CanAm Aesthetic Inc.

UltraPlus VPL By: Energist Group

Who are Energist Ltd?

• Pioneer of world renowned

Variable Pulsed Light (VPL™) technology

• Researching, developing & Manufacturing Pulsed Light systems since 1999

• Specialists in Light Treatment systems

• Distribution network worldwide in 40 countries

• Over 6000 VPL/iPulse systems sold to date

• Manufactured in UK

• ISO 9001:2000 & ISO 13485:2003 Certifications

• CE 0120 medical mark

• FDA clearance No. K060216

* Dr Richard Fitzpatrick – Dermatologist Goldman, Butterwick, Fitzpatrick, & Groff, Cosmetic Laser Dermatology, La Jolla, California (USA) * Dr Christopher Zachery - Professor and Chair, Department of Dermatology University of California, Irvine, USA * Dr Michael H. Gold – Dermatologist & Clinical Assistant Professor Vanderbilt University School of Medicine & Gold Skin Care Center, Nashville, Tennessee (USA) * Prof Robert Knobler – Associate Professor of Dermatology University Hospital, Vienna (Austria) * Prof Rolf-Markus Szeimies – Professor of Dermatology University Hospital, Rechlinghausen (Germany) * Dr Maria Gonzalez - Senior Clinical Lecturer in Dermatology University Hospital, Cardiff (UK), Home of the UK’s largest post-graduate dermatology unit. * Dr Johannes Lang - President of ELAS (European Laser Aesthetic Surgery) Erlangen, Germany * ‘Dr Panagiotopoulos Antonios – Dermatologist & Ass. Director Andreas Siggros’ Hospital, Athens (Greece)

Energist Clinical Partners

Reference ‘The VPL system presents itself as an efficient and

safe method for long-term hair removal. In addition, the VPL system was effective in a

selected group of patients which included those who had previously failed other forms of

treatment.’

DIVISION OF SPECIAL & ENVIRONMENTAL DERMATOLOGY

Robert. Knobler, MD Assoc. Prof. of Dermatology

Department of Dermatology, University of Vienna Medical School Währinger Gürtel 18-20, A-1090 Vienna, Austria

Treatments with the Ultra Range • Hair Removal

• Skin Rejuvenation

– Collagen Stimulation

– Epidermal Pigmentation

– Vascular Lesions / Thread Veins

– Active Acne

– Rosacea

- all VPL systems

UltraPlus

How Does Pulsed Light

Work?

How Does

VPL Work?

VPL™ Pulsing • Delivers a series of very

rapid, short pulses of light energy to the skin

• Aim - to effectively heat the hair follicle/vessel whilst keeping the surrounding skin cool

• Result - the hair follicle is disabled through the absorption of particular wavelengths of light

• The client only feels a momentary mild heating sensation

VPL™ - wide range of pulse types

• Variable Pulsed Light allows the operator to select the exact treatment parameters for each individual client: – Number of Micro-pulses: 2 – 15

– Micro-pulse length: 3, 5 & 7 milliseconds (ms)

– Delay between micro-pulses: 1 – 20ms

– Total pulse time: 7ms – 385ms

– 840 possible pulse combinations!

Why VPL™ - Variable Pulsed Light?

