Sponsored by Cynosure, LLC
The Elite iQTM Aesthetic Workstation from Cynosure, LLC (Westford, Mass.) is the latest addition to the Elite family, the world’s first Alexandrite/Nd:YAG system, delivering increased power and dual-wavelength versatility for rapid, highly customizable treatments. As the next generation of the Elite+TM platform, and following in the footsteps of its predecessors, this device treats the spectrum of laser indications starting with gold standard hair removal and moving through benign pigmented and vascular lesions, scarring, skin revitalization, photo-aging, pseudofolliculitis barbae (PFB) and more. This modern-looking, easy-to-use platform also features its signature Skintel® live Melanin ReaderTM for guided setting adjustment on the fly, maximizing safety as well as outcomes.
Deanne Mraz Robinson, MD, FAAD
Will Kirby, DO, FAOCD Dermatologist
E. Victor Ross, MD Dermatologist
Christian Karavolas, CLS Founder
Romeo & Juliette Laser Hair Removal
Todd Tillemans CEO
An Enhanced Experience
Skintel truly separates Elite iQ from the hair removal pack, according to Deanne Mraz Robinson, MD, of Modern Dermatology of Connecticut (Westport, Conn.) and assistant clinical professor of dermatology at Yale New Haven Hospital. “This provides users an accurate reading of skin type that then translates into settings you can use with confidence. You can do this during the treatment session. So, if your patient has different skin color at the armpit because it doesn’t get as much sun, or you are dealing with the bikini area, where there can be dramatic change of skin color in a small area, you can take additional readings to modify treatment parameters easily and rapidly on the fly for top safety and efficacy.”
“The world is a diverse place, and the aesthetic market reflects that. Moreover, the patient population seeking aesthetic services is simply much more diverse than it was even 20 years ago,” said Will Kirby, DO, a dermatologist in Hermosa Beach, Calif., and chief medical officer of Laseraway. “Our clinics are in major metropolitan areas so we see the most diversity and the widest range of skin types, from I to VI, as we practice. It is extremely valuable to be able to treat patients safely and effectively regardless of ethnic origin. Elite iQ is definitely the next evolution in aesthetic laser devices.”
There’s even more to like, according to E. Victor Ross, MD, a dermatologist in San Diego, Calif. “The previous platform was a popular and proven technology, but this goes beyond the next step. It is still a workhorse, and excels at hair removal. With higher maximum energy and large spot sizes – up to 24 mm – you can use high energy and faster rep rates because of the increased power. It still treats everything you’d expect with this type of laser system, regardless of skin type, and even more safely with Skintel technology,” he said. “It utilizes top-line air cooling, and with more power, the fully adjustable fluence, pulse durations and rep rates are available in more modes than before.
“The markets for hair removal, vascular and pigmented lesions, and skin revitalization continues to grow,” Dr. Ross continued. “Hair removal is the most popular aesthetic indication. People will spend thousands of dollars and many days over the course of their lifetime to manage unwanted hair, and this doesn’t take into account patients with more serious issues. And the male market segment is growing rapidly as the stigma associated with treatment is dropping with a concurrent rise in the popularity of more carefully managed or even crafted facial and body hair.”
Christian Karavolas, CLS, founder of Romeo & Juliette Laser Hair Removal in New York City, N.Y., has been using Cynosure devices for laser hair removal for almost 20 years. “Cynosure did its first workshops for laser hair removal in our facility in 2002,” he said. “I’ve watched these devices evolve into what Elite iQ is today. Originally, we had smaller spot sizes with fixed pulse widths. Now we have a variety of spot sizes, variable pulse widths and better cooling techniques. The beam profile is idealized for consistent and uniform delivery of energy. The pulse rates are up to 50% faster than its predecessor, with larger spot sizes.”
For hair removal specifically, Elite iQ offers the gold standard 755 nm Alexandrite and 1064 nm Nd:YAG lasers. “With these you can treat virtually any treatable hair removal patient,” Mr. Karavolas pointed out. “The Alexandrite is ideal for lighter skin and lighter, finer hair because the wavelength is highly absorbed by melanin. And, it is well known that the Nd:YAG is the laser of choice for darker skin types and tanned individuals because of the low absorption by melanin combined with higher penetration to deliver energy where it needs to go without damaging darker skin.”
A Commitment to Innovation & Safety
“In the midst of a global pandemic, Cynosure remains committed to the future and driving continuous innovation,” according to new CEO Todd Tillemans (Westford, Mass.). Mr. Tillemans, who has a strong history of building top consumer brands, such as Unilever’s Dove brand, is on a mission to build Cynosure and expand their global leadership in medical aesthetics. “We’ve always put the patient first,” he said, “and we have always invested in science-based technology that delivers superior patient outcomes. Going forward, we will invest more than ever to inspire consumers to engage in medical aesthetic treatments, driving patient demand to our customer providers,” he emphasized.
