procedures laiso reiemti i( iierein as uno i.ocosmeii e 'iTcatmenup. inc lading hghvbased ic.g.. usin'! :: laser or lamp) hair removal. n'ectmen· 0::'van0us akin iesious. ι.;υ:ι.ου removal· facia! rssarrinemg. and sitir: rciuvcnauor. Currently. photo cosmetic procedures am pmbmnc using. professional-matie devices ma; cutrn ties tru ciive heating of targe; suuctares located iu the emdemus/dernn of:·: si tin.

To mat. canaocosineLh proeeuLirc;·. have, beei'i performed in a harm awing!, ink on Ice parrialJy because oflhe expense ohti.it hev.iact used to perform foe pro ced tires.. partially because of safety concerns reiated w hit devices. and partially because of hit noth to tare for optically induced wounds on tbepatisnth si-tin. Such wounds rnay arise from damage 10 a natisrors epidermis caused by foe high-power radiation and may result in significant pain and/or risk of infection. While certain piioto cosmetic procedures. such as CCy laser facia! resurfacing, will continue to be performed in foe dermatologist·'ξ office for inedieaJ reasons f e c.. foe used for posl-onerati.ve wound care), there are a lame number of nhoto cosmetic procedures that couid be performed in a rion-medical environment (e.g., home, barber shop, or spa) if foe consumer could perforin the procedure in a said and sSective manner. Ever, for nrocetiurss csrformsc iu a medical environment. reduced sltin damage would reduce recovery rime.

Photocosmetic devices for use hi medical or non-medictii environments may benefit from following characteristics . (' 1) The device musl be safe, Eor example. it is necessary w avoid eve and sltin injuries. (2) Preferably foe device is easy to use, thus allowing an operator to achieve acceptable cosmetic results after only reading a brief training period. (3) Preferably the device is robust and rugged enough to withstand abuse, f5) Preferably foe device is easy io maintain. (5) Preferably the device is manufacturable hi high volume. (7J Preferably die device is available al a reasonable, price. (7) Preferably the device is small and easily stored, foi example, m a bathroom. Currently available phnLocosmctic devices have limitations related to one or more of the above challenges. SUMMAJtrf OF Tl-IE PPtficfoTICfo Λ firs; acpec: of the invention is a photo cosmetic device for use on an area of a putienrs sitiu comnrning1 t treatmem head for use in close proximity to fine patient's sltin. at leas; one source of efoarromagnatic radiation positioned within foe rrea.une.ri! head and configured m project radiaiion onio Hit area of skin, a eooiing surface Iliermally coupled u> die <11 icasi one source. end u meeharnsm io direel a ptiase change si.itis;mice onio the cooling surface. Optionally. Hie phase change substance comprise!; a lujuid Alternatively, the phase charier suosiance comprises a solid. 5 in some embodiments of the first aspect the surface has a texture 'Hie te?:ture mat be a mica; uroovr pattern 01 a coneeiitnc groove panerii Allemanvel\ Ihe texture is a plurality of' proieetions The mechanism wa\ be a sprav iet The mechanism may iurihci comprise a valve coupled to the sprat tel. wherein the valve controls the amount of liquid projected onio the coohnu surface A heal sensor may be used pi produce a signal indicative of the icmperaiure of 10 at least a portion of Hie area of skin, and a contiOlier .niavbe be used to receive the signal from Hie heal sensor and control the valve in response to the temperature. A container may be included r.o hold (he substance. In some eTubodmianrs. the substance is a refrigerant. For example. the icifigcrant comprises tctraHuorocthanc. The solid mav be ice or an organic compound, or an Gu/hi alloy. 15 The cooling surface may be a thermally conductive electrode providing powei to the source. Alternau vslv. the cooling surface may be a surface of a thermally conductive heat sink that is thermally coupled to trie source. The cooling surface may have at least one channel thsreHrraugh to receive Hie phase change substance. Alternatively, the cooling surface lias a plurality of channels therethrough to receive the phase change substance, the plurality of 20 channels aligned along the length. A second aspect of the invention is a pholoeosmetic device for use on an area of a paHenfs skin comprising a treatment head for use in close proximity to the patient's shin, at least one electromagnetic radiation source configured to project radiation through Hie treatment head onto Hie area of shun, and a first mechanism coupled 10 the treatment bead and configured to protect a first substance onio the patient’s skin. The eJectromagi.iet.ic radiation source may lie Positioned within Hie treat,mem head. The device may include an optical svstern to transmit radiation to Hie area of shim the optical system having a surface configured to contact the patisiifs skin. The device mav furtliei comprise a cooling surface thermally coupled to the nt least one source and said surface; and second mechanism to project a phase change, substance 30 onio the cooling surface, wherein the firs! mechanism is configured to rise a gas formed by the phase change of Hie second substance to drive the first substance onto the patient 's skiti. The device may further comprise a cooling suidace thermally coupled to the source and said PC’T/ί JSIU711>43? siiriacc, and a second mechanism configured k> proieci a portion of the first substance onio the cooihtg surface.

Tin- first substance may be a hcuiid and the portion of the first substance project, ed onto fuc. skin is t. gar. resulting iron·] a phase change of the first suhstmict. AdLernaiiveiy. the first 5 substance is a solid mid the portion of the first subsumet projected onio tire skin is a liquid resulting from a phase change oftiic first substance, hi yet another uhernative. Hie first substance is a solid and the portion of the first substance projected onto the skm is a gas resulting front a phase change οϊ the first substance.

The first substance may be a liquid. and foe liquid may be a lotion. Alternatively, the .1 b first sLibsiuuee may be u gas, mid the gas may he cooled air. The second substance may comprise a plurality of components. The cooling surface may be a surface of a thermally conductive electrode providing power to the source. The cooling surface may he a surface of a thermally conductive heat .sink that is thermally coupled io tine source. Optionally, the source is one of a diode lassr bar·, fight emitting diode and lamp. 1.5 A third aspect of the invention is a device far use on an area of a patient1 s shin comprising a treatment head for use hi close proximity to the patient’s siting at least one electromagnetic radiation source positioned in the treatment head and configured to project electromagnetic radiation onto the area of simp a cooling surface thermally coupled to the at least one source of electro magnetic radiation and including at least one channel therethrough. 20 mid a mechanism to project a substance onto the cooling surface, and into me at ieasi one channel.

The substance may be a liquid or a gas. A fourth aspect of die invention is a device for use on an area of a patienfis sltin comprising at least one electromagnetic radiation source configured to project radiation onto 25 the area of skin, a cooling stud ace thermally coupled to the at least one source,, and a solid mass thermidly coupled Lo die. cooling surface, the solid mass changing phase in response to heat absorbed from die cooling surface. in some embodiments the solid mass is ice or mat' be dry ice. The device may further comprise a mechanism to bring the solid mass into contact with the cooling surface. Tim SCI device may further comprise a treatment head, wherein die source is positioned within the treatment head. The source may be one ui a diode laser bar, ligin emitting diode and lamp,

The cooling surface is a surface of a thermally conductive electrode providing power to trie source, or a thermally conductive heat sink that is thermally coupled to the source. WO 1 Ιό

I’CT/USUC/t mSS A fifth aspect of the invention is a device for use on an area of a naticnr's skin comprisin'* a: leas; one electromagnciic radiation source configured to project elscnOinagnstic radiation caao fi.it area of skin, a cooling surface Lhernialiy coupled to the at least out source, a solid mass theruialiy coupled to the cooling surface, a! leusi a ροπίοη of the .mass becoming a 5 liquid m response 1.0 absorption of heal tini. iht cooling surface, and an exhuus; vent, conftuured 10 receive a portion of the liquid and project the portion of the iicuud onto the patient’s skin.

The device may further comprise a mechanism for combining the liquid with a chemical substance and directing the liquid and chemical combination onto Lhe patient’s skin. ] 0 A shift aspect of the invention is a device for use on an area of a patients skin comprising at least one electromagnetic radiation source configured to project e]ecrramagnetic radiation onto tire area of slti.n, a cooling surface thermally coupled 10 die at least one source, and a reaction chamber thermally coupled το the cooling surface and containing at least a first chemical compound mid a second chemical compound, the tirst and second chemical 15 compounds selected to provide an endothermic reaction within the reaction chamber.

The cooling surface may be a surface of a thermally conductive electrode providing power to the source. or tire cooling surface may be a surface of a thermally·' conductive heat sink that is tliermaliy' coupled to the source. A seventh aspect of the invention is a device for use on an area of a patient's skin 20 comprising a treatment head ibr use in close proximity to the patient’s sltrn. at least one source of electromagnetic radiation positioned in the treatment head and configured to project electromagnetic radiation onto the area of skin, and a couhug surfa.ee: thermally’ coupled to the at least one source of electromagnetic radiation, the cooling surface hasting a channel therethrough to allow a low-boiling point liquid to flow onto a surface of the cooling surface. 25

The device may further comprise a valve connected to the channel to control the evaporation of tine low-boiling point liquid. The device may also further comprise a heat sensor to produce, a signal indicative of the temperature of the area of skin, and a controller to receive Idin signal from the heal sensor and control flie valve in response to the signal· The 30 device may have a pressure source is coupled to the channel to control tire boiling of the low-boiling point liquid. The source is one of a laser diode bar. light emitting diode and lamp.

The eififth aspect of Lhe invention is a device for use on an area of a patient’s sltin comprising a Treatment head for use in close proximity to the patient’s sltin. to least one wo (IC/WMI it, ϊ·0ΤΖί!Η(Ι2.Ί ι-435 - 6 - eiecuOtuagusiic radiation source positioned in the- ireauriem head and conftgui’ed no proieci radiation onio the area of skim a iieat spreader ihermaby coupled to i.iae a; jean one source, arid a cooling surface tiiermaliy coupled to the heal spreader. The source may b- one of a diode laser bar. hum emitting diode and iarnp. Tat cuoiiug sun ace may be n surface of a tliennallv 5 conductive electrode providing power it» die source. or ma}.· be a surface of a thermally conductive heal sink ihai is thermally coupled 1.0 the source. A ninth aspect of the invention u a cooling sysicm for cool ing a heat generating device a cooling surface tiicminlly coupled a; the heat generaiing device, and a nozzle configured to project a high pressure liquid, the liquid iorming a flowing liquid on the cooling surface. The ? 0 high pressure liquid may be projected such Thai the liquid forms a stream of liquid the entire distance between the nozzle and the cooling surface. The cooling surface may be textured, Cmtionaily the cooling system may further comprise a cooling chamber to redirect the liquid to the cording surface, The cooling chamber may include sidewalls and a cover. While many of the embodiments are described with reference to performing photo co emetic treatments in a 15 non-medical suvironment it is to he understood ilia: the benefits of aspects of this invention apniy io medical devices as well as non-medical devices, and the. invention applies to either with out i miilati on.

BPJ5F DESCRIPTION OF THE THAWINGS 20 Illustrative, non-limiting, embodiments of die present invention will be described by way of example with reference to the accompauAng drawings, in which the same reference numeral is fur the common elements in the 'various figures, and in which: TIG. 1 is a .schematic illustration of some basic elements of a photo cosmetic device according to some aspects of the present invention: 25 TIG. 2A is a side view of one example of a radiation system according to some aspects of the present invention for use in performing a photocosmetic procedure on an area of a patient ; skim TIG. 2B is a schematic top view of an irradiated area of a patient's skin taken along lines 2B - 2'JT of TIG. 2 A; 30 NG. 5 is a aide view of an example of a radiation system that is capable of forming two areas uf radiation on am area of a patients skin: TJG. d is a top view of one example of a system appropriate for formation of islands c>f treatment: wt> u'btru.i η.

PCT/L'SOt/'iwiSS FIG. 5 .is a schematic cross-sschomil sick- view ok on? embodljueni of a head according io aspects of the present invention: FIG. dA .is a cross-sectional side view one example of one embodiment of a cooling system lliai uses evaporative cooling: 5 FIG. oB is a cross-seciional side view of another embodiment of a cooling system