• Increased safety

• Delivers right wavelength to target chromophore

• Reduces side effects – esp. on darker skins

• Increased energy density

• Increased effectiveness

• Kinder to skin

Pulse Train Examples Hair

Skin Type IV, Hair Thin – 5x3x6

Max Energy = 27J/cm2

• Short on-time to put the energy into the hair quickly

• 5 pulses to get enough energy, but keep heating time short

• 6ms Off time for sufficient skin cooling on dark skin

3ms

6ms

31ms

Pulse Train Examples Hair

Skin Type V, Hair Thick – 5x7x8

Max Energy = 44J/cm2

• Long on-time to make sure the hair is heated sufficiently

• 5 pulses to get enough energy

• 8ms Off time for sufficient skin cooling on darker skin

7

8

51ms

Pulse Train Examples Thread Veins - Face

Skin Type II, Vein Medium – 5x5x2

Max Energy = 38J/cm2

• Long on-time to make sure the blood is heated sufficiently

• 5 pulses to get enough energy but still heat quickly

• 2ms Off time is enough time for skin cooling

5

2

33ms

Pulse Train Examples Epidermal Pigmentation

Skin Type III, Surface – 2x7x1

Max Energy = 30J/cm2

• 2 pulses to create a short sharp shock

• Long on-time to maximise available energy

• 1ms Off time as minimal heating of surrounding skin

7

1

15ms

1

10

100

1000

10000

400 500 600 700 800 900 1000 1100

Wavelength (nm)

Ruby Laser 694nm

Alexandrite 755nm

Diode 810nm

Nd:Yag 532nm

Dye Laser 585nm

Melanin

Oxyhaemoglobin

UltraPlus System

Ab

so

rpti

n

Nd:Yag 1064nm

1

10

100

1000

10000

400 500 600 700 800 900 1000 1100

Wavelength (nm)

Ruby Laser 694nm

Alexandrite 755nm

Diode 810nm

Nd:Yag 532nm

Dye Laser 585nm

Melanin

Oxyhaemoglobin

UltraPlus System

530-950nm

Ab

so

rpti

n

Nd:Yag 1064nm

Filtered Energy

0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

400 500 600 700 800 900 1000

Wavelength (nm)

Inte

nsit

y

Skin Rejuvenation

Hair Removal

© Copyright Energist Ltd. 2009

1

10

100

1000

10000

400 500 600 700 800 900 1000 1100

Ruby Laser 694nm

Alexandrite 755nm

Diode 810nm

Nd:Yag 532nm

Dye Laser 585nm

Melanin

Oxyhaemoglobin

Acne Handpiece

415nm / 630 – 950nm

Ab

so

rpti

o

n

Nd:Yag 1064nm

Absorption

Wavelength, nm

NEW Acne Applicator

1

10

100

1000

10000

400 500 600 700 800 900 1000 1100

Ruby Laser 694nm

Alexandrite 755nm

Diode 810nm

Nd:Yag 532nm

Dye Laser 585nm

Melanin

Oxyhaemoglobin

Acne Handpiece

415nm / 630 – 950nm

Ab

so

rpti

o

n

Nd:Yag 1064nm

Absorption

Wavelength, nm

NEW Acne Applicator

Absorption

in PpIX

Treatments using

UltraPlus VPL™

Treatment Indications

• Hair Removal

• Photo-ageing

• Epidermal Hyper-pigmentation

• Cherry spots (Campbell de Morgan spots)

• Spider Naevi

• Thread veins

• Diffuse redness

• Rosacea

• Acne Vulgaris

Energist ULTRA VPL™ (Variable Pulsed Light)

Treatment of Excess Hair

Criteria for Hair Reduction • Skin colour

• Hair colour

• Hair thickness

• Depth of hair follicle

• Stage of growth cycle

Body

Region

Telogen

Hair %

Anagen

Hair %

Telogen

Duration

(weeks)

Anagen

Duration

(weeks)

