The present apparatus and method are related to methods and apparatuses for treating skin and in particular to skin rejuvenation and tightening procedures that reduce the appearance of abnormal skin vessels and wrinkles that occurs in aged and photoaged skin.
Radiofrequency (RF) energy treatment is a technology widely used for many cosmetic, aesthetic and medical skin treatments. Radio Frequency (RF) energy is applied or coupled to skin by at least one electrode and frequently by two or more electrodes. Application of RF energy to skin heats the segment of skin or tissue located between the electrodes. Such skin heat treatment is a popular non-invasive treatment method for skin rejuvenation, skin tightening, vessel shrinkage, wrinkles reduction, collagen rejuvenation, acne treatment and other skin treatment procedures.
Most of the skin treatments are successful only when the skin reaches an optimal treatment temperature. In reaching the optimal treatment temperature, several factors are considered, such as location of the skin segment, energy coupled to the skin, electrode size and orientation of the electrode relative to the blood vessels.
The following patents U.S. Pat. No. 7,041,100 and U.S. Pat. No. 7,238,183 both to Kreindel and assigned to the assignee of the present patent application may be of interest.
Skin rejuvenation is a general term for skin treatment that includes removal of vascular and pigmented lesions, improving skin texture, and reduction of fine lines and wrinkles.
In the context of the present disclosure the terms “skin” and “tissue” are used interchangeably and have the same meaning. The terms include the outer skin layers such as stratum corneum, epidermis, dermis, and the deeper subcutaneous layers such as adipose tissue.
The term “bipolar electrodes” as used in the present disclosure means that the RF induced current flow passes between two usually identical electrodes each placed on the skin surface a short distance apart from each other. RF energy is applied to the volume of skin/tissue to be treated and the propagation of the current is limited predominantly to the volume of skin/tissue between the electrodes.
The term “skin cooling temperature” as used in the present disclosure means a temperature of 30 degrees C. or less, when starting at 32 degrees C.
The term “non-therapeutic treatment temperature” as used in the present disclosure means a treatment temperature of 37 degrees C. or less, when starting at 32 degrees C.
The term “therapeutic treatment temperature” as used in the present disclosure means a treatment temperature of 45 degrees C. or more, when starting at 32 degrees C.
A number of methods and apparatuses suitable for selective skin treatment have been described. In one example, a pair of RF electrodes is applied to skin. The RF electrodes receive RF energy from an RF energy generator and couple the RF energy to the segment of skin located between the pair of RF electrodes. The RF electrodes are also configured to apply positive pressure to a segment of skin located between the pair of RF electrodes to partially or completely occlude the blood flow in one or more vessels in the segment of skin located between the pair of RF electrodes. Occlusion of the blood flow in a segment of skin located between the pair of RF electrodes reduces heat dissipation by the skin segment located between the pair of RF electrodes and supports further increase of temperature of both the skin segment and vessels located between the pair of electrodes.
Described is also an applicator for selective skin segment temperature increase. The applicator includes a pair of RF electrodes configured to apply RF energy to a segment of skin to raise skin temperature to a therapeutic treatment temperature. The pair of RF electrodes is further configured to apply pressure to skin and at least partially occlude blood flow in a segment of skin located between the pair of RF electrodes to reduce heat dissipation by the skin segment located between the pair of electrodes.
According to another example, for selective heating of a skin segment, a pair of RF electrodes is applied to the segment of skin. The RF electrodes are configured to couple RF energy to the segment of skin such as to raise the skin temperature to a first nontherapeutic treatment temperature. A cryogenic fluid is sprayed onto the segment of skin for cooling the superficial layers of skin. Continued application of RF energy to the RF electrodes further raise temperature preferentially of deeper skin layers located between the pair of RF electrodes to a second therapeutic treatment temperature.
According to another example, for selective heating of a skin segment, a pair of RF electrodes is applied to the segment of skin. A cryogenic fluid is sprayed onto the segment of skin for cooling the superficial layers of skin to a first skin cooling temperature. The RF electrodes are configured to couple RF energy to the segment of skin such as to raise the skin temperature of the superficial layers of the segment of skin to a nontherapeutic treatment temperature and of the deeper layers of the segment of skin to a therapeutic treatment temperature.
According to another example, for selective heating of a skin segment, a pair of RF electrodes is applied to the segment of skin. A cryogenic fluid is sprayed onto the segment of skin for cooling the superficial layers of skin to a first skin cooling temperature. The RF electrodes are configured to couple RF energy to the segment of skin such as to raise the skin temperature of the segment of skin to a nontherapeutic treatment temperature and of blood vessels in the segment of skin to a therapeutic treatment temperature.
According to an additional example, the method of selective skin segment temperature increase includes application to a segment of skin of a pair of RF electrodes configured to couple RF energy to the segment of skin to raise skin temperature to a first nontherapeutic treatment temperature. The RF electrodes are also configured to apply positive pressure to a segment of skin located between the pair of RF electrodes and at least partially occlude blood flow in a segment of skin located between the pair of RF electrodes. The method further includes use of a cryogenic fluid for cooling the superficial layers of skin; and continue application of RF energy to the electrodes to further increase temperature to a second therapeutic treatment temperature of selected skin segment layers located deeper between the pair of electrodes.
The applicator for performing this treatment includes a pair of RF electrodes configured to apply RF energy to a segment of skin to raise skin temperature to a first skin treatment temperature and a cryogenic cooling fluid delivery unit configured to direct a spray of cryogenic vapors to cool skin located between the RF electrodes. The pair of RF electrodes is further configured to apply pressure to skin and at least partially occlude blood flow in a segment of skin located between the pair of RF electrodes to reduce heat dissipation by the skin segment located between the pair of electrodes.