Lii.iiming a cooling liquid: FIG. 6C is a schematic of anoliier embodiment of a cooling system utilizing a cooling liquid and having, a cooling, chum her. FIG. dD is a cross-sectional side mew of an embodiment a head utilizing a cooling 10 liquid in which the exhaust vent is separated from die pori through which cooling liquid enters chamber: FIG. 7 is a cross-sectional side view of an embodiment of a cooling system having channels: FIG. f is a cross-sectional side-view of another embodiment of a head utilizing 15 evaporative cooling of a liquid: FIG. 9 is a cross-seen on a] side view of an embodiment of a cooling system using a solid phase-change material according to aspects of the present invention: FIG. 10 is a cross-sectional side view of an embodiment of a cooling system using an endothermic chemical reaction for cooling; 20 FIG. 11 is a cross-sectional side view of an embodiment of a device having an exhaust vent to cool a patient's slum FIG. 12A is a side view of one example of an embodiment of a single-element optical system appropriate for use ivith pbotocosmellc devices according Io some aspects of the present invention; 25 F.1G. 12B is a ray trace of one example of an embodiment of an optical system as illustrated in FJG. 12A; FIG. ISA is a side view of one example of an emhodimeni of a two-element cylindrical optica! system apptOuriate for use with photo co emetic devices according to some aspects of the present invention: 30 FIG. 13B is a ray trace of one example of an embodiment of an optical system as illustrated in FIG. 13A: -6- ί’·Ίζί 1ΑΛ is a side vmv ofanotbei example οι a embodiment of a i wo-element cviiiicinea! optical sysiem appropriate for use with phomcoGiueLie devices according 10 some aspects of the presen: invention. PIG. MB is a ray tract of one example of an embodiment of an optical sysiem as 5 illustrated m FIG. P1A. FIG. 1 5 A is a side view of ailofnei example οι a embodiment of a two-edemen; cvhndricai optical sysiem appropriate ioi use with phoioeosmeuc devices accorctmg to sorne aspeets of die present invention: FIG. 15B is. a ray trace of one example of an embodiment of'an optical svsieni as .10 iliustraied in MG J f A. FIG. I GA is a schematic .id a strati on of an exemplary embodiment of a .head for performing pboiocosmelic procedures, PIG. 16B is a schematic, illustration of an exemplary embodiment of a head for performing pboiocosmetic procedures dint also provides the capability to perform muscle 15 stimulation during a photoeosmetic procedure; PJG. J 7A is a schematic illustration of one example of one embodiment of an apparatus aceordtna io some aspects of hie invention, which optically determines contact between an optical element and the surface of a patient's skin; FIG J 7B is a schematic illustration of one example of one embodiment of an apparatus 20 according to some aspects of the invention. which optically determines contact between an optical clement and the surface of a patient’s shin; FIG. 1 7C is a schematic illustration of one example of one embodiment of an apparatus according to some aspects of fbe invention, which electrically determines contact between an optical clement and the surface of a patient A skin; fIG. .IMA is a cutaway .side view of one embodiment of a handpiece having a motion sensor: FIG. 1 BB is a schematic illustration of one example of an embodiment of a motion sensor system; ihG. 19 is a schematic illustration of another example of an apparatus having, an optical 30 morion sensor: FIG. 20 is a schematic illustrat ion of one example of one embodiment ai a handpiece ill li strap ng some aspects of a self-contained photoeosmetic device according io the present invention, FIG 21 is a schematic illustration of one example of an embodiment of a handpiece 3 b docking station fot docking a self-contamed photocostriem device: FIG 22 is a soil ci i kj lie j 11 ustraiion of one example of tine embodiment of a handp i ecu iitt(ijK a dcu.ichaoie need. FIG. 2? is a schematic illustration of a module; handpiece having, one oi more components suitable io; usci-replacement. 5 FIG 2-4 is a schematic illustration of a modular optica' assembly having one o; more components suitable Tv use;-replacement. FIG 25 is a schematic iI lustration of one example of a phoioeosmetir device i 111ist.iatiiiu, some aspects of the uieseu! invention. FIG. 26A is a schematic illustration of one example of a phoiocosmetic head ill usi.ratine. 1 0 aspects of the present lh vein ion directed to treating a curved area of ski it. FIG 26B is a schematic illustration of one embodiment oi two transmission systems of a.head to treat a curved surface. FIG. 27 is a schematic illustrating an embodiment of some aspects of handpiece. 2700 according io the present invention; and 15 FIG. 28 ts a schematic illustration of one cmboduitsut of a pho to cosmetic device according to at least some aspects of die present .invention. PEG AILED DESCKIfTiCfC OF THE ΙΕΛΈΙΤΤίΟίν FIG. 1 is a schematic illustration of some basic elements of a photocesmetre device 100 20 according to some aspects of the present invention. .Area J10 is an area of a patient’s skin on widcli a selected phoioeosmede treatment is to be perfonned. Area of skin .110 has a basal layer 140 m between an epidermal Saver 12.1 and a dermal layer 130. Typically, photocosmetic treatments involve Treating a target area located within epidermal layer 121 or dermal .layer 1 30. For example, in the case of hair removal, it may be desirable to heat a bull·; 150 of a hair follicle Ή 1 60. Alternatively, oiiiy a portion of bulb 150 may be heated, for example, the basemenl membrane 152 between the papilla and the follicle.

In some- embodiments o.fibe present invention, the major sub-systems of device 100 include a handpiece J 70. a base unit 120 and cord 126 to couple handpiece 1 70 io base unit 120. Base unit 12() may include a power supply 124 to powet control electronics 122 and 30 electromagnetic radiation (FMK) source 125. Power supply' 124 can be coupled to handpiece 17() via cord 126. Cord 126 ts preferably 1 ighiweiglii and flexible Alternatively, as described with reference to FIG. 21 below, cord 126 may be omitted and base, unit 120 may be used a.s a charging station for a rechargeable power source (e.g.. batteries or capacitors; located in ν'ί.ι l)U/lr'>i ι 11 PC'i'/ΐJS(iC/'i ι>->35 - JO - handnieee 1 70. In some embodiments. base min 120 cun be compisteJy cumulated by including a rechargeable power source and an AC1 adapter in tin/ handpiece j 70.

Llandpicce J 70 includes a trcatiuem head ) SO (also reicrred to simply a;; a head) eonfumred io lie i_n comae; with a patient A skin, mid a huti.dk J A) lhai may ba grasped bv an 5 operator to wove Laud 3 80 in any direction aero;;:: the paiicnu, skin. luu example. head 3 00 mav be pushed across the slum in a forward direction J 05 or pulled across hie skin in a backward direction 3 06. Typically during a given stroke, coiiiad will be maintained between head ISO and the padcnTn skin 1 10 while head 1 SO it moved. Handpiece I70 may be mechanically driven or hand-scanned across the sldn surface of area j '1 0. Firm contact I Cl between head 1 SO and skin 110 is preferable to ensure good thermal and optical contact. As described in ureater detail below, in some embodiments of me present invention, head IS Ci and/or area of sitin 11 0 are cooled iyv a possivo or aefwe cooling apparatus lt> prevent, damage to the head and reduce tire occurrence of slum damage (e.g.. wounds).

In an exemplary embodiment, source 125 is located m handpiece 170. for example hr 15 head 1 SO. Alternatively, source 125 is located in base unit 120 and connected to head ] 80 the an optical fiber 128. Optical fiber 128 may emend through handle 190. or may be otherwise connected to head '1 SO for the purpose of delivering light to the patient skin. in some embodiments; controls 122 receive information from head 1 SC over lines 132. for example information relating to contact of head ISO with sldn 110. the rate of movement of 20 head J SO over the· patient's sldn, and/or sldn temperature. Comtek 122 may iransmh control signals to head 180 over hues 132, Lines 132 may be pari of a cable him is also connected io head 1 SO through handle 190 or may be otherwise connected to the head. Controls 122 may also generate ouipms, to control the operation of source 125 and may also receive information from the source. Controls 122 may also control a selected output device 119. for example an 25 audio output device (e.g., buzzer), optical output device, a sensory output device (s.g.. vibrator), or oilier feedback' control to an operator. Depending on operator preference, other commonly used output devices may also be used, in some embodhnents. outran device 119 is located within handpiece 170. FJG. 2Λ is a side view of one example of an illumination system 2()0 according to some 30 aspects of the present invention for use in performing a ph otocosroehc procedure on an area of a patient s shun J 3 (J. KfG. 2B is a schematic top view of an irradiated area of a patients skin 310 taken along lines 2B - 2B' of TIG. 2A. In an exemplary embodiment of the invention. WO 02 Λ,'‘U HI, .”C"i7L}SB2/1i.43> - 11 - system 200. including. an LAID source 204, h; located in the bene! of a photo cosmetic device ten.. bend ISO in FJG. 1such tliai the Elvilt source in located proximate the shun surface 11 0.

Depending on the treatment to be performed, source 204 may be configured to emit at single wavelength, multiple wavelengths, or in a wavelength band. Source 204 may be a 5 coherent iufut source. for example a ruby, alexandrite or outer solid state laser, gas laser, died; laser bar. or other suitable laser light source, Aliemah verly source 2()4 may he an incoherent irgjit source tor example. an LED. are lamp. flashlamp, fluorescent Inrun, halogen lamp, halide lamp or other suitable lamp.

Ad optical system 206., comprised of a plurality of optical element;;, includes a surface 1 0 207 for transmitting radiation from an EMR source 204 and for contacting the patient's slum 110. Further details of optical system 206. are given below with referenex1 in FIG. 12 - 1 6.

The phrase “optical system’' is used herein to refer to a system for transmittmg any type of optical radiation suitable for perfomiing plioweosrnetic procedures.

In some erabodnnenn. source 204 has an emended dimension in the x-direction (e.g.; 15 the light source is substantially linear). One of ordinary sldll would understand that a plurality of point sources may be combined to form a substantially linear source. Additionally, relatively small linear sources may be combined io form a single, longer continuous linear source, or a longer linear source having one or more discontinuities. Dor example. source 204 may be a diode laser bar having a 1 cm long emission line and a few micron hne width; 20 optionally source 204 may'· include two or three bars placed in a line along the x-direction to create a 2 cm or 3 cm long emission line.

Alternatively, linear sources may be placed adjacent to one another in die y -direction to form a source having an increased line width. System 200 may include one or more additional sources 205, similarly or diflerently configured than the one or more sources 204. 25 In embodiments having two sources, source 204 and source 205 may emit at the same or different wavelength ranges. in embodiments having multiple Elvfli sources 204. 205, it may' be desirable to activate only selected sources for a given treatment. For example, in cmlxxlnncn.tr having sources emitting at different wavelengths, for cerium applications, for example, hair removal, it 30 may be preferable to only·' activate a selected one or more source;; and for csrLuin other applications, for example. acne treatment or Sirin rejuvenation io activate a selected one or more other sources. ATtile sources arc discussed as cmlttinu radmlion at a wavelength, one of 211859 -12- ordinary sldll would understand that any radiation source produces light over a finite range of wavelengths, accordingly a specified wavelength may be a part of a broader range.

Radiation source 204 may be a pulsed or continuous wave (CW) source. For applications that require coverage of large areas such as hair removal, CW diode laser bars may be preferable. A method of utilizing continuous wave (CW) light sources for the treatment of various dermatologic disorders is described in U. S. Patent No. 6,273,884 BI entitled “Methods and Apparatus for Dermatology Treatment,” to Altshuler, et al.y^fao-qubotanoo of -whioh is-horoby inoorperatod by referenot* Some aspects of that patent teach die use of a C W light source in combination with a contact optical delivery system that can be either hand scanned or mechanically driven across the skin surface to create a precise temperature rise in the targeted biological structures (i.e., using continuous contact scanning (CCS)).

Most commercial diode laser bars exhibit lifetimes of >5000 hours, but application . according to the present invention may only require 10-100 hour lifetimes. Accordingly, in some embodiments of the present invention, a source 204 may be overdriven with current to increase radiation output, thus causing the diode laser to operate at a higher temperature, and thereby sacrificing lifetime.

Diode laser bars appropriate for use with the present invention include diode laser bars emitting at wavelengths of 790-980 nm or other suitable wavelengths. Examples of sources of diode laser bars appropriate for use with aspects of the present invention include Coherent Inc. of Santa Clara, CA, or Spectra Physics of Mountain View, CA. The above examples of sources 204,205 are exemplary and it should be understood that aspects of the present invention include devices and apparatus using any appropriate EMR source currently available or yet-to-be-developed.

For some embodiments of the present invention, for example those requiring either low power or for treatment of small areas of a patient’s skin, LEDs may be used as light sources 204,205. LEDs are available in a wide range of emission wavelengths. Similar to the diode laser sources discussed above, multiple LEDs emitting at different wavelengths could be used in a single optical system. Typical lifetimes for LEDs are in the 50,000-hour range; similar to laser diodes, it may be possible to overdrive an LED and sacrifice lifetime to generate higher optical power. For applications that require high power density, a reflective concentrator (e.g., a parabolic reflector) could be used to decrease the spot size at the skin surface.

Broadband sources (e.g., low-power halogen lamps, arc lamps and halide lamps) are another type of light source that could be used as sources 204,205. One or more optical filters wet 02/0'M Ι.']ι i’C'T/iJS02/i 240 and 242 can be used to provide a wavelength band of interest for a given apniicaiion. Iviultiuk hunps can be combined to produce high power, and. similar to· the case ofEEIlfi a concentrator conic: he used to deerea.se hie spoi size, ai the sion surtace. in some embodiments, several diffirem Types of light sources can Lie incorf.vjrated into a phowoosmetic device (t.g.. 5 device WO of TIG. Ip la some embodiments of system 200. a beam splitter 23() splits .mtiiation from sowee 20~ to torm a first portion of BMP. and a second rmruon of Ehil t. The firs! portion and second portion nitty be 'filtered bp filters 241) and 242 respective!;. After filtering, the portions may have Lhe stune or different wavelength ranges. The functions of hue first and second pontons J 0 .may be 'the same or different. Tor example, the function of the second rtorl.i.ojj of EhbR may be in preheai the patieitlfi skin 110 in preparation for rreatmenl by the frrsi portion cTEMlk Ffiternatively. both the first portion of.EMiR ark Lite second portion of EMIR. itoy provide treatment, referring to FIG. 2B, in some embodiments, optical system 206 (visible in TIG. 2A.1 is 15 configured to form a first area of radiation 210 along a first axis 2] 1 on the patient7 s sitin 110. First area of radiation 210 is formed ήυιη at leas’ a first portion of electromagnetic radiation from source 204 (visible in TIG. 2A). hi some embodiments. a second area of radiation 220 along a second axis 221 is formed on the patient's shin 110. Second area of radiation 220 may be formed from a second portion of electromagnetic radiation from the radiation source 204: 20 alternatively second area of radiation 22b may be firmed from light from second radiation so urce 205 (visible in FIG. 2AJ.

In some aspects of the present invention, the first rads 211 and second axes 221 are parallei: however in other embodiments, the arms 211. 221 are not parallel. System 206 may be configured to firm the first area 210 a selected distance from the second area 220, or may 25 be configured such that the first portion of radiation overlaps at least, a pan' of the second portion of radiation. Optionally, system 206 is configured to firm (e.g.. focus or collimate) the firsi portion mid second portion substantially as lines. Optical system 200 may be configured to nrodtiec one or more lines of hgih at the sitin surface, each having a length of 1 -300 mm and a width of 0.1 -10 mm. Astigmatism of the beam can be in the range 0.0] -0.5. The term 30 ‘‘astigmatism’' is herein defined to mean the ratio of beam width m five beam length. Also, optionally, system 206 may be configured to form one or more additional areas of radiation along addfional axes (not shown) on thepatienf s skin 110, the additional areas of radiation 211859 -14- formed from corresponding additional portions of electromagnetic radiation from the radiation source 204 or 205, or radiation from one or more additional radiation sources. FIG. 3 is a side view of another example of an illumination system 300 for use in performing photocosmetic procedures, that is capable of forming two areas of radiation 311, 5 316 on an area of a patient’s skin 110. In system 300, two optical systems 310,315, instead of a single optical system 206 (Fig. 2), each generate a corresponding area of radiation 311,316 (e.g., areas of radiation 210,220). The radiation used to generate the lines may be from two sources 304,305 or a single divided source as described above with reference to FIG. 2. FIG. 4 is a top view of one example of an illumination system 400 appropriate for 10 formation of islands of treatment System 400 includes a plurality of sources 410 (e.g., a conventional laser diode emitting a line or circular spot of illumination), each having a corresponding optical system 415 to direct light onto an area of skin. The illustrated system may be used to create a square (or arbitrarily shaped) matrix of focal spots having islands of treatment within the area of skin. The term "island” as used here is defined to mean an area of 15 specified treatment separated from other areas of the specified treatment, such that areas between two or more areas receive radiation in an amount below that necessary to achieve the specified treatment. Islands of illumination are discussed in greater detail in U.S. Provioionai

PuVVOfcHon Wtt, a0O2/otCl357Ai

Patent Application 10/033,302, filodDooombor 27,200¼. by Anderson, entitled “Method and Apparatus for EMR Treatment” the subetanoo of whioh-io hojeby-iiieorporatcd by letemcti 20 For embodiments of photocosmetic devices according to the present invention that utilize high-power sources, management of waste heat from the sources is important for avoiding wounds and other injuries to the consumer. For example, in the case of a photocosmetic device that includes diode laser bars in the handpiece, up to 60% of the electrical energy may be dissipated in non-optical waste heat. In addition to the removal of 25 heat to avoid wounds, removal of heat may be important to prevent the source from overheating and shortening the lifetime of the source. FIG. 5 is a schematic cross-sectional side view of one embodiment of a head 500 according to aspects of the present invention. Head 500 includes an illumination system including an EMR source (e.g., diode laser bar 510) and an optical system 520. Head 500 may 30 be located in a housing to protect the optical components and to protect the operator of a photocosmetic device; the housing is omitted to avoid obfuscation. In FIG. 5, a diode laser bar 510 operates as the source of electromagnetic radiation (e.g., source 204 in FIG. 2) and may be used to form one or more areas of radiation (e.g., 210,220 in FIG. 2). Diode laser bar 510 is WO (C/O'Ul κ, !’CT/i!SU2/l 1.405 located between positive elscm.ide 5.15 and negative electrode 5J6. Eieotnides 5.15.. 51o Broviac electrical newer to diode lose; bar 53 0. and may be made of any suitable materiaj having good electrical conducdA'ity. Il some embodiments. electrodes 51 if 516 are in thermai comae: with diode laser lair 51 0. and have good thermal conductivity in transfer waste hea: 5) away from diode laser bar 510. Foj cxauipie. electrodes 51 5 and 5] 6 may be made oh aluminum or copper.