“Elite iQ is a great example of a proven technology taken to new heights of safety and efficacy through science and innovation,” Mr. Tillemans continued. “This more powerful Elite iQ not only looks and feels more modern, it is more user-friendly and has new features like the Skintel Melanin Reader which has built-in treatment guidance that helps deliver the highest levels of efficacy, safety and personalized treatments.”
The watchwords for Elite iQ are intelligence, power and style. Overall, no feature brings to mind the word intelligence like Skintel technology. Using a wireless handpiece, the device provides an objective, consistent reading of “melanin index” between 0 and 99 (based on an average of three readings it takes automatically), which corresponds to Fitzpatrick Skin Type grades.
“Visual assessment of melanin content is inconsistent and inaccurate, even with a trained eye, and certainly no match for Skintel,” Dr. Mraz Robinson began. “If one overestimates, treatment is too conservative and patients are disappointed, or subject to additional treatment sessions they may not have needed with optimized treatment. Conversely, underestimation can lead to unnecessary discomfort from over-aggressive treatment parameters, with higher incidence of side effects, including scarring. Skintel not only maximizes safety, it maximizes results by providing optimized, individualized treatment for every patient,” she explained.
“One can easily imagine a scenario where a new technician or physician, not totally comfortable with a device, keeps treatment parameters too low,” Dr. Mraz Robinson continued. “At the very least they get a suboptimal result which nobody is happy with. At worst they stimulate paradoxical hypertrichosis where you have more hair growth in a certain subset of patients. Or worse, they are afraid to be too light and end up too aggressive. Elite iQ and Skintel will minimize this.” Additionally, up to 25 preset parameter combinations can be saved for easy recall.
“Also, Skintel readings are translated directly into base treatment parameters by the device,” Mr. Karavolas added. “This takes the guesswork out of treatment, and you can adjust these parameters afterwards based on your experience. With about 700,000 treatments of experience in close to 20 years of operation, we still find Skintel to be remarkably accurate and helpful, giving us even greater confidence in safety and efficacy.”
The Alexandrite laser in the Elite iQ system is 19% more powerful than its immediate predecessor and its Nd:YAG is 43% more powerful. “Rarely have we seen an Nd:YAG laser that is adequately powered to get the most out of its potential,” stated Dr. Ross. “In the past we were making compromises with fluence, rep rate, pulse width and spot size to make sure we could adequately treat. Elite iQ gives us the power to maximize the YAG regardless of spot size.”
A Touch of Modern
A modern look and feel to the Elite iQ platform doesn’t simply bring it to the level of the competition, it takes the lead. As part of its beautiful and functional ergonomic styling, the 13-inch slimline touchscreen display is prominently placed. The graphical user interface (GUI) is modern and intuitive.
“These improvements are arguably as profound as the addition of Skintel. The touchscreen display and interface are application-driven with integrated reading and input characteristics that are easy to understand,” Dr. Ross noted. “This is one area where we see a dramatic improvement over previous devices. Anyone with basic tech savvy can understand what is going on with this device, so it is quite easy to train a technician to perform safe and effective hair removal consistently.” Additionally, the handpieces are lightweight and ergonomic. On-board storage features include a flat top tray as well as easy-to-access internal drawer. An adjustable six-color LED logo and backlit wraparound handle complete the package. “With these improvements, the outside of Elite iQ is as sexy as the technology inside.”
“One cannot discount the importance of an intuitive interface and overall ease of use, especially when you are talking about a device that you are putting into the hands of a clinician and expecting them to hit home runs with in every single clinic in a group such as ours,” said Dr. Kirby. “Overall we want safety, but with the ability to get optimized, accurate, efficient treatment parameters virtually automatically, every time – that’s outstanding.”
“Another unique feature that adds to safety is the color coding of wavelengths in use,” Mr. Karavolas added. “When you are using the Alexandrite, the display is blue. With the Nd:YAG, it is predominantly yellow, so at a glance users can be sure of which wavelength is ready for use.”
Though not a frontline feature, Dr. Kirby enjoys the lack of consumables. “Those are the bane of the aesthetic practice. With the Elite iQ system it is plug-and-play, which makes it a very easy device to integrate into your practice and operate profitably. Return on investment,” he explained, “is variable to gauge because different markets will bear different price structures, but with an easy payment plan and an easy-to-use device with immediate utility, the money comes in quickly.”
Wide Spectrum of Applications
When considering hair removal devices, safety is king, followed closely by efficacy, then comfort and ease of use. “One cannot overstate the importance of a comfortable treatment for patients,” Mr. Karavolas explained. “You want patients to complete their course of treatment, which will take several months, and return for maintenance when needed. These patients will be the best advertising you can have. Between Skintel, the beam profile, adjustable settings and air cooling, treatment comfort is certainly manageable. Air cooling is the best because you get cooling before, during and after firing the laser. Ease of use and ergonomic design are also essential because technicians will be performing treatments day in and day out. We want to provide them something they’ll enjoy using, as well as use comfortably, throughout the day.