Follicle

Density, cm2

Depth of

Follicle,

mm

Scalp 15 85 16 104 350 3.0 - 5.0

Beard 30 70 10 52 500 2.0 - 4.0

Upper Lip 35 65 6 16 500 1.0 - 2.5

Breasts 70 30 12 16 65 3.0 - 4.5

Trunk 70 30 14 16 75 2.0 - 4.5

Pubic Area 70 30 12 10 70 3.5 - 4.5

Arms 80 20 18 8 80 2.0 - 4.5

Axilla 70 30 12 16 65 3.0 – 4.0

Legs/Thighs 80 20 24 16 60 2.5 - 4.0

Hair Growth Duration Chart

Hair Removal

Hair Removal

Reduction 6 weeks

after 1 Treatment Before treatment

Hair Removal

Reduction 6 weeks

after 2 Treatments Before treatment

Hair Removal Before

3 treatments

9 months post last treatment

Hair Removal

Before After

Hair Removal

Before After

Hair Removal Before treatment After 3 treatments

Before 3 Treatments

12 months post final treatment

Hair Removal

Treatment Protocol

• Medical history, informed consent form

• Prepare area

• Patch test

• Treat area methodically

• Apply soothing gel

• Hair will fall out usually 1-4 weeks later

• Redness of treated area can occur

• Repeat treatment approx. every 4-6 weeks

VPL - Clinical End Point Mild to moderate peri-follicular erythema

VPL - Clinical End Point Mild to moderate peri-follicular erythema

Energist ULTRA VPL™ (Variable Pulsed Light)

Treatment of skin problems and premature photoageing

Skin Rejuvenation

•Coarse skin texture

•Pigmentation alterations

•Loss of elasticity

•Wrinkles

•Red veins, Rosacea

•Open pores

Chronic UV light exposure

Epidermal & dermal changes

Goals of VPL™ Treatment

• Improve texture of skin

• Softening of epidermal hyper-pigmentations

• Reduction of fine lines and wrinkles

• Treatment of vascular lesions

• Shrinkage of pore size

• Restoration of even skin colour

• Acne Management

Hair Removal using Energist ULTRA VPL™

Positive side-effect

Skin Rejuvenation Results

Collagen Stimulation

Collagen Stimulation Before After

Collagen Stimulation Before After

Epidermal Pigmented Lesions

Before After 2x Tx (2x7x1,30J/cm2)

Sun Damage

Courtesy of Russell Smith, New Zealand

Facial Epidermal Pigmented Lesions 1 Treatment. (Courtesy of S. Summons, Beautique Salon, Reigate, UK) Client: Skin Type III, Mid 30yrs - No. pulses: 5, On: 3ms, Off: 1ms. 30 J/cm2

© Copyright Energist Ltd. 2009 1 Treatment. (Courtesy of S. Summons, Beautique Salon, Reigate, UK)

Immediately after treatment 1 week after treatment

3 weeks

after

treatment

Before After Single Tx 9-3-1 70 Jcm2

Specialist Applicator - Sun Damage

Courtesy of Absolute Aesthetics, UK

Vascular Lesions

Facial Thread Veins Before treatment After 3 treatments

Facial Thread Veins

Before treatment After treatment

Vascular Lesions

Before After Single treatment

Specialist Applicator - Vascular Lesions

Courtesy of Joshua Fink, MD, USA

Acne Management

Acne Management

Before

Photographs courtesy of Dr. Gramlich, Germany

Treatments with the Ultra Range:

After

“VPL is an outstanding method for the

treatment of acne vulgaris at every level of

severity. The therapy is important and

valuable in the treatment of this

dermatological complaint.”

Gebhard Gramlich, M.D. Chefarzt Privatklinik Hagenmühle GbR,

Germany

Rosacea

Rosacea

Before 4 weeks after Tx1

Rosacea

Treatment Protocol

• Medical history, informed consent form

• Cleanse skin

• Select energy as per guidelines

• Apply contact gel

• Apply waveguide to skin and activate a pulse

• Methodically cover treatment area with pulses

• Remove gel and apply soothing gel or cool if necessary

Contraindications • Oral acne medication in the last six months (Accutane) • Certain Medication • Photosensitivity in the last six months • Pregnancy • Epilepsy (consult a Physician) • History of skin cancer • Tanned skin • Malignant or suspicious tissues • Haemophilia • Diabetes (certain drugs can cause photosensitivity). Treat cautiously due to loss of

sensation in extremities and poor healing rate. • Vitiligo • Use of St Johns Wort • Tattoo over treatment area • Be aware of Moles • Any anti-inflammatory medication taken daily • We do not treat anything raised

Treatment Frequencies

• Pigmentation:

– 2-5 treatments

– Appointments every 4 weeks

• Vascular:

– Normally 3-5 treatments (diffuse redness often needs several treatments)