Optionally. waste hear from diode laser bar 510 may be transferred via electrode:; 515 and 51 6 to a heatsink 530. Heal sink 530 may be, made of any material having good thermal conductiwty to transfer waste hem away from diode bat 510. For example, heat sink 530 may '10 lie made oh aluminum or copper, ideal sink; 530 can be cooled by any appropriate, known method oh cooling including a stream oh ah. Optionally, cooling uia\' be enhanced tv adding fins (not shown) to heat sink 530. Alternatively, hea; sink 530 may be cooled by one or more oh the heat removal methods discussed below with reference to FIGs. 6-11. Also optionall y, a heat spreader 522 may be located between electrodes 515. 51b and heatsink 530, Heal 15 spreader 522 is thermally coupled to electrodes 515. 516 and hea· sink 530. Heat spreader 522 may be made oh any suitable material having good thermal conductivity; preferably heai spreader 522 is electrically insulative, Diamond and carbon fiber are wo examples oh materials suitable tor use as heat spreaders. in some embodiments, electrodes 515, 51b are eonriguted to be-heat sinks to conduct 20 waste heal away from diode laser bar 510. Accordingly, heat sinl; 530 and heat spreads;· 522 may be omitted. In such embodiments, electrodes 515 and 51 6 can be imide of any materially exhibiting good thermal and electrical conductivity. Optionally, one or more thermal sensors 524 (h,g. a thermo couple, a fnentiisior) may be used to monhor a temperature indicative oh a pahenris skin (cup, the temperature a; dm interface of an optical system 520 and electrode 5] p ) 25 for use in a cooling system as described below.

Diode laser bar 510 may lie secured to electrodes 515 and 516 using any method capable oh maintaining good elec hi cal con Lack between bar 51 (i and electrodes 5] 5,516. In embodiments where transfer ohvmste beat is desired, ant' suitable method of achieving good thermal and electrical contact may be used, in one embodiment, diode laser bar 51 Ci is 30 clamped bchveen inc two electrodes 515 and 51 6, A spring or oilier suitable device may be used to clamp diode laser bar 510 itrmJy between electrodes 515. 516. la another embodiment, diode laser bar 51 0 may also be glued in place with thenriai/ejecuical conductive epoxy. in another embodiment. diode laser bar 510 is soldered in place with a low--temperature solder On 211859 -16- or Au/Sn solder, etc.). Automated soldering may be achieved using an indium preform placed between diode laser bar 510 and electrodes 515 and 516, and applying heat using a die bonder to heat, compress, and then cool the solder and diode bar. Optionally, a spacer 525, made out of a material with high thermal and low electrical conductivity such as BeO, may be included 5 to provide electrical insulation between the electrodes 515 and 516.

According to some aspects of the present invention, optical system 520 couples light from diode laser bar 510 to a patient’s skin. Optical system 520 may be separated from diode laser bar 510 by an air gap 511. Exemplary optical systems 520 are described in greater detail below with reference to FIGs. 12 -15. In embodiments according some aspects of the present 10 invention, optical system 520 is configured to contact an area of a patient’s skin, and the optical surface 521 is cooled to provide cooling to the patient’s skin.

In some embodiments, cooling of diode laser bar 510 and optical system 520 are achieved using a single cooling system. For example, electrodes 515,516 may be thermally coupled to optical system 520 along dimensions A; accordingly, both diode laser bar 510 and 15 optical system 520 may be cooled by cooling the electrodes 515,516 directly or via cooling of a heat sink 530 that is thermally coupled to electrodes 515,516. Dimensions A are typically

<img img-format="tif" img-content="drawing" file="IL211859AD00021.tif" id="idf0001" />

PTCfmfrpr-2ft, 1999,Jhf* ”’bi"h if h?r?by by r?frrrnocr 20

Contact cooling of the skin may be used to protect a patient’s epidermis during delivery of high-fluence radiation to the skin, for example at wavelengths where melanin exhibits significant absorption. In some embodiments of head 500, optical system 520 includes a sapphire element configured to contact a patient’s skin due to its good optical transmissivity and thermal conductivity. As described above, optical system 520 may be cooled to remove 25 heat from the sapphire element during treatment. Optionally, prior to treatment with the photocosmetic device, a lotion that is transparent at the operative wavelength(s) may be applied on the skin. Preferably, the location is thermally conductive to enhance heat removal from the skin through optical surface 521. Preferably, the lotion also facilitates the gliding motion of the optical system 520 over the skin surface and has a refractive index match 30 between contact surface 520 and the skin 110 to provide efficient optical coupling of the radiation into the skin.

The lotion may also be used to show which skin areas have been treated by choosing a lotion with optical properties (e.g., color or reflectance) that are altered in response to WO U2/I)l’4J H- i'CT/uSUC/ i (.435 - j / - irradiation by an EMR source (g.g.. laser diode- 5J Ox not cxangnle. if tire lotion is initial]}- a giver coior. after irradiation it would become van spur uni lor u dhTerem eoiori. The ability to distinguish treated iron} untreated areas is particularly imnorumi fur treetaunts such as hair rsmovd that arc performed over a large surface area. 5 FIG. 5 also illustrates one, embodiment of a system ini' cooling, diode bar 51 () and optical system 520 vita heal sii.ih 530. hi FIG. 5. a heat absorbiLive liquid flows tlirough a thermal]}’ conductive conduit 540 that is thermally coupled to heatsink 530, For example, in one embodiment, water is used as the liquid. Optionally water may he provided by attaching a source chcold water, such as tap water: referring it' FIG. i. water ma}' be provided through a 10 handle 190 having suitable plumbing. Alternatively, a closed-circuit cooling loop having a heal exchanger ('not. shown) in remove heat from tire liquid: the heat exchanger ma}1 be located in handle 19D or base unit 12(1.

Referring again to FIG. 5, conduit 540 covers at least a pardon of ane or more surface:·, for example, surface 542 of heai sink 530. Λ single planar conduit mat’ cover the entirety of 15 one or more surfaces of heat sink 530. Alternatively. a plurality of conduits, each covering a portion of a surface heatsink 530. may be used. Alternatively. one or more conduits 540 may cover at least a portion of deep-odes 515. 516. Since cooling may·’ be applied to either heat sink 530. directly to electrodes 515. 516. a surface of a heatsink (e.g.; surface 542). a surf ace of an electrode, or any other appropriate surface from which heat is to be removed shall hereinafter 20 be referred to as a "cooling surface.7' While a cooling surface is ilia muted as an external surface, it. is io be understood hat. a cooling surface may· ba an internal surface, such as a surface exposed to a conduit tiriOtigli a heat sink or an eiectrode. FIG. 6A is a cross-sectional side view one example of one embodiment of a cooling system G00 that uses evaporative cooling, hi FIG. 6, a phase change liquid is sprayed from one 25 or more spray’jets 61 (J and 620 onto the cooling surface 623. The liquid can be any suitable evaporative liquid, such that the liquid evaporates in response to heat absorbed hum the cooling surface. In sonic embodiments, the liquid is a low-temperaiurehoiimg-tromt liquid, directed on the heat sink such that as the hquid boils in response to heat absorbed from the cooling surface 623. in some embodiments, the hquid is ietrafinoro ethane (1soiling, point - B0 26°C),, CO;- (boiling point -7fFC) although any other suitable liquids (e.g., freon or liquid nitrogen.) could also be used, in some embodiments, the liquid m atomized by spray jets 61 0 and 62 Q. ϋρι,ίυιιηΐίν, the liquid caii lie contained hi a cuntaincj· 62? located in Git bast unii or Llanelli:. Freieraobt. conuiiner 625 ή conveniently accessible by a use;· so at to lit user- replaceable. Λ conduil 626 is used το transtion the liquid 10 spray jets 61 &lt;' and 620. The. amoLini of cooian: flow is regulated by valve 627. which cun be conitOlied manually or 5 electrically using information regarding the aniouin of heat present in a sysiem (e.g.. syaLem 500 of FIG. 5j. For example, a senso; (e.g.. sensor 52-1 in FOG. 5) can be used το comrol a .feedbseh-ootiUOl.led solenoid m valve 627. ϋριίοηϋΠν. ouch spray jet 61 0 ;uid 620 can be a combination valve and spray id elnuinaLing the need for a separate valve 627.

Optionally, the cooling surface 625 ίτοιη winch evaporation occurs can be textured το 1 0 increase the surface area from which five .Liquid can be evaporated. Although triangular lertturing 615 of Lite evaporative surface is shown. any shape suitable for increasing surface ;usa may be implemented. The illustrated triangular texturing 615 may be a nail of a Ihteai grooves paltein. a cross-sectional view of a concentric circular groove pattern or any other appropriate groove pattern. Other texturing includes a plurality of projections (e.g, 15 sennspheres, cylinders, or pyramids projecting mom the cooling surface). Optionally, a collar 650 may lie used to surround spray .jets 610. 620 and heat sink 550 to contain the spray. A phase change liquid may also be used to cool the electronics 644 used to power and ha· control a photo cosmetic device. In particular, power field effect transistors (PETsj used to control the power of a photo cosmetic device generate a huge amount of heat. 20 Conventionally, power FETs have been cooled using a relatively large heat sink, and a fan to remove heat. Such systems tend to be large and heavy. Cooling systems according to the present invention provide an alternative method of cooling.

Optionally, a pordon of the phase change liquid conduit 626 that provides liquid to remove heal generated by Ute EMR source may be configured to hired a portion of die phase 25 change liquid to the spray jet 640. Spray jet 646 directs a portion of the phase change liquid onto a cooling surface (c.g.. a surface of a hea! sink 642). A heat sensor 646 (e.g.. a thermistor) may be used lc&gt; control the amount of liquid projected onto cooling surface. for example, by controlling a 'valve 656. FIG. 6E is a schematic of another embodiment of a cooling sysLcin 650 foi use in a 30 head titilizmg. a flowing, cooling liquid 605, in FIG. 6E. a high-pressure liquid is maintained in a container 655 (e.g.: tenufiuoroethane under 1 to 5 atmospheres of pressure) arid projected through a nozzle 660 onto a cooling surface 665. The projected liciuid 607 from noztde 660 may bn in Gte form of droplets or stream of liquid. In some embodiments, the liquid is protected as a suemn to overcome the pooi aerodynamic properties fi.e., high drag) of droplets, dim improving the heai removal properties of cooling system u5l). As described above, cooling surface 665 may be any material dial is a stood eondticiot ofheat fc.g.. copper oi silver) Pre.feraliix. cooi.mg surface oo5 i;.· selected lo have dimensions large enough such (hai die liquid 5 655 evaporaLes horn suri'ace 6b5 rather titan drips oil’said suri'ace l-’iojccicd liquid oil? Iroin nozzle bob .is projected onto cooling suri'ace ou5 to form a flowinu 1 iqiud i&gt;(j5 on cooling surface u65. Nozzle o60 and cooling surface o65 mtiv be selected such dial Li'ie liquid 6(7 projected from the .nozzle tbeJO .is a sti'eain of liquid the entire distance between the nozzle 660, and upon impmgnig surface o65 'forms a (lowing iicimd ai cooling 10 .surface ob? Aherunrj vely. nozzle 660 and cooling surface ooh max be selected such Inal die liquid 6(.17 projected from nozzle 66b may form a sjiray of'droplets between nozzle 666 and cooh.nu surface 665 before aggregating to form a f.lowuig liquid at cooling surface 665.

Because liquid projected from nozzle 660 is unde; high pressure, the flowing liquid on the cooling surface 665 flows across the cooling surface 665 at a relatively lugii speed V. 15 Forming, a flowing liquid 605 on cooling surface 665 may be used to provide increased beat removal from surface 665 compared to conventional cooling system m widch droplets fi.e., a uon-flowing liquid} are formed on cooling surface 665. For example, die improved beat removal max· result from the fact that droplets (as formed in a conventional system) are not formed in sufficient uumbei or density to achieve and maintain a selected amount of neat 20 removal. FIG. bC is a schematic of another embodiment of a cooling system 670 for use in a head, uffhzmg a cooling liquid 655 and haxniig a cooling chamber 684. Head 670 ims sidewalls 675 and a cover 686 having a port 682 lor entry of the liquid 655 from nozzle o60. Sidewall 675 and covei 686 form chamber 684. Ron 682 may also serve us an codiaust vent for evaporated cooling liquid. As indicated by arrows 686. sidewalls o75 and cover 680 redirect the liquid 655 from cover 6 8 0 h ac k to tl i e e o o.l.m g s ur f 'aces 6 6 5. The sidewall s 6 75 a re p 1 el e r a b 1 y selected to be thermally coupled to Lite cooling surface 665 such that liquid contacting the sidewalls 675 rnay remove beat from the cooling surface 665. Option ally, the side walls 675 may be integraled with coo Imp surface 665 such dial liquid contacting, the sidewall 675 may 36 remove heat. In some embodiments il may lie preferable that cover 680 has pour thermal couducti viiy and pool wetting characteristics for die cooling, liquid it) improve the likelihood that the cooling liquid will reach the cooling surface 665. For ex an i pi e. in some embodiments, cover 680 is made of'a polymer or organic glass. Allhough chamber U'0 112!I ’‘V J )», f'f ”"ί’ζt.JSiJL Ή.-; J5 - 20 - ΠΗ js jiiusmnec] as having sidewalk and :·. cover forming on ungh- inereijenveen the chamber met be formied iun'ing a cuntinuom catrvaiure.