“Improved energy output over previous devices and the repetition rate provides us enough energy output to successfully penetrate the hair follicle, even with larger spot size and finer hair, to disable the hair follicle’s reproductive cycle. Adjustable pulse width is key to further expanding our treatment capabilities as well,” he added. “Unlike other lasers it allows us to fine-tune pulse widths down for finer, less pigmented hair. As treatment progresses and returning hair becomes lighter and finer, this becomes increasingly important.”
“Remember, probably 70% of the pulses fired from this laser worldwide will be for hair removal,” said Dr. Ross. “It does other things very well, but hair removal is what Elite iQ does like nothing else on the market. Treating other indications generally requires more skill and experience, but for hair removal, you just use the device to get the right settings, hold the handpiece correctly and fire away with confidence. Because it is so good at the most popular indication globally, it may bring a lot of people into your practice where they may later go for other types of treatments you offer.”
For vascular lesions, treated with the 1064 nm wavelength, the unique utility of Elite iQ provides the variable fluence and pulse duration to deal with larger, deeper vessels as well as finer, superficial vascularity, according to Dr. Ross. “The 2.5 mm spot size really comes in handy here. It is more for discrete vascular lesions such as leg veins or telangiectasias on the face than diffuse redness.”
When it comes to benign unwanted pigmentation, such as café au lait macules, lentigines and solar lentigines, nevi and more, the 755 nm Alexandrite wavelength is the most ideal and is best used on lighter skin types. “You’ll typically use the 5 mm spot size for discreet lesions and the 18 mm spot for diffuse pigmentation, typically at 5 ms with the cooling off and the appropriate fluence for that particular skin type,” said Dr. Ross.
Treatment of photodamage is, again, a function of choosing either wavelength based on individual needs. Skin types I–III are handled by the 755 nm Alexandrite laser, targeting melanin but sparing surrounding tissue, while the 1064 nm Nd:YAG heats skin deeply to stimulate neocollagenesis and refresh skin. “We perform a treatment we call a ‘Fire and Ice’ laser facial – many other clinics have their proprietary name for the same thing – using Elite iQ to revitalize skin and skin tone. Patients experience a strong heat sensation with the laser, followed by cooling with the Zimmer cooler. After treatment we use refrigerated facial masks infused with ascorbic acid,” Dr. Kirby said.
Users can choose from among ten available spot sizes ranging from 2.5 to 24 mm, to treat many indications and any body location. “Combined with the other improvements, the range of spot sizes provides much more versatility and speed,” Mr. Karavolas said.
“The name of our company is ‘Laseraway’ and we rely on lasers as our name suggests,” Dr. Kirby said. “We need a reliable, consistent platform. We get that with the Elite family of lasers and Cynosure devices in general. And with 59 clinics, it is imperative that we feature the safest, best device on the market for this indication.”
“When you juxtapose our clinics with a practice of someone like Dr. Mraz Robinson, you see a highly educated, highly skilled and experienced physician with a top dermatology practice, compared to me with a chain of top aesthetic clinics,” Dr. Kirby continued. “Our patient population tends to be younger and more price conscious. Dr. Mraz Robinson’s practice will offer a much wider range of therapies, both medical and aesthetic, where we offer a specific range of aesthetic procedures. Her’s is a physician practice, whereas we have a lot of specially trained care extenders delivering treatment. Together we represent two ends of the spectrum, a physician with a top dermatology practice, versus me training a new nurse to do laser hair removal at a clinic with Elite iQ, both of us confident in the device and knowing it is the best out there. That says a lot about Cynosure and Elite iQ.”
Reliability is always prized and Elite iQ is no exception, earning the moniker ‘work-horse,’ according to Mr. Karavolas. “We primarily perform laser hair removal at my clinic,” he said, “which means regular and repeated use. We rely on our Elite lasers like no other. It is designed for heavy use and backed by a company that is even more reliable than the devices it provides. We enthusiastically use it with confidence. Our relationship with Cynosure goes back almost 20 years for a reason – they deliver.”
Editor’s note: This article is sponsored by Cynosure, LLC. The Elite iQ Workstation is not yet available in Canada.
Dr. Kirby, Dr. Mraz Robinson, Dr. Ross and Mr. Karavolas are Cynosure consultants.
The Elite iQ aesthetic workstation is indicated for the following, but not limited to: permanent hair reduction and treatment of veins, non-cancerous pigmentation, wrinkles, warts, scars and ingrown facial hairs. Most common side effects include redness, swelling, crusting and scabbing.