– Appointments every 4 -6 weeks. Can be extended after third treatment to about 8 -10 weeks

• Collagen Stimulation:

– 3 - 5 treatments every 4 weeks

– Maintenance treatments every 3 - 6 months

• Acne Management

– Treatment every 2 - 4 weeks

– Inflames the acne in days following treatment

Treatment Frequencies

UltraPlus VPL Features

4 Treatment-Specific Applicators

4 applicators available with UltraPlus

(SR, HR, Acne, Specialist)

• HR – Hair removal

(610-950nm)

• SR – Skin Rejuvenation

(530-950nm)

• ACNE – Acne Vulgaris

(415nm and 630-950nm)

• SPECIALIST – Pigment & Vascular

(530-950nm)

High Energy

• However - energy must be delivered safely or side effects can occur

• VPL Systems give up to 51J/cm2

Higher

energy

delivered

Better

chance of

absorption

Better

results

© Copyright Energist Ltd. 2012

Energist launch their NEW High Energy 530nm applicator

To meet the exacting demands of the medical sector in gaining more effective treatment of more difficult vascular and benign pigmented lesion cases, Energist have developed the new High Energy 530nm applicator.

High Energy 530nm applicator - Reference

“We are getting great results with this applicator on photo-damaged skin. In fact we are using this in preference to our various lasers for photoaging, Rosacea, and solar lentigo treatments”

Dr Maria Gonzalez, Senior Clinical lecturer, Cardiff University Hospital

© Copyright Energist Ltd. 2012

plus… NEW High Energy 530nm applicator

• Up to 108J/cm2 – Market-leading energy output • 1 cm2 Spot size - Specifically designed for treatment of

benign vascular and pigmented lesions, including: – Telangiectatic matting – Venous lakes – PWS – Pyogenic Granuloma – Strawberry haemangioma

• Short pulse train for more effective treatment • 5000 shots lifetime • Available after 18 month development programme

with our lamp manufacturers • Improvements in lamp technology and processing,

combined with the latest HV technology ensures higher energy lamp with greater reliability

• Available exclusively on the UltraPlus VPL™ System • For medical/specialist use only

© Copyright Energist Ltd. 2012

Specialist Applicator Energy Table

No. Pulses On Off Max Energy (J/cm2)

5 3 1 68

9 3 1 90

5 5 1 85

9 5 1 99

2 7 1 68

5 7 1 93

9 7 1 108

Single Pulse IPL Multi-Pulse IPL Energist VPL

Consistent Power Output

• High energy gives the best effect when output is consistent

• Energist VPL systems are able to maintain power output over the whole shot

• Many IPL’s are not able to maintain consistent high power over the whole shot – slow rep rates & inconsistent outputs

Water Versus Air Cooling

High energy outputs need water cooling and multiple pulses

• Water is far more efficient for cooling than air

– Air cooled systems generally require a cooling down period after a number of shots

– Energist systems will function 24 hours a day at full power

Highest Quality Parts

Applicators • Applicators get extremely hot during

use • Energist uses very high quality parts to

withstand very high temperatures – Stainless steel cavity – Ceramic reflectors

• Many air cooled systems use plastic parts in applicators – may melt or lose reflectivity – reducing light output & treatment efficacy

often after just a few shots

Highest Quality Parts

Energist Waveguides • Very high quality BK7 Glass • Increases the distance between the lamp/filter and the

skin without losing energy • High transmittance of light • Does not heat up • Decreases amount of conducted heat reaching the skin

from cavity Filters • Energist uses high performance absorption filters for

safe & effective treatment, resulting in – Sharper filtering – Exact & constant cut-on – Even output over lifetime – Withstand high energy densities

UltraPlus VPL™ Features - Summary • Multiple Applications - hair, skin & acne • VPL™ - Widest range of pulse types

available - 840 • High & safe fluence – 51J/cm2 • Consistent power output • Water cooling • Effective filtering • High quality durable parts • Minimal client discomfort

• In depth clinical training & support • Efficient technical support