Beccvl!se pori o!&gt;'2 operatcc as an exhaust veu· iron.·: evapormud liquid 655. 'the me;; S of ;jor; 582 detenn!ue.r the nrcssure maititamcc within chamber 624. in some emuoduncntc. non 682 it selected to have ;&gt; area 2 large enough» to prevent buci; raesrun- that simvi. the speed oh Lite liquid protected on the cochins sari bee bud: however. port bob may be select ad το be small ana unit (a; allow the cover 6S(! to redirect a signiucan'! porum: ohhqmd bach to the cooling surface bob. an! io maintain pressure in chamber aim to k.eep ilia Lililud from evaporating Luo quickly. For example. not! arsa S n.;sy be tipprcxurnate.ly one hundred to two hundred tunes as lares as. the area s oh numbs buG. hi some embodiments. the cooling liquid is, selected to be a liquid that has an boiling temnerature (i.e.. evaporation rernpenuure) oh less than -2b degrees Celsius for pressures less than or equal to atmospheric pressure. FIG. 6F) is a cross-sectional side view oh an embodiment a laser head 690 nulizing a cooling liquid in which tire exhaust vent 692 h; separated from the port ebb titrough which coo tint liquid enters chamber 696. Chamtrer 69b is bounded by a cooling surface 688. side walls 593. and a cover 695. Cooling sutiace 632 is thermally coupled to source 525. and optical system 520 vn coupling uiate:; (described in greater detail below), k cooling liquid tUOtn nozzle 698 is projected onto textured cooling surface 638. Λ portion of the cooling liquid which does not contact cooling surface 588 directly is redirected by side walls 69? and cover 095 as indicated In arrows 686.

Optionally, cover 695 mat’ he selected to have a resonant frequency to enhance its ability7 to redirect the liquid to cooling surface 688. huso, optionally a means to reduce the kinetic energy of die liquid (e.g., propeller, no! known j may bcyrhineed between hire nozzle 698 and the cooling surface 688 io cool the Iicftiid..

FiG. 7 is a cross-sectional side view oh an embodirneni of'a head 7QG for contacringt skin surface 11 0. Head 700has channels 730 and 751 in the electrodes 515, 516). Evaporative cooltng may occur along the bottom surface oh electrodes 5 J 5. 516 and along die. surface of channels 7.30. 731. thus increasing die cooling surface are;·. ofticad 7t)0. Preferably, the location uh channels 730 and 751 is nroxbnai.e diode laser bar 510. in one embodiment, channels 730. 731 are located along the iengih of the di tide laser bar 510 (i.e., Hong dircctlon-x). in some embodiments, channels 730. 731 me located proximate a spray jet 610 to receive spray. Channels 730 and 731 may have a rectangular cross section oj any other shape appropriate to improve cooling. Per example, onenings 740. 712 may be Fared tc» receive, spray W (,! IV/W _! ] i; /1.'.si's:Γ η ίΐΌΐυ sow iei 6)0 A: an absnumve to a single cuanne! extendius Aung the length of the diode bur AC. a serier. of chauneL· may be placed on one or both sides of diode laser oar Ait1 Honu rue ieruriii oi me diode laser oar. P'JCA [.· it, s emssmecdomil side- view of another embodirnam ode cooling sttstem 202. 5 In d JO- &amp;amp; a liquid η used ro ιηιηονν hea; iron; coming surmee 221 bu; im Liquid is no; used in spniv form. Jr· die lilusuatcd euempkirv ernhotiiment, liquid ilown oui ofreservcm 225 tiuo a pi Lirai.iTy oi'ciiauuri.1; 02 located vntiun nocking suiAa; 223. The .length of each of the niuraiiiy of channels 232 monels mtite direction of the iengtb of source 510. The liquid is biOLinh: .inin thermal comae; or physical contact with cooling surface 223. 0 Cpuonaliy.. die fiemid may bo a low-boiling point liquid Liitit evaporate;,? in response to heal absorbed Koni cooling surface G23. A vaive 233 may be used to control the liquid ewaiioraiicm; when siguifioaul cooling is desired, valve 233 ie opened and a pressure less than ea miibrj'Lin·; is applied to foe liquid to facilitate evaporation. The press me drop causes iite liquid to Doll, which.removes heat from cooling surface 223. Although channels S32 are 5 illustrated as eatendin a in a direction naralisl to the iernrth oi htstit source 510. orA ttjg channels are ihusuated as having rectangular cross sections, other shape of channels 832 aligned in one or more in various directions are possible and are witiiin the scope of lire present asoect of the invention. A. feedback signal can be derived front a thermal sensor fa.g., sensor 524 in TIG. 51 to control a solenoid in control valve 233. 2 TIG. 9 is a cross-sectional side view of another cyrorupkrry embodiment of a head 900 for contacting a ritin surface i 10. Head 900 has a cooling system having a cooling suidkce 923 that is brought into physical contact with a solid mass (also referred to as a phase change solid.'). At leas; e portion of the solid muss »34 changes pause in response, to heat absorbed from cooling surface 923. The phase change may be from a solid to liquid, or a solid to a gas. 5 In some sinbociiments, the solid has a melting temperature between apprmtimaisjy -I OC; and -HOC: bowevey .in some applications, materials undergoing a pirorov change outside this range.. mu'ticuiarly below Irik range, may be utilized.

In some embodiment;.·, the solid mass is conveniently located within a device handpiece fug. bcuxiniecr 170 In FIG. 1; so as to he user jupkiceabie. in some embodiments. Lbc solid j mass is contained m an insulating sleeve to avoid contact with user's hands. and/or to minimize rocking do io euporore to room temperature. In the illustrated emoodtinent. temperature control cm be achieved by tiring a manually or electrically conirolled solenoid or a spring S35 to brine the solid mass in and out of contact with coolinu surface 923. in one embodiment of the phase-change cooling, system. hie phase-change solid is ice. hi this ci π bobu i leur. a user conid keep one oi" more fiozen ice blocks .in tushie; freezei When the user wains to operate hie plwtocosmetic device, a frozen tee bloc); coni ci be inserted in the device In anothei embodiment. dr\ ice. which has a sublimation poun sigitifican!.iv iower than 5 hie inclLiar point of ice. could also lie used io achieve greater cooling capacity It is to lie understood that the ice bi ooh .imp contain water, or waici with one or more additives 1.0 meat a user's shin.

In some embodiments. commeiciaiiy available organic compounds t'e.g.. paraffin wav-based mai.erta!s. fatly nods, cross-linked polyethyieiies) may he used as phase change '1 (J solids. Examples of appropriate paraffin wax materials include lff25 produced by kubiftienn Cimbrl. ET25 has a melting poun of27.7IJC. 'in othei embodiments, greases .havine melting points in the 20-?5c,C range may be used as the phase change solid, in another embodimeng Ga o r a Ga all ep ' (t. g.. G; i /in. G ad π/S n. or Ga/J n /S n CEi i j. w .1 rich rs tai1 or ed to exhi bi! a met mi g p o i j l! m the J5-&gt;5U°C range, rs used as the solid mass, hi a Ga/in alloy, the .relatively high thermal 1 5 conductivity of Gs GO.6 WmmKp and .In (8J .6 VGGnGGj would help to spread the waste heal throughout the allov volume. A disposable phase-change cooler cartridge may be used to contain the phase-change solid: for example, die phase change solid may be used either once and then discarded or wav be rechargeable hue.. resolidified one or more timesp EIG. hi Is an embodiment of a head .1000 having a cooling system m which an 20 endothermic chemical reactions is used for cooling. Examples of appropriate reactions are ammonium nitrate Ο'Ε-ΕΝΟρ or amrnomum chloride OGHyGj) introduced into water causing an endothermic reaction. For example, if 200 ml of water is mixed with 20b g of ammonium nitrate, a temperature of approximately -5°C can be achieved, flint; allowing absorption of a heal. 5 hi FIG. 10. an endothermic reaction is contained wilhin a reaction chamber 1050. and tit e r cacti 0.11 cl i am b er i s ft t arm til) v coupled 1 o co oh.n g s urine e ICG?. In some erri b o ci in i on ts. reaction chamber 1050 could be coupled to (he cooling surface 102? via a material having a good thermal conchrcbvitv, In some embodiments, the mechanism .includes a thin membrane 1051 separating, a first chamber of water and aiiollici chamber of ammonium chloride. In some 30 embodiments, membra tie 1 05 I can be broken to inmate the reaction and the reaction chamber could be a disposable container. for example, the user could apply force (o a .flexible plastic reaction chamber to break' a membrane and thereby prod nee a reservoir of cold kiepud prior t.o turning, on Lhe device. Alternatively, (.lie membrane may be removed oi otherwise manipulated /’Cri7ii.s(;g/K.-Xj5 ,,π 2ί· I. CrommaeUCJliai 3KU Ά'-V (U αΏ ΟΙΠΟΟηηηΟΓίί οί L. device ΤΙ Ob bavint’ ci auuduf 1 110 ant? an exhuma vtit 1120, hi FIG. 11, a liquid or gas entering exhuuR! vent 122 5 i«, directed u- an area of slidn J 130 so a;· κ pre or pot; i coni Llie area of skin 1 ISO during ueaunent. For example, a norlion o: the same tooling luunc mat is .sprayed onio cooling muhaee 130 or dm gas restihing hmm bio cvaporauon of ihe licuiid may emei conduit I I ID mid be sprayed onio skin by void 1120. The porLion ot f.iqtiui may bo. condensed evaporate or shunA excess. ikiuich if. as described above, tap water war utilized fur cooling for an ice 10 uhase-chimge cooler as described with reference to FIG. 9u u may be possible io divert a nortion uflbc water EUterihc warn war used ίο cool tbr w.ioutig sendee 522. hi some embocmnsnis. the nrsssure from a gas resulting froin a phase change cooling system may be used to drive a lotion onto apadsnlT sihn, Although the illustrated embodiment .illustrates diverting a ponton of tlie cooling liquid afier ii is used to cool surface 130. in some is embodiments a portion oi the cooling hcjuic may re directly nrojeetec onto tiie skin 'WiLnour being used re coo! the cooling surface 530.

Cmhonally. one or mure additives may be added to dee Iiquid via conduit 1112 (e.g.. to form a cooling lotion; prior to spratdug on die skin. The additives could be stored in a cartridge (not shown) in the handpiece or base. unit. In some embodiments, to achieve a lb Aliower effect,all of the wafer exiting the heatsink could he exhausted onto the sldn. As an thternative m using, the evaporative liquid, an alternative source of gas. liquid or lotion (he., ujciependen: of km cooling system) could be stored in a eariridge in the handpiece or the base unii. and dispensed while the handpiece is moved across the shrill surface.

To avoid obfuscation, the following exemplary embodiments ofopii cal systems tor List·

Id with aspects of the uresent invention will he described with reference to a single electromagnetic radiation source; however as described above, one oi more sources may be used to form one or more areas of radiation, Infbe exemplary opLical systems described below, each of the surfaces having optica) power has optical power along a fust nun; (e.g.. the ymxbq and zero optical power along an axis normal to die first axis (i.e.. the maxis). That is, 0 fue lenses; ate cylindrical. Although the enibudlments discussed below have planar or cylindrical curvatures,, omer refractive o? diffractive optical designs are 'within the scope of die present invention. Y\'( ) ι?^1’ i&lt;T/US&lt;j2'b^35 1 21 ι r r·) ρι,γ;^ fit ,'ΠΉ“ OZ ZLIZ CIUί?ί'CiLUJ2ΐ]Ί 0; Li S'llLlit' ~ 1 ^ΊΊ-ΓΓ. (JOLILILL1 s\’si.em 1200 appronruiLe lor use with photoeosuietic device:.. accerdme u. some 0:0:1020: of the prcsew invention Optical system 12(1(/ inciudes tm element 1210 hx uansmiumg light from aii eleetiOniaguetic radiation sOtirct- 1220 pug.. t. iaser diode nan to t. patienhs skin I 10. 5 Fieruent 121(.1 ha:, at mptt surface 1211 anti an outtuu ::1.11:.1020 1213 couflgured 1.0 ounmai a patiamh: slim suriace

Source 1220 is closely coupled in inrun surface 121.'! of ihe clewem 12.1 0 (o.o.. 1 cam senuraUGnj; close coupimg enables 0 largo fraction of light along 0 Ji.igdy divergent ή; an axis oh a laser diode source to ho trans milled to u patientx Am in some embodiments;. input surface 10 1211 has an undreflecuve (APp coming.

As described above, demean. 1210 h; made of a maiedal subsmntially Transparent at the operative wavelangdh, and preferably made oh a malarial Li mil is dremmlly conductive 1:0 remove heat from a treated sidn surface (mg... sapphire), In some embodiments. the lateral sides 1213 oh dement 1210 are coated with a material reflective at the operative wavelength 15 (s.g.. copper, silver or gold). Additionally., the space 1221. between source 1220 mid input surface 121 I, may be surrounded with a reflective material 10 increase hie strength oh light incident on stt.ti.hce 1211.

In one embodiment, optical element 121 0 is a. sapphire plate hue.. surfaces 1211 and 1212 are nlanat. mid have 110 optical power). In another embodiment oh optical system 1200. 20 optical surface 1.212 ham a cyhridrical curvature (at shown in Fig. 12) and is selected to converge light incident on surface 1212. For example, in one smbodiment. surface 1212 has a radius of curvature oh approximately 3 mm. This system can be used to treat sldn structures that require high treatment iiueiice. For example., the lens system oh FIG. 13 car· be used to target stern cells ofluiir follicle. sebaceous gland, inmainnindiixilurri. vascular tissue, tattoos,, or 25 co hag sir.