One of the obstacles of radiofrequency skin heat treatments are non-uniform heating in the treated skin segment and difficulty in reaching desired skin temperature, since blood flow acts as a heat sink and distributes the heat over relatively large skin areas. The present disclosure suggests application of positive pressure to a treated by RF energy skin segment to reduce or even partially (temporarily) occlude the blood flow and associated with it heat loss or heat dissipation by the skin segment located between the pair of electrodes.
The present disclosure makes use of increase in blood conductivity with temperature to enhance RF energy selectivity towards blood vessels as well as optimize the RF energy frequency and application for skin rejuvenation and blood vessels treatment.
Disclosed is also a method of pushing RF heating and increase of temperature of deeper tissue layers by cooling the skin/tissue surface with cryogenic fluids. The cooling reduces the electrical conductivity of superficial skin or epidermal and upper dermal surface layers. The depth of the heating achieved is dependent on the relations between the amount and time of cooling fluid application and RF energy application.
In one example, bipolar RF power/energy is applied between a pair (or pairs) of adjacent RF electrodes, leading to increase of the skin segment temperature. Concurrently, a certain positive pressure is applied to the skin located between the electrodes to reduce or even partially occlude the blood perfusion between the two electrodes in the skin segment and reduce heat dissipation by containing a reduced amount of the heated blood to the region between the two electrodes. Application of RF energy to the skin segment continues to further increase temperature to a therapeutic treatment temperature.
For temperature independent conductivity, σ=σo (dashed lines), reference numeral 108 (
Coupling of RF energy to blood leads to an even faster, increase in blood conductivity and temperature increase and supports faster achievement of a second therapeutic treatment temperature of 53 degrees C. when starting at 32 degrees C.
The bipolar RF electrodes (504
In addition to the dependence on temperature, the electrical conductivity of tissue depends on the frequency of RF energy that induces the current flow in the tissue.
Table 1 below shows skin/tissue conductivity of different skin segments.
As demonstrated above, blood and parts of the body with high blood content have the highest electrical conductivity. The pattern of distribution of electrical conductivity demonstrates the possibility for selective treatment of blood vessels using RF energy of proper frequency.
RF energy generator 408 and skin cooling unit 412 could be located in the same packaging as the control computer or could have separate packaging. In some examples, RF energy generator 408 and skin cooling unit 412 could be located in applicator 500 (
After achieving the first skin cooling temperature, control computer 404 could start application of RF energy to the skin to reach a first non-therapeutic temperature in skin and achieve a second therapeutic treatment temperature in the target of interest. The target of interest can be an underlying blood vessel or the deeper skin layers.
An electrical contact improving gel could be used between electrodes 504 and skin fold 528 to avoid formation of air pockets or to wet the outer dry layer of skin thereby reducing the electrical impedance. In some examples electrodes 504 could be made of a porous and electrically conductive material. Such electrode structure could facilitate removal of air trapped between the skin fold and the RF electrode.
Skin cooling unit 412 (
A combination of cryogenic skin surface cooling with bi-polar RF energy application also supports heating and increase of temperature of deeper skin layers, than currently existing RF electrode cooling methods. At present cooling is predominantly used to minimize skin burns from hot spots that occur at the RF electrodes. Cryogenic skin surface cooling reduces skin surface temperature and increases resistivity of the upper layers of the skin. The increased resistivity (or reduced conductivity) drives RF induced current flow into skin layers with higher conductivity and namely into the deeper uncooled skin layers to further increase temperature of the deeper skin layers.
The aim of these techniques is to heat dermis and subcutaneous tissue while minimizing heating of the epidermis and upper dermis, and consequently reducing damage to the superficial skin or dermal layers
The bipolar RF energy can be delivered as a single pulse or as multiple RF energy pulses. Cryogenic spray can be delivered as a single burst prior to or at the beginning of the RF energy pulse, or in multiple cryogenic spray bursts at various times during, and after the RF pulse. For example, a complete treatment pulse could include four DCD/RF sub-pulses delivered within one or two seconds, preferably less than 1 second. The duration of each DCD sub-pulse could be varied from 10 to 100 ms and preferably could be 10 or 20 ms in duration. The duration of the each RF sub-pulse could be varied from 50 to 200 ms, with a preferable on time of 100 ms. Using a 200 W RF generator this corresponds to a sub-pulse RF energy from 10 to 40 J, for 4 sub-pulses a total RF energy between 40 and 160 J. By selecting a proper combination of RF energy delivery time and intensity and cryogenic spray delivery, it is possible to deliver RF heating deeper into tissue without overcooling the skin surface. This becomes possible, since surface cooling has reduced electrical conductivity of the upper skin layers and supply of RF energy created a current flow through the hotter deeper located skin layers. In addition, by splitting the RF pulse into smaller RF sub-pulses, more RF energy can be delivered to tissue while avoiding skin surface burns from electrode hotspots.
The present document discloses a method and apparatus for RF energy delivery to deeper skin layers and selective heating of the desired skin layers. This is achieved by increasing the conductivity of the skin with increase in skin temperature, proper selection of the RF energy frequencies and application of positive pressure between the electrodes to at least partially occlude the blood flow and reduce blood perfusion in the skin segment and associated with it heat dissipation.
The document also discloses a method of RF energy delivery to deeper skin layers by selecting a proper RF energy pulse duration and cryogenic skin surface cooling.
While the method and apparatus have been described with respect to a number of examples, it will be appreciated that many other variations, modifications and applications of the method and apparatus may be made.