UltraClear from Acclaro

In each issue, Modern Aesthetics® magazine spotlights a new device that aesthetic physicians are introducing to their patients. Here, Lesley Clark-Loeser, MD, co-founder of Precision Skin Institute in Davie, FL, discusses Acclaro’s UltraClear, the first FDA-cleared cold ablative fiber laser.

What is UltraClear?

Lesley Clark-Loeser, MD: UltraClear is a first-in-class 2910nm Erbium-doped fluoride fiber laser with a platform of four distinct treatment modalities. We can provide light to deep resurfacing, treatment of wrinkles, scars (including from acne), benign pigmented lesions, unwanted pigmentation, enlarged pores, and induce collagen remodeling.

How does UltraClear work?

Dr. Clark-Loeser: The 2910nm wavelength targets water and is engineered to deliver cold fractional ablation as well as an option of dialed-in coagulation. This allows for precise and consistent tissue impact, minimizing unwanted thermal damage. This permits us to safely and effectively treat all skin types. The laser energy can reach specific depths based on treatment parameters.

We can ablate thin layers of the skin to stimulate the natural healing process to replace old skin with younger-looking new skin. In deeper treatment modes, UltraClear ablates micro-channels deep into the dermis with mechanical and thermal fractional lesions at multiple dermal depths that will trigger profound rejuvenation as the skin heals and creates new collagen and elastin. Because all UltraClear treatments are fractionated, they leave a significant bridge of healthy tissue that promotes rapid healing while reducing the chances of side effects.

How have the results been?

Dr. Clark-Loeser: The device is fairly new in our practice but the short-term results have been extremely favorable. Patients have been very pleased with results so far, even after one treatment. They get brighter skin with a quick treatment and minimal discomfort and downtime. The laser can deliver a full-face treatment in as little as 10 minutes. Most patients are highly motivated to come for their next treatment.

What makes UltraClear unique?

Dr. Clark-Loeser: Many ablating systems use laser energy sources that are not efficient ablators, thus causing significant unwanted collateral thermal damage to the skin, increasing the PIH risk, and requiring the use of numbing cream or nerve block.

No topical numbing is required for a wide range of resurfacing and collagen remodeling treatments with UltraClear. Treatments are relatively painless with minimal downtime.

The spot size is only 170µm. The ablative channels have a smaller diameter than some other systems so they can close and heal more quickly with less pain and bleeding. With a very fast pulse delivery (3000Hz), UltraClear fiber laser automatically breaks up deep ablation pulses into four sub-pulses. Each cold ablative sub-pulse is followed by multiple thermal, coagulative sub-pulses, delivered at a different depth up to 1.5mm in the dermis with the same energy and optimal timing in between. The sub-pulse delivery minimizes pain and delivers thermal energy at multiple depths in the dermis, creating profound and 3D collagen remodeling. As a result of the fractional cold ablation and dialed-in coagulation, the device delivers extreme precision regarding tissue impact to deliver a relatively painless treatment with low social downtime.

At the wavelength of 2910nm, combined with the advanced energy control for optimized ablation and coagulation, UltraClear is safe for darker skin types. It’s an efficient and precise fractional ablative laser that allows us to adjust coagulation levels for different skin types and conditions, to deliver the right amount of thermal energy without causing too much thermal damage.

How has the return on investment (ROI) been?

Dr. Clark-Loeser: Not having any consumables on the device is a significant advantage. This will allow us to offer packages of UltraClear or 3DMiracl treatments to meet each patient’s goals and to keep patients’ coming back to treat additional areas. The treatments are fast and easily tolerated, and potentially delegable to physician extenders.

How are you marketing UltraClear?

Dr. Clark-Loeser: We are currently marketing the new treatments through a robust social media campaign and had an in-office launch event in September. Our patients are very educated and savvy and are always interested in new, new, new treatments that work well. UltraClear meets that high demand in our practice.

What procedures do you pair UltraClear with?

Dr. Clark-Loeser: In theory, UltraClear can be paired with almost any aesthetic procedure we do in the office, such as laser hair removal, peels, injectables, and non-invasive body shaping.

What is UltraClear’s 3DMiracl?

Dr. Clark-Loeser: 3DMiracl is UltraClear’s signature anti-aging lunchtime treatment. It stimulates natural exfoliation for brighter, younger-looking skin. 3DMiracl is designed to treat patients under 50 who seek improvement of the appearance of their skin to combat aging. 3DMiracl treatments are superficial, targeting the uppermost layers of the epidermis.

Another popular treatment modality coupled with 3DMiracl is to add the Ultra treatment mode at variable depths to rejuvenate the skin for collagen remodeling, adding lifting results to improve the appearance of sagging skin. For these patients, we can offer a series of 10–15-minute treatments every two months that can be delegated and keeps the patients coming back to the practice.

Is there a learning curve?

Dr. Clark-Loeser: There is a short learning curve, particularly with the 3DMiracl lunchtime treatment. For all the platform treatments, the available and adjustable treatment parameters are very clear. The guided user interface is very intuitive, so we know the optimal treatment parameters based on patient selection.

Please share your treatment protocol/s and any pearls.

Dr. Clark-Loeser: For added patient comfort in more aggressive treatments, we utilize forced air cooling in our practice, specifically a Zimmer® cooler. As with any new laser or technology in your practice, start with conservative settings and see for yourself how patients respond and what their recovery will truly look like. Once you have become comfortable with predictable outcomes, then it’s time to push the potential of the device and/or treatment. UltraClear is a powerful laser, and I am certain that we are seeing just the tip of the iceberg in terms of what this platform can achieve.