In sonic embodiments, lateral surfaces 1213 have a length L approximately in the range 5- oh mm. and a cross-sect 10 nul width 1'measured m tire /-direction) and height (measured in die y-dnecLion) are selecied 1.0 collect light from source 1220. For example., for a source comprised oh two I cm diode laser bats; close-coupled to element 1210. the cross-secdorim 30 width is selected no be 2 cm. and the cross-sectional height is 2 cm, 2x illustrated, ontical element 1210 transmits a portion oh high: from source 1220 directly 10 suidhoe 1212 with no reflections on lateral surfaces 1213 ('e.tx exemplary ray 1230; and a nortion ohliehi from source 1220 is reflected from lateral surfaces 1213 uxor to reachhm -25- 211859 surface 1212 (e.g., exemplary ray 1232). An element, such as element 1210, that directs a portion of light from source to surface using total internal reflection is also referred herein to as a “waveguide.”

Optionally, a tip reflector 1222 may be added to redirect light scattered out of the skin 5 back into the skin (referred to as photon recycling). For wavelengths in the near-IR, between 40% and 80% of light incident on the skin surface is scattered out of the skin; as one of ordinary skill would understand the amount of scattering is partially dependant on skin pigmentation. By redirecting light scattered out of the skin back toward the skin using tip reflector 1222, the effective fluence provided by system 1200 can be increased by more than a 10 factor of two. In one embodiment, tip reflectors 1222 extend a total of 3 mm from the upper lateral surface and lower lateral surface of element 1210. In some embodiments, tip reflectors 1222 have a copper, gold or silver coating to reflect light back toward the skin. A reflective coating may be applied to any non-transmissive surfaces of the device that are exposed to the reflected/scattered light from the skin. As one of ordinary skill in the art 15 would understand, the location and efficacy of these surfaces is dependent on the chosen

<img img-format="tif" img-content="drawing" file="IL211859AD00022.tif" id="idf0002" />

4999; the subctanoo-of both1 is hereby incorporated by roforonoa. FIG. 12B is a ray trace of one 20 example of an embodiment of such an optical system 1200 having a source 1220 and an element 1210 as illustrated in FIG. 12A. FIG. 13 is a side view of one example of an embodiment of a two-element cylindrical optical system 1300 appropriate for use with photocosmetic devices according to some aspects of the present invention, in which a collimator 1310 is used in conjunction with element 1210. 25 In FIG. 13, a fast-axis collimator 1310 is very closely coupled to optical source 1220 (e.g., 0.09 mm). In one embodiment, collimator 1310 has a length 1.5 mm, a planar input surface 1311, and an output surface 1312 having a curvature of to collimate the output of collimator 1310, Element 1210 is located 0.1mm from output surface 1312. Collimator 1310 produces a beam of radiation that is substantially collimated in the y-dimension at output surface 1312. For 30 example, collimator 1310 may be a lens module number S-TIH53 produced by Limo Gmbh of Dortmund, Germany.

The collimated beam is projected onto input surface 1211 of optical element 1210. As described above, element 1210 may be a plate or may be weakly converging (e.g., output -26- surface .1 2 J 2 may iiave a radius of curvature equal to 3 mm) to compensaLe for scattenfit· m die skin Tins system can be used io rrsat slriu sirucmies dim require high ti satin tun fiuence dor example. die Jens system of'FIG. I3A can ds used to Large! stem ceils oJ’lian follicle, sebaceous aland, i.n.i nun id nclii mliitu. vascular, tattoo, or collagen .FIG 1 5B is ;.j. ra\ trace of one example

5 of an embodiment of such tm optical system !500 Having a source 1220 and a collimator 1310 and an cleme.ni 12 lit as dliistimed in FIG. .S3A

FlG 14 A a. a side mew of another example of an embodiment of a iwo-eiemeitl eviliidrjcal optical .system 1400 apjnopriaie for use vvjili piioioeosmeiu devices according to some aspects of die present invention. In optica! system 1400. die fast-axis collimator 13 10 of JO F.1G i?A is used in conjunction with an element 1420 located 0 1 mm from surface J312 of collimator 1.3 10 to project light from source 1220. Element I 420 Hasan input surface 1421 with a curvature of 1 .min. a planat output surface i 422. and a length of 1 mm System M00 focuses light at approximately 1 nun from surface 1422 fi.e.. J mm below the skin surface for embodiments in winch surface 1422 is configured it' be in contact with a patieiiks skin), In one .15 embodiment, die heights of elements 1310 and 1420 are selected to be 1.5 mm. in some embodiments, lens 1420 is made of sapphire, Fins system can be used to target shallow skin structures that require high treatment fiuence. For example. die lens system of E1G. 14A can be used to target psoriasis, sebaceous glands, hair sltaiis. or iiair stem celts. _FJG. J 4B is a ray trace of one example of an embodiment of such an optical system 1400 having a source 1220 and a 20 coliijnaior 15,10 and an element J 42b as illustrated in FIG, .'MA.. F.1G. 15A is a side view of another example of a embodiment of a two-element cylindrical optical system 1500 appropriate for use with p'noioeosmedc devices according to sonic aspects of the present invention. FIG. 15A. illustrates an optical system 1500 dun can be used, for example, to focus, die diode bgln deeper than die optical system J400 in rig. 14 .For \5 example, opdcal system 15(f) may focus die diode i.ighi approximately 2 mm below die stkm surface (i.e.. 2 mm iron] surface .1522) to target deep structures fug. iiair bulb, deeper ifiood vessels, subcutaneous fat) in the skim

Svstem I 500 is a two-element symmetrica! lens system to project iigth from a source J220. A first clement 15.1() is located approximately 1.4 mm from source 122() and lias a input 50 surface 151 ! dial is planar and an output surface .15 12 having, curvature of 2.5 nun: accordingly, lens 15.1(' qnasi-eollimaics the iighl from light source 1522. A second lens 1520 havmg an input surface 1521 with a curvature of 2.5 mm and apiaitar output surface 1522; accordingly lens 1 522 focuses the quasi-collimated light 2 rum below the shin surface in the \Λ·( ! IjVWJJ 1 )ι. run substantially uniform i'i.e.. “fim ιορ'Ί spatial optical inteusip proihe a': outon* surface i 522. Tiie- iku lop inteiisnv proiik· is subsurntmlh derernnned by spherical anarrutitm m ti nkuic utmsveuir ic the cylindrical surface 1522. in some einbodhnems. lenses 2 5.10 mid 1520 ait 5 made η sappinre. rJG i of: is a ray trxt· oi Of.it eaanahe oi an ernbodirrtent of,such an optical sysren ! 500 inn,dug a source 1220 and an eienien· 1510 and a? element 1520 as il 1 ustrateb hi FIG. 15 a. FIG. 1 uA is a schematic illustration o: an exemplary embodiment: of ahead 1600 for oer.fonnmig pbotoccyarteLic procedures, hlead 1000 is hkisuated withou: a bousing, to facilitate J 0 description. Am described above head 1 660 wild be moved along an area oi’a patient's skin, rypisally in direction 2 662 or direction 1604.

Flead 1600 includes an optical system 206 to transmit light from an EivlR source 1630. Electrodes 1620 activate an ElvfR. source 1630, Am electric insulator 1650 may be located between electrodes 1620 to prevent electrical contact between electrodes i 620 Electrodes lr&gt; I o20 may oe tancred to reuuee me region cn contacL wiim a naticnt s stem. FIG. 1 6B is a schematic illustration of an exemplary embodiment oi' a head 1 650’ for performing photocosmetic procedures that also provides the capability to perform muscle sthuuiation during a pbotoeosmstic procedure. Electrical muscle strmtdarion is a welkltnown physical therapy procedure that may enhance the efficacy of some phoiocosmsric procedures. 20 For exanapie. electrical muscle sthuulation may be used to improve foe efficacy of v,nmJ.de treatment or cellulite treatment.

In one ernbodtrnenf two electrodes 161(1 for delivering the electrical stimulation are located on opposite sides of optical system 206. on ε poition of head 16()0 that' is designed to he in eontaci with a patienf s skm during a ph oh icosmeLic treatment (he... during foe delivery of 25 EMR by system 206p One electrode 1610 contacts an urea of a patient’s skin prior to optical system .206 and the other electrode 1610 contacts an area of skin after optical system 206. A thermally conductive electric insulator 1615 (e.g.. made of BeO or diamond or other suitable materia!) can lie used 'to proverb electrical eoniaei between electrodes 1610 whjeb provide electrical ahrmuauoc, and electrodes 1620 which activate EMIR source 1630. Am 30 electric insulator 1 656 may be located berween electrodes 162() to preverh electrical cuntaet between electrodes 1626.

By applying a constant for pulsed) electrical current tc&gt; a patient’s sltiii via electrodes 1 61 0 while the handpiece is scanned across foe-* skin surface, simultaneous muscle stimulation

Gh ana electromagnetic treatment sail be achieved In some embodiments. electrodes inav provide :adm ireoucnc\ iFTi cunent tin ougb skm Aiiernmi veh. cieewodes. ielbinax piovide a fjC eunem or a microwave bold i.n some embodiments. skin can be scanned with a i&lt;_F eurreut 01 microwave held io seleeiivek heal a portion of skm io be treated with 2MR radiation 5 /'reheating skin may enable die power of the Etvlf source 1630 io L&gt;e? decreased FIG ϊ "Ά is a schematic i 1 (ustration of'one example okone embodiment ok,an apparatus according lo some, aspects of the invention. which deteimines contact between an optical elemoni I 7(G je.g.. clement 12 I b okk'lCi. .121 and the surface oka patient's skm 1721. 'ko provide eve saietv. in some embodiments okphotocosmetie, devices, a contact sensor is used to 4 ft enable an electromagnetic treatment source (e.g.. source 510 of FIG 5 i to activate or.siy when the device is in contact with a patient's skin. i.n FIG I7A. an rluimination source 1 702 (e.g.. diode laser ot LED. separate from the treamieni source) is mounted a few millimeters (e.g.. 5 mm) away from element 1704, and directed toward skm suriace 1 7Q]. Optionally;, illumination source 1 702 may be mounted to 3 5 direct light toward skm surface 1701 through element 1704. Source 1702 may emit radiation ;n the same wavelength as the treatment source 510 bin piekerably emus radiation at a different wavelength than the treatment source 5 10. A detector J 712 is located to detect bgilt from the rhumiriamm source dm! is reflected or scattered from the surface of skin 1 70 3. Optionally, a kilter 1 70X may be added i.o selectively transmit light from source 1722, and to eliminate 20 wavelengths okhght corresponding to the ireatmeni source 53 0 and any other extraneous wavelengths of light. in the case ok pool or no skin contact, a relatively large amount ok radiation baht from source 1 702 would reflect or scatter from the skin surface 1703 through the optical system 1 70-4 to detector I 712. As iflustrated in FIG. J 7B. when element 1704 is in good contact with die 75 skin surface 3 721. scattering and absorption nt the sixin would attenuate light from the ill umma bon source 1702. and a relatively small amouui of radiation would reach detector 1712. Thus, by using an eleettome means (e.g.. a comparator) to measure the output ok detector 3 7.12. and selecting, an appropriate threshold, the treatirient source can be configured to activate only when the output of detector .1712 is below the threshold. Optionally, source j 702 andAii 20 deieclot .174 2, imp- tie located in a base unit and one or mote optical fibers may he used io couple light from (he handpiece Ί.Ό die source oi detector.

In anolher embodiment, detector 1712 delects hulk born die treatment source to determine contact between element 1724 and skin surface 1721. la such a svslem. hahi from I’CV'USie' i, ,.135 source 5 2 1’ it scrmered and I'sfiecmh by sun. suriact. 1 7()1 through cicrnern 1 7 (.A to detector L'12. A radiation h.liei 17(.)7 .may seiecuvep uruxmir tiii: scaucred and reflected radimion m, cietccm; J "1.2. L this erubodiment. di? uemmem sourer ?Hj it mummined a; a low -power eyt-said murk- uuti] Arm comae' with hit skin surfaer AAl a. nxide. Whou ftieiv it no or poor ? comae; bciwcen sinn surface 1701 and clemen: j AA. tm output of domain; 1 712 is relativelx' low. However. whan element 1707 u in good cornua; witi; me slim surface 1701. the output of detcemr j 701 .in relauvciy high. Thug. treatment source 51 () would bo comtgurcd to fire oniy what' me output of tietecmi 1712 was above a threshold icvcl.

Alternative!y, instead of source 1702 and detector 1712. a standard option] contact 1 (i detector that is in an optical computer ay’SLcm mouse can be used, for example. the optical cotmict system in a Cordbess Ivl oueemanTA': produced by Logitech of Fremont. CA.

As ;m alternative to die optical methods of determining contact, electrical methods can be used to detect contact between ciomsn; 1707 mid a paticnf s skin .1 701. FIG. 1 7C is a cross-sectional w ow of handpiece having two electrical contacts located m a portion of Lite, handpiece 15 such drat when element 1707 is in contact with skin 1701, contacts 1 720 are also .in contact wild Ann 1701. Contact can be determined by measuring resistance (or capacitance) between the contacts. Treatment source 510 would be activated when resistance (or canacitancs) between contacts J 720 was within u selected range (he., a range typical for skin). In another embodiment, contacts I 720 may he magnetic sensors to detect contact with skin surface 1701. 20 to another alternative embodiment, contacts may·' be mechanical sensors to delect, contact with sliin surface 1 701. For example, one or more spring-loaded pins or burtons may be located such that when the clement 1707 is in contact with the shun the An or bution is depressed.

Multiple sensors, pins, buttons, or other mechanical sensors located around tire perimeter of element I 704 could he used io help ensure dial the entire uurface of eJemerri 1707 face was in 25 good contact with slum Alternatively, contacts 1 720 can be conventional load cells to determine comae; with sidu surface 1 701. Contacts, sensors, pins, buttons, or other mechanical sensors thui allow for the measurement of resistance or capacitance; may·' be preferred to ensure that die contact to warn stun and not with another surface, for example, 2 mirror or countertop. hi imofner embodiment, one or more temperature censors arc nsec· to determine contact 30 wild) skuj surface 1701. .7 typical sitin surface temperature is in the 30-32°C range: accordingly temperature sensors could be located near a surface of the device which contacts a patient A skin, and coumci could be determined to occur when the measured temperatures were 211859 -30- within a selected range (e.g., 23-27°C). Alternatively, contact could be determined to have occurred when the temperature sensors measured a temperature versus time slope indicative of contact. In still another embodiment, where lotion is to be dispensed on the skin (described above with reference to FIG. 11), skin contact could be detected by using a pressure sensor within spray jet 1120. The pressure sensor would measure the pressure needed to eject the lotion onto the skin. Only when the handpiece was in good contact with the skin would relatively high pressure be provided to dispense the lotion. Petetxfc UwkAU* TUbRorttom.

Contact sensor designs are described in greater detail in U.S. Application 09/847,013} filed-April 30,2001? entitled “Contact Detecting Method and Apparatus for 15 15 20 20 25 25 an Optical Radiation Handpiece/ the.6ubetanoo of whietwa heroby incorporated by reference. A handpiece is preferably scanned across a patient’s skin within a specified speed range. If the handpiece is moved too slowly (typical minimum speed limit would be between 5 and 25 mm/s depending on the application), the light dosage will be too high and undesired thermal damage may result. Correspondingly, if the handpiece is moved too quickly (typically the maximum speed limit would be between 50 and 500 mm/s depending on the application), the light dosage will be too low to achieve treatment efficacy. Thus, only when the handpiece is scanned within this speed range does the handpiece emit electromagnetic radiation for treatment. An exemplary speed range for operation of a photocosmetic hand piece for hair removal / growth delay is 10 - 500 mm/s which corresponds to the speed ranges with which is approximately equal to the speed which a typical razors passes over their skin. FIG. 18A is a cutaway side view of one embodiment of a handpiece 1800 having a motion sensor 1820 for determining handpiece speed. Motion sensor 1820 may be used to prevent injury to skin 1810 by providing feedback control to a treatment source (e.g., source 510 in FIG. 2), such that if the handpiece remains motionless or if the movement across the skin 1810 is too slow or too fast, the intensity of source maybe decreased or increased, respectively, or the source may be turned off. Optionally, the treatment source may be disabled instead of reduced in power. In one embodiment, a wheel 1821 is positioned to make physical contact with skin 1810, such that the wheel rotates as handpiece 1800 is moved relative the skin 1810, and handpiece speed can be determined.

Handpiece 1800 may be configured to inform the operator when the handpiece speed is inside or outside of an acceptable speed range. For example, a tactile indicator (e.g., a vibrator) could be configured to vibrate the handpiece, when the handpiece speed is inside or - /· I - nuiside the desired r:.ifi£ze AJternab veh. a visual uniicuioi list1-! je.g, au LEI..),! tu ;m audio indreaioi 1 e.m. beepen ma&gt; be user! to inform the operator that hue handjueee speed us inside oi outside ibc desned range. In some embodiments, muiuple indicator;; 18(,6 (e.g,. l.,EI9s iiaviup dtffemni colors. 01 different sound indicaiors; rna\ lie- used io mionn die operaioi tlmn 5 tbe handpiece speed is cither too high os loo low or is within die desired range. i'-'ldi tub is a schemai ic of one example of an embodiment of a modem sense, 1 svsiem havin'; til Icasi one wheel 182 I Preferably a second wheel i 82 i a, added and located on an opposite side of'optical svsimm 206 io ensure that (he enure skin eoni.ucimg surface of die optical svsiem 206 moves at a rare of speed within die acceptable range to provide uni form

If) idiuninaiK.ili cm a patient :. skin. di one. embodiment, each external wheel ! 82 I is coupled It) a corresponding auxiliary aliened wheel 1822 having peri'orations around us perimeter A source I Sod projects fight mi Lbe direction of a corresponding dsLeoiot 1832 so that as a wheel J 821 rotates, the perforations of auxiliary wheel 1822 alternaiefv transmil and block lighi projected b\ source .)830: as a 1 5 result, as handpiece 1 800 (visible mi PIG. ISA} moves across a patient ks skm. cisLect.ors J £32 produce a signal having a churn of pulses.

One of ordinary skiJI would understand that die speed of the handpiece across a patient's skin is proportional to die rate at winch the pulses occur. A controller .1 834 correlates the pulse rate to the handpiece speed. 'The above-described perforated auxiliary wheel design is 20 similar to a standard computer system mouse design. Tor example, a mouse wheel m the 3 Bth Wheel Mouse produced by Dogbee Corporation of Fremont, CA. which is just one example of an apparatus to measure handpiece speed, many other appaiamis are possible and are witLiin the scope of this aspect of hie invention. For example in an alternative embodiment. a simple electric rnoior is coupled to wheel .1821 to generate a 'voltage that is proportional to handpiece 25 speed. FIG. 1 9 illustrate:; another optica) apparatus J 9()() having a motion sensor lot deierrnimng handpiece speed. In apparatus 1900. a light source J 902 hyp. an mfrared LED pis coupled into the transinilting fiber 1904. A light deleelot 1 9'IO (e.g.. tin inexpensive CCD camera o; a diode sensor) is coupled to Lite end of a receiving Tibet B-’Oo. bi apparatus .1 900. the 10 ends of the transmitting .fiber 1904 anti receiving libei I 9()6 are coupled together to form a single fiber end 5 909 huil is in contact with the skin 1908 A portion of light ptrojected onto skiji surface 1.908 by truiisn11tiing, Tibet OHM through fiber end 11909 is reflected or scattered TiOin the slun surface 1 9()8 and .received by receiving fiber 1906 through liber end 1909 and detected b\ deteetoi l°lb. because the skin surface h-hJk has a seim-penodic structure (e.g.. the c'lisinnees between smuhrr tissues such as lia.u iodide. vessels elands are alt)lost constant structure; deiectoi output ts modulated at a rate dependent on the handpiece speed One of orthnan skill would Luideistand that handpiece speed can bt calculated from die modulated 5 detector output. CipiiouaJIv. a second transmitting fibei I 0)5 and recet vine fibei 1907 coupled loucdict through nbet end .191 1 imp be added, so that (he Tarsi and second irausrmtri.iig fibeb reeeivnm fiber pair;; tire located on opposite sides of'optical system 20b to ensure dial the entire skm-ooritacuug surface of optical system 2bo moves, across the skm with m the acceptable range to provide uniform illumination on ;i patient s skm 1 0 in svstein 190ft. each transmitting fiber j bpa. | bps js conpied to a corresponding teceivinu, fitacr J9(/6, 1907; alternatively, n transmitting, flier and corresponding receiving fiber., litas contact the skm at distinct, separated pomts fi.e.. the transmitting liber and corresponding receiving Tibet are not coupled tit flic skin). in such an embodimenr die ends of die libers contactma the skm may be separated by tiny distance at winch photons scattered by tissue layers ! 5 can be reliably detected, in stick embodiments, die upper bound on Ihe fiber spacing occurs when the light coupled into receiving fiber is reduced to a point at winch tlie amount of scattered photons generates a signal that is too small to be accurately delected.

Although optical apparatuses for measuring handpiece speed have been described, .it should be understood dial other methods of speed measurement are with die scope of dds aspect 20 of die invention. For eaampJe. electromagnet'iL apparatuses that measure handpiece speed by recording die time dependence of electrical ('capacitance and resistance ^/magnetic properties of die slmn as the handpiece is moved relative the skm. Alientativek . tine frequency spectrum or amplitude of sound emitted while an object is dragged across die sdan surface can be measured and die resi.ihi.ng information used to calculate speed because die acoustic spectrum is 25 dependent on speed. Anothci alternative is to use thermal sensors to measure handpiece, speed, by using two sensors separated bv a distance along the direction .in which the handpiece is moved along the skin fe.g.. one before the optica! system and one after) In such embodiments. a First sensor mom tors die tetnpen.iritre of untreated shim which .is independent o.f handpiece speed, and a second sensor monitors Lite post-irradiation skin temperatmc; Lite slower die 20 handpiece speed, die higher die iiuence delivered io a given area of the skin, wliich results .in a higiter skin temperature measured by the second detector. Therefore, the speed can be calculated based on die temperature difference between die two sensors WO 02/094116 211859 -33-

An alternative system to measure handpiece speed using thermal characteristics uses a heat source (e,g. the treatment source or another means of heating an area of skin) located a selected distance from a thermal sensor along the direction in which the handpiece is moved along the skin. In such embodiments, the handpiece speed can be determined from the temperature measured by the thermal sensor. For a low handpiece speed, the heat would have sufficient time to propagate through the skin from the heat source to the thermal sensor; however, at high speed the heat would not have time to reach the thermal sensor. Thus, a high skin temperature measured by the thermal sensor would indicate low speed whereas a low skin temperature would indicate high speed.

In an alternative embodiment of a speed sensor, an optical apparatus is used to measure handpiece speed using Doppler-shift techniques. In such a system, the wavelength of light from a probe laser is projected onto the skin and the speed is determined by shifted frequency of a reflected portion of the light.

In any of the above embodiments, a speed sensor may be used in conjunction with a contact sensor (e.g., a contact sensor as described above with reference to FIGs. 17A-17C). In one embodiment of a handpiece, both contact and speed are determined by the same component. For example, an optical-mouse-type sensor such as is used on a conventional computer optical mouse may be used to determine both contact and speed. In such a system, a CCD (or CMOS) array sensor is used to continuously image the skin surface. By tracking the speed of a particular set of skin features as described above, the handpiece speed can be measured and because the strength of the optical signal received by the array sensor increases upon contact with the skin, contact can be determined by monitoring signal strength. Additionally, an optical sensor such as a CCD or CMOS device may be used to detect and measure skin pigmentation level or skin type based on the light that is reflected back from the skin; a treatment may be varied according to pigmentation level or skin type.

In some embodiments of the present invention, a motion sensor is used in conjunction with a feedback loop or look-up table to control the radiation source output. For example, the emitted laser power can be increased in proportion to the handpiece speed according to a lookup table. In this way, a fixed skin temperature can be maintained at a selected depth (i.e., by maintaining a constant flux at the skin surface) despite the fact that a handpiece is moved at a range of handpiece speeds. The power used to achieve a given skin temperature at a specified

He. 6,4--75 depth is described in greater detail in U.S. Pat. ApplioationNo. 09/034,981, which wa» incorporated by reference herein above. Alternatively, the post-treatment skin temperature may u. 0 iU/! IΙι !’CT''IJSI!2 Ίι-435 A nioniwrec. and e it;^dbi.Lc:i: Juop used to rnaiuuur sunsLajuialiy coutacui.t fiLienee ai iua- sum surface by varying die laser oumut power. Sitm temperature car tv- monhored pa- usma either convunttona: uienr’al sensuri or a non-cuntac: mic-mirared optical sensor. The above motion .sensors arc cx.cmpkiry: morion sensinr can bo achieved m orner .mean:; such as sound te.g.. 5 uetng Doppler inforuiatiojij.

Although rile above embodimeiiu·; were discussed with reference· to a svstem moihwrine hancipisce speed as moved ny an operator the nandpiece could be mourned on a Translation singe ro move hie handpiece at controhed. predetermined speed across the akin surface. In such an en food uncut the apparatus would be positioned relative the p alien: torrent 10 a selected area of skm and the translation stage could be moved to a sub sequent area as necessary. FIG. 20 is a schematic of one example of one embodiment. of a handpiece 2OO0 iliustrathig some aspects of a selDcontainsd photoeosmetic. device. Handpiece 2000 includes an optical source 2055. a power .supply 2047, an optical system 2044, a coohng system 204-6. 15 and a sueed and/or contact sere;or 2048. The dsA-ice is shown in contact with an arse of shin 2(i43. Optica! system 2044 couples light from light source 2055 into the skin meatmen* area 2043.

Cooling system 204-6 can be a phase-change cooler or any other appropriate cooling system. In some embodiments cooling system 2045 is in good thermal contact with the 10 heatsink 2045 (or electrodes or other cooling surface. not shown). A power supply 2047 (e.g.. battery or capacitor) supplies electrical current io optical source 2055. Contact and/or speed sensor 21()40 ensures safe and effective ireauue.ni as described herein above. Although a contact and speed sensor is illustrated as a single component. ri should be understood the conlaci and speed sensor may be different components and there may be multiple of each type of sensor as 15 described above. Control electronics 2049 process data from contaci/speed sensors 2048 or other sumors (e.g., thermal sensors) and control optical source 2055 and cooling system 2046. Cooling system 2046 may be cooled prim· to treatment vie a thermal-contact plate 2050.

Povror source 2047 may be charged via electrical contaci 2051. Cm/of5button 2052 controls the electrical power. A housing 2053 may be used to encluse, protect, or mourn one or more of the 0 above p;ms.

Optionally, a hair removal crevice 2054 may km located to remove hair prior to irradiation tv light from optical source 2055 to ensure [ha: substantinlly no hair extends above the hhu surface, for examoie. hair removal device 2054 mav oe a blade razor fe.g,; a safety WO 02/094116 211859 • -35- razor, a cartridge razor), an electric razor, a stripping device wherein the hair adheres to a surface and is pulled out as the handpiece is moved across a user’s skin (e.g., a device like the Epilady™ produced by Happy Lady, Inc.), an abrasive device that grinds the hair, or a chemical compound that dissolves the hair. A hair removal device may be made disposable such that the hair removal device is easily replaceable by a user. In the instance of coarse hair, a razor having one or a plurality of blades may be used; however in the instance of fine hair, an abrasive paper may be used. A body location having coarse hair initially may have fine hair after one or more photocosmetic treatments; accordingly, a blade razor may be used for the first few treatments and an abrasive paper may be used for subsequent treatments. In some embodiments, the abrasive paper may be simply moved across the skin with a stroke of the photocosmetic device; and in other embodiments the paper may be vibrated by a vibrating mechanism (e.g., a motor).

FIG. 21 is a schematic of one example of an embodiment of a handpiece docking station 2100 for docking a handpiece 2000. Docking station 2100 is contained in housing 2155. Power supply 2156 charges battery/capacitor 2047 via electrical contact 2051. Cooling material 2046 is cooled by chiller 2157 (e.g., a Peltier element). For example, chiller 2157 may be used to recharge a cooling system, by condensing a phase change liquid or freezing a phase change solid. Heatsink 2058 dissipates heat produced by chiller 2157. Heatsink 2058 may utilize gas, liquid, or solid (phase change) media for heat removal or may simply be fins that are cooled by exposure to room temperature. Umbilical 2159 contains wires to supply electrical power to the docking station from an electrical outlet and may further include tubing for water cooling of heatsink 2058. A self-contained photocosmetic device, and a handpiece docking station are described in greater detail in U.S.^Application^o. 60/293827,"filed· 2003/0012^50 December· 28,2000;-by G. Altohulor ot nl., entitled “Method aadApparatuo-for EMR

Trcatmont·,” the oubotanoe of which is herebyineorporatod by roforonoo.

For some embodiments of a photocosmetic device, it is advantageous to have one or more replaceable components. For example, in some embodiments, where the handpiece will likely be dropped or otherwise abused, it may be advantageous to make one or more optical systems removable from the handpiece. In addition, to achieve a variety of treatments that each require different optical sources or optical systems (e.g., treatment of. pigmented lesion removal and treatment to achieve hair removal), interchangeable optical components would permit the user to perform different applications with the same handpiece. Additionally, for --,1 .- svsterns eniJdoving light sources ot pttwei sources having a iniiiied irieume iepiacettteiit of tiie Imli! source1 ;.n iiie cud of' useful hie max ho deai ;ible J-(G 22 is a sci iL3i i uiLic illustration of one example of hiil' ei i1 Lx ,du uei ii of a handpiece 220(1 tiavme a detachahle head 22 )0. Handpiece 2200 has a handle 2220 coupled to a head 5 22 1 0 Handle 2220 may he coupled Io head 22 1 0 usina any known meihod of fastening

Prcferubb head 22 I 0 includes optical components ( eg.. head IbOOofFIG I 6A Ho facilitate the use of replaceable eomponenu; FIG 22 is a schematic illusiraiion of one example of an embodiment of a modular handpiece 2300 Itawng one or more components suitable for ease of .niaiiufaci.Lirab.lity and/or 10 uscf-tepiacemenL rot example, handpiece 2200 facihtat.es assembly and/or replacement of a head as sen ib F 23.10 (including an optical svs’temy a cooling assembly 232(2 ano a powei assembly·' 2330. Preferably, modular handpiece 22()() is configured such I hat when assembled, head assembly 231() contacts a malting power plug ofpowei assembly 2230. FIG. 24 is a schematic illustration of an optic;)I assembly 2400 including a source 24 10 15 (e.a.. two diode-laser-bars]. The source 2410 may be incorporated into a user-replaceable disposable cartridge including electrodes 241.2. heal sink 2430, optical system 2420 and couplijig plates 2440. Coupling plates 2440 may lie used to fasten optical system 242(..( source 2410. and heat sink 2430. Preferably the fastening mechanism of source 24 10 Is configured to automatically align source 241() to optical system 2420 Also preferably. coupling plates ate 20 made of a material having a good thermal conductivity (eg.. copper! to conduct heat mun the optical syiuein 2420. To simplify7 alignment of source 241() and element 2420, source 24.12 may be fixedly'· mounted to optical system 2420. .'in addition to replacing (fie source 2410 a! the end of its useable life tune, u may also be desirable to faeii.it.aie the user-replacemeui of light sources 24 10 for use for different cosmetic 25 treatments without bavtng to purchusc multiple handpieces, Furthermore. it may be desirable to facilitate user-replacement of bghi sources 24 10 based on skin type, hair type and/or on the location of the area of skin to be treated (eg.. underarm, bikini, leg. face) P IG. 25 n; a schematic illustration of one example of a pboloeosmetic device 25()0 illustrating, some aspects of the present invention Device 25()0 has a head 258() and a handle 30 2590. Head 2580 bus a first optical system 251() (eg., optical .system 3 10 in P’.IG. 3) to form a first area of radiation (eg., area 31 1 in .FIG. 3 ). and a second optical system 25 I 5 (eg., optical system 3 15 in FIG. 3) Io form a second area (/) radiation (eg.. area 3 1 6 in FIG. 3J on a pan cut s skin. As described above with reference to FIG 3. radiation to form the fust area and the second area in;i\ be limn a single divided source oi two sources fsouteer· ihh shown ; Device 250(1 also i.iicJudes a motion sensoi system Iiaviim a wheal 2521 (e.g.. eomespondmr to wheal 182.] of FIG I Si. and a second wheel 2522 ie.g., eorresjiondmg ίο wheel 1822 ofblG. I Si located on an opposite side of optical svsiem 25 lb to ensure tliai the enure skin contacting surface of the 5 optical cleinctu 25 I (J moves at a rale of speed wilhin the acceptable range to provide substantial^ uniform illumination on a pat.ie.nld, sk.m. FIG 26A is a schematic illustration of one example, of a phoioeosmene head 2o00 iJiusrratmg aspects of Hie presen: invention directed io a mealing curved area of slew (e.g.. a taw. back or arm). Head 2()0(1 includes (wo pivoting [ransimssion svsiems 2() 10 and 2620 for ] () delivering electromagnetic radiation The components of bead 2600 aie substaiuiahv contained within a housing 26.20 and coupled to a base unit (not shown) via cord 2640. Housing 2620 is illustrated as a transparent wire frame io facilitate description. The size of components of head 2600 mav be selected according to the body pari with winch they are to be used, and multiple heads min1 be connectable to cord 2640 io permit treatment of various body pans. 15 Alternatively, each head may have a fixed cord such that each cord can tie plugged duo a base Lirnl and remewed. FJG. 26B is a schematic illustration of one embodiment of two transmission systems 26 »0 and 2620 of a head io treat a curved surface. Transmission systems 2610 and 262() arc illustrated without a housing to illustrate there, relative positioning. FIG. 26B diusrrai.es that 10 transmission systems pivot in at least one rotational direction to faethtate maintenance of contact with a curved area of shut. For example, transmission systems 2610 mid 2620 may be rnounied at an angle relative to one another (e.g.. 5 - 30 degrees ) and mounted to enable rotation about axis X and X’. FIG. 27 is a schematic illustration of an embodiment of some uspecLs of handpiece 2700 ,5 according lo the present invention. Handpiece 270() includes a housing 27.10 having a handle 2702 and a head 27()4. Handpiece 27()0 include:·; a head assembly 271() ('including an opneal system), a cooling assembly 2720. and a power assembly 2730 FIG. 28 is a schematic illustration of one embodiment oi a photoeosrnctic device 2800 according io at leasl some aspects erf H io present invention. .Device 280() includes a It arid piece 0 2810, a base unit 2820. a cord 2826 to couple handpiece 2810 to baseuuil 2820. Handpiece 2810 may be grasped by an operator to move n head 2830 across a paiienl s skin (ttol shown/ Head 2830 may be any head as described herein above or any odier smliible head to achieve a phoioeosmene treatment foi example, any of the treatments described below. WW-

Tlu* following e. a discussion of examples of'treat men is that can ire achieved using appurnms and methods according to the jnesent invention, iiowevei. the rreamienis discussed are exemplary and are not intended to he limiting Apparatus and methods according the prcsenl invention are versatile and may be applied 10 am known or yet-n-be-dcvolopod 5 treatments. Exemplan ircai.menl mechanisms include absorption of light by a chromophore within a tissue responsible foi the unwanted cosmetic condition 01 by a chromophore in proximity to the tissue Ticatmenl may be achieved by iimiicd heating of’the target tissue below leinpeiaLiire of irreversible damage oi max be achieved by heautic to cause irreversible damage (e.g.. denauiruiion). Trcatmeiu nun be achieved bv fhreci stimulation of biological response to 10 beat, oi bv induction ol'a cascade of phenomena such that a biological response is indirectly nchieved by beat A treaimen! may restill from a combination of any of the above mechanisms. Optionaliv, cooling. DC or AC DFID electrical cuiyenl. physical vibration or other physical stimulus / action may be applied io a treatment area or adjacent area to increase the efficacy of a treatment. A treatment may result from a single session. 01 multiple sessions may be used to 15 achieve a desired clinical effect. A device according io one or more aspects of the invention may operate in a variety of optical ranges. For example, electromagnetic radiation delivered to the skin may have wavelengths withm the range 3SG-1900 nm. The power of the light delivered may be in the range 0.00 J -?ht) W/cm. and exemplary scan speeds .include 0.r-500 mm/ssc. The desired 20 radiation characteristics may tic achieved by any suitable LEDs, lamps, and di ode lasers or any other suitable light source presently available or yel-io-be developed. fundi an on-induced hair removal is a cosmetic treatment that could he performed by apparatus arid methods according io aspects of the jrresent nrveiwort Lu the case of .Inrir removal the principal large! for thermal destruction is the hair bulb and preferably the hair 25 matrix, hah papilla or basement membrane of (he bulb. For ban removal treatments, melanin located in the han shaft and fol.liete is the targeted chromophore·. While the bull.) contains melanin and can thus be thermally treated, the basement membrane, which pixivides the hair giowth communication pathway bciween the papilla within the bulb and the matrix within the hair shaft, contain!·· the iiighest concentration of melanin and imp Ire selectively targeted. 30 Wavelengths between 0.6 and 1.2 pm arc typically used for hair removal, by proper combination of power, speed, and focusing geometry, different hair related targets i'e.g.. bulb, matrix, basement membrane, stein cells,’ can be healed to the deuuturatioii temperature while WO 02/094116 211859 -39- the surrounding dermis remains undamaged. Since the targeted hair follicle and the epidermis both contain melanin, a combination of epidermal contact cooling and long pulsewidth can be

<img img-format="tif" img-content="drawing" file="IL211859AD00023.tif" id="idf0003" />

APPARATUS FOR IIAIR-GKOWTH GOHTROL/^by-Rox Anderaon, et alrfikd March P, 2002, which ic hereby incorporated herein by reference·

Hair removal is often required over large areas (e.g. back and legs), and the required power is therefore correspondingly large (on the order of20-500 W) in order to achieve short treatment times. Current generation diode bars are capable of emitting 40-60 W at 800 nm, which makes them effective for use in some embodiments of photocosmetic device according to the present invention.

Exemplary methods of hair growth management may be achieved by combining low power irradiation of hair follicles with light and physical extraction of hair shaft, and/or complete or non-complete physical extraction of the'hair follicle from the body. According to some embodiments irradiation is achieved by irradiating a portion of the skin containing the hair follicle with a light source emitting at a range of wavelengths absorbed by melanin or other endogenous or exogenous chromophores in the follicle. Physical extraction can be performed by mechanical, electromechanical or other suitable techniques. This treatment can be used for either temporary hair reduction or permanent hair reduction. A first exemplary embodiment of a method of hair growth management according to the present invention includes first physically removing hair (“depilation”) and then irradiating the skin as described above. According to some embodiments, the hair removal can be adjusted to remove mostly hair shafts from hair follicles; alternatively hair removal may be down to keratinoized zone. This depilation can be done by electromechanical depilation or waxing.

Phototreatment can be performed, for example, using one of the embodiments of photocosmentic device described above. According to these embodiments, light is absorbed by melanin in hair matrix and as a result of thermal injury hair growth is decelerated or completely arrested.

Optionally, after depilation but before irradiation, a topical lotion can be applied to the skin (e.g., via the handpiece) in a treatment area to fill empty hair follicles corresponding to the removed hair. In some embodiments, the transparent lotion is selected to have a refractive index in a range suitable to provide a waveguide effect to direct the light to a region of the skin vvq (I'l/iRJ i ii PCt'P.'StUmUS' - 4C - in be irradiated. Prexeraoly ine index ηί rxrrzLCiiOii ch tLie lotiun ii hiubcr that. the index cif refiaetioi ut vVcU/jj· b.e.. approxiniateiy 1.3? depending ox eheimeai aauitives of mt water x fit some embodiiueiifs. trie index of refraction of the knion is higher thar. the index ch refraction of ur- dermis fee., appromnuuriy id i. hi some eufootiinjenur tiio index ofrefiaction of the 5 iuiiOL· Ils ugher than the index of retraction of ihe inno root sheath ffm approximately·' 1 .55 i. lii einbodi.meni.s, viuere lio mdex to refraction is greater than foe index of refraction of the inner roe! sheath. .light maiden; on hbt· stmtaee of the skin eon be delivered directly i.o uair matrix without signiiicrmt auerimtuoii.

The eneotivc puke length usee to uraihai.e the shut it; given by hue beam, size dim deci J ϋ by the .speed of scanrkiig of the irradiation source. Tor example a 2rrun beam size moved at a scanning speed of 5(bi 00 mink provides an effective pulse length of 20 - 00 ms. Tor a power density' of 250 Vf/cni the effective, fptance is 5-10 fl/binf which approximately doubles the fluenae of the light delivered by a device, without the use of a high index lotion. in some embodiments., the pH of the lotion can be adjusted io decrease the dena.tuiation 15 threshold of matrix cells. In such embodiments, lower power ip required in injure the hair mandr. and thus provide hair growth manngemeut. Optionally, the lotion cam be doped by molecules or ions or atoms with significant absorption of light emitted by the source, Due to increased absorption of light in hair follicle due to the lotion, a lower power irradiation f.Ource may' be used to provide sufficient irradiation to heat the hair matrix. 20 A second exemplary embodiment of a method of hair growhb management, according to the present invention includes first irradiating the shun, and then physically removing hair as described above. IBy first irradiating the skin, attacliment of the hair such to the follicle ortho nan follicle to dermis is weakened. Consequently, mechanical or eisehom call ark cal depuahon may be more easily achieved (c.g.. lay using a soft waiting or eiecbomachanica! epilatori and 25 paw may be reduced.

Irradiation can weaken uhaciiinerii of hair bulb to skin or slD cutaneous fat; therefore il is possible to pull out e fignif cantiy higher percentage of the hah follicle· fiOiu the skin compared to the. depiiati.on alone. Because the diameter of the hair bulb is close io the diameter of the outer moi sheath, gulling out hair with hair Bulb can permancntiy··’ destroy the 30 entire hair follicle including stem calk. Anwurduigly. by first irradiating and then depilating, new hair gucwlb can be delayed or terinmaied.

Treatment of csihdjte is another example of a cosmetic problem that may·' lie treated by apparatus and methods according to aspects of the present invention, The formation of WO 02/094116 211859 -41- characteristic cellulite dimples begins with poor blood and lymph circulation, which in turn inhibits the removal of cellular waste products. For example, unremoved dead cells in the intracellular space may leak lipid over time. Connective tissue damage and subsequent nodule formation occurs due to the continuing accumulation of toxins and cellular waste products. 5 The following are two exemplary treatments for cellulite, both of which aim to stimulate both blood flow and fibroblast growth. In a first exemplary treatment, localized areas of thermal damage are created using a treatment source emitting in the near-infrared spectral range (e.g., at a wavelength in the range 650 -1850 nm) in combination with an optical system designed to focus 2-10 mm beneath the skin surface. In one embodiment, light having a 10 power density of 1 -100 W/cm is delivered to the skin surface, and the apparatus is operated at a speed to create a temperature of 45 degrees Celsius at a distance 5 mm below the skin. Cooling may be applied to avoid or reduce damage to the epidermis to reduce wound formation. Further details of achieving a selected temperature a selected distance below the

Ho. skin is given in U.S. Patent Application 09/634? 693rfiled· August 9,5000, tho oubataaoo of- 15 which wao incorporated by roforcnce horwaubove. The treatment may include compression of the tissue, massage of the tissue, or multipasses over the tissue.

In a second exemplary treatment, a treatment source emitting near-infrared light (e.g., a light emitting diode emitting at a wavelength in the range 700 - 1300nm) is used to focus the light a distance 2-10 mm beneath the skin surface, to elevate the dermis/subcutaneous fat 20 temperature to a point well below the thermal damage threshold (e.g., a temperature in the range 42 - 60 degree Celcius). According to the second exemplary treatment, heating may increase the rate of lipolysis (i.e., fat breakdown) and cause apoptosis (i.e., programmed cell death) of fat cells. Optionally, a topical lipolytic cream may be used in combination with the second exemplary treatment; the elevated temperature profile in the dermis/subcutaneous fat 25 may enhance cream penetration and thus increase its efficacy. Due to very long thermal relaxation time of subcutaneous fat (i.e., longer than 1 minute), multiple scanning treatments of an area can achieve the desired heating of the fat, while maintaining normal skin surface temperature. The above exemplary treatments may be used for fat metabolism activation and fat reduction. 30 Acne is another very common skin disorder that can be treated using apparatus and methods according to aspects of the present invention. Acne results when sebum from the sebaceous gland cannot reach the skin surface via the hair follicle, and a bacterial infection WO 02/094116 211859 -42- occurs within the hair follicle. Photocosmetic treatment is an alternative to traditional treatments (e.g,, topical and oral medications).

The following are exemplary methods of treating acne according to the present invention. In each of the exemplary methods, the actual treated area may be relatively small (assuming treatment of facial acne), thus a low-power CW source may be used. A first possible treatment is to selectively damage the sebaceous gland to prevent sebum production. The sebaceous glands are located approximately 1 mm below the skin surface. By creating a focal spot at this depth and using a wavelength selectively absorbed by lipids (e.g., in proximity of 0.92,1.2, and 1.7 pm), direct thermal destruction becomes possible. For example, to cause thermal denaturation, a temperature of 45 - 65 degrees Celsius may be generated at approximately 1 mm below the skin'surface using any of the methods described in U.S. Patent Appli8ation^/^F^691) filed-Auguot 2000» the cubctane»o£whigh.wag incorporated by reference horoin above.

Optionally, a linear matrix of focal spots (as described above with reference to FIG. 4) may be used to create islands of damage. Although the exact position of the sebaceous glands may not be known, each treatment with a matrix of focal spots will result in a certain number of sebaceous glands being damaged. Thus, by treating the area multiple times, a significant number of sebaceous glands will be damaged.

An alternative treatment for acne involves heating a sebaceous gland to a point below the thermal denaturation temperature (e.g., to a temperature 45 - 65 degrees Celsius) to achieve a cessation of sebum production and apoptosis (programmed cell death). Such selective treatment may take advantage of the low thermal threshold of cells responsible for sebum production relative to surrounding cells. Another alternative treatment of acne is thermal destruction of the blood supply to the sebaceous glands (e.g., by heating the blood to a temperature 60 - 95 degrees Celsius).

For the above treatments of acne, the sebaceous gland may be sensitized to near-infrared radiation by using compounds such as indocyanine green (ICG, absorption near 800 nm) or methylene blue (absorption near 630 nm). Alternatively, non-thermal photodynamic therapy agents such as photofrin may be used to sensitize sebaceous glands. In some embodiments, biochemical carriers such as monoclonal antibodies (MABs) may be used to selectively deliver these sensitization compounds directly to the sebaceous glands.

Alt iit &gt;ugb ike above procedures were described as u euu actus foi acne. because the ijeaunciiis ihvoIvl- damagcvdesiruciion oi the sebaceous glands kind l.iterefore reduction of sebum ouipuir die treatuictus may also be used io rreai excessively oily skin guoflier light-based method ol treating acut involves. thermal destruction of die bacteria 5 A’ Licitcsi responsible id; the characicrisnc inflammation associated with acne Idesrrucnoi) of the bacteria tna\ be achieved b\ targeting porphyrins stored in ,-true.v I’orphynnes. such as proioporpbvrms. copt'oporphvrins. and Zn-proiopotpityrius are synthesized bv anaerobic bacteria as then metabolic product l'1 orjrhyri 1 ies absorbs bglu in the visible spectral region from 400-700 uni, with strongest peal; of'absoiption around 415 urn by providing light iui the

If selecicd wavelength ranges in sufficient iniensip heal resulting from absorption causes death of the bacteria. For example, the desired effect may be achieved using a ttrearuicnl source eirulttug at a wavelength m Lite range 360-700 um using an optical system designed l.o focus 0.2 -linm beneath the shin surface and a powet density of 0.01-10 W'/cut at the shun surface.

Yet another technique for treating acne involves using light io expand the opening of an 15 infected ham follicle io allow unimpeded sebum outflow. fn one embodiment of the technique, a lotion that preferentially accumulates in the follicle opening te.g.. hptd consistent lotion with organic non organic dye or absorbi'ion particlesi is applied to the shun surface. A treatment source wavelength is matched to an absorption band of the .lotion, .hot example, rn the case of ICCi doped lotion the source wavelength is 790-810 nm By using an optical system io generate 20 a temperature of 45-100 degrees Celsius at the infundibulum/ uiffainfundibulum. for example, by generating a fmencc of at shin surface fe.g.. 1-100 W/cmj. the follicle opening can be expanded and sebum is allowed io flow out of the nan follicle and remodeling of mfrauifuudibulum m order to prevent comedo (Ye.. blackhead ) fonuaiion.

Non-ablative wnnkle Treatment, which is now used as an alternative to traditional 25 ablative CCb laser skin re,surfacing, is anolher cosmetic treatment that could be performed by apparatus and methods according to aspects of the present invention. .Non-ablative wrinkle, ticatmeni is achieved bv simultaneously cooling, the epidermis and delivering iigitt to (he upper layct of the dermis to thermally Siiniiilaie fibroblasts to generate new collagen deposition. hi wrinkle treatment, because the prim ary chromophore is walet. wavelengths ranging 30 iron.' 0,8-2 pm cite appropriate wavelengths of irearmenl radiation. Since only wrinkles on the face arc ty[)icall\· of cosmetic concern, the treated area ts typically relatively small and the required

Wi) I '2/1»'t-l ΐ 11 PCI /PS I It Ί coveraue une I'cuj'/.s'irj, ::, conuspondmgly iov, and a retauveh iow-iaowcr ηνοΐπνην source mm be used. An optica! system providing suh-surraer ioeusing in combmation with epiderm coolin'-' may be used to achieve the desired result Precise cuiiuoi of the uppe:-dermis lamp snore is imuonanu id hie tempeitULue is loo high. the induced thcnnal damage of the 5 eoiderim: wii; be excessive. and if the temperature u mo iovr. the amount of new collagen deposition will be rit.inimal. _A ipaed sensor fin the case of a munuuliv scanned handpieces or ; mechanical drive may be used Lo precisely control die uppct-denins temperature. A.ltornativeb a non-coinaci iniG-iufrajed thermal sensor couici be nsec to uionlm; dermal Leniperal.uiu.

Vascular lesions fug. pori-wine stains. rosacea, spider veins! presem another cosmetic 1 0 problem tha; could be ireated by apparatus and methods according to aspects of the nresem. invention. Por meatmen1. of vascular lesjonc, die target chromophore is blood in these lesions. Exemplary ueatmeni wavelengths range from 0.4-0.6 pm for superficial vascular lesions and 0.6-ί .3 for deep vascular lesions, in the case of treatmcni of spider veiny the relatively large size and corresponding long thermal retaliation time of the tarts* tissue requires a large 15 denotation of energy over a long rime period to achieve thermal destruction and to preserve the epidermic. In addition, aggressive epidermal cooling (partieuiuriy for· patients vdth darker skin type IV-Vf) can be used to prevent epidermal damage. The use of CW sources is advantageous nr the treatment of lesions because, similar to hair removal, par: of the targeted structure (vein wail) contains little blood and must be damaged by thermal diffusion. 10 Pigmented lesions such, as age spore can he removed by selectively targeting file cells c on Laming melanin hr these sumcrares. These lesions are located using an optical system focusing at a depth of 100-20Cl tun below fire skin surface and can be targeted with wavelengths in fire 0.4-1.1 urn range. Since the individual melanin-bearing cells are small with n shod thermal relaxation time. a. shallow sub-surface focu:: is helpful to reach the denaturatiou .5 temperature.

Elimination of underarm odor Is another problem Ilia: could be treated by an apparatus and niefhods according m aspects of the preseni invention. In such a treatment, a source having a wavelength setactivtay absorbed by the eccrine/,'ipoerme glands is used to thermally damage the eccrme/npo crane glands. Optionally, a scusiiir.ation compound may be used to 0 enhance damage,

Tattoo removal is another procedure tha: cm be achieved by apparatus arid methods accordthig to aspects of the present invention. Conventional devices for tattoo removal include shorl pulsed ( 10-50 um Q-swiichecl ruby uiexandiile. NffYAG and tfequeney-doubled Nd YAG for cosmetic iartt&gt;f&gt; removal 'iypicalb. a source wavelength is selected based on the color of the tattoo Io be removed te.g.. a green lasei is used io remove a red portion of a tattoo). Smet· the ink particles are actual!) nioorporaiod ml ω individual cells. one embodiment of a '·. thermal iTeatment lor tattoo removal causes the rupture of the ceils. thereby releasing the mb.

Exemplar einbcxiimeim of npnaiatu;. according to aspects of the present invention foi use in talioo removal use a GW source, and an optical system selected to lightly focus radiation from a treatment source at the depth where the cells coutauung the nil: panicles reside te.g... ] Sp-7(K) pm) to rupture the mk-coiitamuig cells Alternatively. t( may' .also be possible to beat W tite cells below their thermal den at i irati o n promt and induce apoptosis .In the case of embodiments designed to cause apoptosis, healing may be enhanced by operating the radiation source in a quasi-continue us mode while the handpiece .is continuously scanned across the skin surface Io ereale areas in which ceils are damaged and areas of uon-irradiated areas in between. .In some embodiments, feedback from a speed sense; could hie used to control laser emission 15 and create equally spaced tines of damage independent cd handpiece speed fo completely remove the tattoo. multiple treatments would tie required

In some conventional, relatively expensive tan ex-rem oval apparatus, a Q-swnched frequency-doubled Nd'YAG laser emitting at 0.532 uni is combined with an (Ng.Y'AG) emitting at .1,064 pun . and alexandrite laser emitting ar ().755 pmi; the lasers are selectively 20 operated to target cells containing various tattoo mi: colors. Embodiments of .modular apparatus according to aspects of' die present invention, provide a relatively low-cost alternative to the above system. Imr example, an embodiment of the present invention ma\ be configured to allow the use of optical sources emitting at distinct wavelengths or wavelength bands or a single source and optical components to modify the wavelength of the light generated by a source. In 25 particular. to achieve a wavelength close m the 0,755 pm wavelength, a (J.KOS ptm diode laser bar may be used: and a Nd: YAG crystal module could be inserted into the handpiece Lfiai would be [lumped by the diode laser bai to produce a wavelength close to the 1.064 pm wavelength; and lo produce a wavelength close to the f.532-pun wavelength, an SrtG crystal may be used to double the frequency of a laser diode emitting 1 .664 pun wavelength radiation. Alternatively, a nO sell-hcqliency-donblinu crystal such as Nd YCOb triav be used. -4υ-

Low-ιm.ensuy therapy' ( LTi’i is anothei procedure that can he achieved by apparatus and methods aecoiding to aspects of die preseni invention Lfl mav be used to for treatment of wminds. carpal-tunnel syndrome I remanent, or to stimulate hair growth, or to accelerate biochemical reactions Rowet densities and wavelengths (G?'G~S2G .inn i typica.liv used io; LITs 5 may he achieved Lisina diode lasers oi LED treatment sources Optionalh' one oi more of the above treat meats may he used for vet ennuis .LH up ph cal ions.

Eh mi run ion of or reduction of (.he prominence of stretch marks and scats are procedures that ma\ be achieved using apparatus and methods according to aspects of (he preseni invention. Similar io (he case of'noii-ublativc skin resuriiicmg. to achieve die above proeeduics. it may be J 0 possible io stimulate collagen deposition and wound healing bv creating a tinn dieruialiv damaged layer in the upper dermis. .Removal of warts is another procedure (hat can be achieved using, apparatus and med tods according to aspects of the present tin'cm tent. Wan removal may be achieved using a source producing light in (he region of blood absorption (G.5-0.8 mid. Tins wavelength is 1 5 selectively absorbed by hemoglobin, which appears to shuts off the warl's blood supply.

Psoriasis is skin disorder that can be treated using apparatus and methods according i.o aspects of the present invention. Exemplary, embodiments of die present invention configured to treat psoriasis emit ai wavelengths near 800 mu. Optionally; one or more sensitization agents such as photodynamic drugs or ICG/Jvlethylene blue may lie used. Treatment may 'be applied 20 several times per week, and may he delivered in several different ways including islands for lines) of treatment. Additional application of apparatus and methods according to aspects of the preseni invention include facilitation of delivery oftopical medications and cosmetic preparations into skin.

Having Lints described the inventive concepts and a number of exemplary embodiments, 25 it will lie apparent to those skilled tn the art that the .invendon may 'be .implemented in various ways, arid that modifications and improvements will readily occur to such persons. Thus, the examples given are not intended Io be limiting The invention is limited only as retpiired by the following claims and et|uivalctiLs Lhereio. Also, it is lo be understood Lint! the use of the terms ,:includiiig,.r’ ''comprising.1' o.i "having" is meant to encompass die items listed diereafici and 30 cijuivalents diereofas well as additional iLotus before, afier, oi in-between the items listed.

I :;;τ ϋ^ΐ,ΰιιΐϊΰ ίΤ ίΕΓ[.·'.;\

Ή' ΐ ('ι] 11/cο ' J &lt;??;*' L JIS'il/J.Jn cra&amp;amp;’an , crnxan rwzn ατα inia^n pnow pnszn irn πτ “|»oa ,ρνιη ηχΰπ naoana ma™ na^maa np’ioa .zruwan rwaa mpnan pmi1? oxnm οιηπη Pi?

<img img-format="tif" img-content="drawing" file="IL211859AD00024.tif" id="idf0004" />

.(moia nannn) cras^an mwa