ited Clinical Study Impact Trans - Epidermal Delivery for Skin Enhancement Multi-Site Clinical Results

Table of Contents About Alma Lasers... 3 Introduction...4-5 Clinical Studies: Scars...6-14 Clinical Studies: Acne Scars...15-23 Clinical Studies: Strech Marks...24-33 Clinical Studies: Skin Rejuvenation...34-48 Clinical Studies: Melasma...49-56 ]2[

About Alma Lasers Alma Lasers is the leading supplier of innovative medical aesthetic technologies. Alma Lasers is recognized by industry practitioners for its whole-hearted commitment to providing complete solutions to professional practices. Alma Lasers offers innovative technologies, dependable equipment and years of industry expertise. Alma Lasers seeks the creation of a strong and lasting relationship with our doctors and aesthetic clinics based on trust and a genuine desire for the success of the practice. For more information visit www.almalasers.com Facebook: www.facebook.com/almalasers Twitter: @almalasers LinkedIn: http://www.linkedin.com/company/alma-lasers ]3[

Introduction: ited - Trans-Epidermal Delivery with Impact Technology ited is a skin barrier breakthrough solution developed to overcome the challenge of introducing active ingredients to the deeper layers of the skin without interference from the stratum corneum (outer layer of skin barrier). ited is a multi-step solution that combines fractional ablation and ultrasound technologies with ProfoundPixel Smart Messengers. Treatment protocol first calls for fractional skin ablation and the formation of microchannels in the skin. ited then harnesses the power of acoustic ultrasonic waves,pushing the ProfoundPixel Smart Messengers into these microchannels, which leads directly to the area that will most benefit from the active ingredients. ited is for the treatment of scars, stretch marks, melasma, acne scars, skin whitening and skin rejuvenation - indications for which there is mostly no effective solution which is not highly invasive. ProfoundPixel Smart Messengers The advantage of Trans-Epidermal Delivery compared to topical, oral, and hypodermic injections - is the ability to deliver the appropriate dose of active ingredients directly to the location that will most benefit. When active ingredients are introduced directly to biological tissue, they are more deeply absorbed and provide a stronger therapeutic effect. Until now, the main problem with effective delivery of skin care products/ cosmeceuticals, was the fact that the stratum corneum is an effective barrier to outside elements. ProfoundPixel Smart Messengers are applied to the skin following the creation of the microchannels. The Smart Messengers are forced through the microchannels by the Impact Ultrasound unit. Impact ipixel RF and ipixelco2 The first step in the ited treatment is to create microchannels in the skin. ited uses the ipixelrf or ipixelco2. The ipixel RF is a radio wave generator that causes precise and controllable thermal damage and fractional ablation, while the ipixelco2 is the world s fastest and most powerful fractional ablative CO2 laser. Both ipixel modules pierce the skin and cause fractional ablation - forming the microchannels. Each microchannel is 80-120 microns in diameter and has a depth of 100-150 microns, depending on the power settings. The acoustic vibrations of the Impact ultrasound module provides the Smart Messengers greater mobility and reactivity. This increases the amount of active ingredients that enter the body, thereby increasing the effectiveness of the ited treatment. ]4[

Treatment Settings Face Treated area ipixel RF Power [W] ipixel co2 Power [W] Neck 30-40 20-30 High Mode Chin 30-40 20-30 High Mode Cheeks 35-45 20-30 High Mode Periorbital 30-40 20-30 High Mode Forehead 35-45 20-30 High Mode Body Treated area ipixel RF Power [W] ipixel co2 Power [W] Hand 30-40 20-30 High Mode Abdominals 35-45 20-30 High Mode Waist 35-45 20-30 High Mode Hip 30-40 20-30 High Mode Buttocks 35-45 20-30 High Mode Treatment The pictures in this clinical bookare of treatments which have been performed in Brazil, Korea, Israel, Russia and Dubai. Patients underwent treatment for the removal of stretch marks and scars, skin rejuvenation, and skin whitening. Other noted changes in the appearance of the skin following the ited procedure include a decrease in skin tension by the scar and the reduction in height or depth of the scar. In addition, using basal blood flow assessment with a Doppler flowmeter, the edema of the adjacent tissue decreased due to improvements of the blood circulation. Conclusions ited treatment is designated for mature scars, post acne scars, stretch marks, skin whitening and skin rejuvenation. ]5[ ]5[

ited Treatment Results Skin Barrier Breakthrough Solution Scars

Scars 1 week after 2 Tx Courtesy of: Maria Claudia Issa, MD, PhD, Rio de Janeiro, Brazil RF: 45 W, 3 passes Cosmeceutical: Triancinolona Impact: 60 Hz, 80%, 1 min ]7[

Scars After 2 Tx Courtesy of: Igor Pinson, MD, PhD, Dermatologist, Moscow, Russia RF: 45 w Cosmeceutical: Contractubex Impact: 40 Hz, 50%, 1 min ]8[

Scars 10 days after 4 Tx Courtesy of: Igor Pinson, MD, PhD, Dermatologist, Moscow, Russia RF: 50 w 2-3 passes Cosmeceutical: Contractubex Impact: 40 Hz, 50%, 1 min ]9[

Scars 1 week after 2 Tx Courtesy of: Maria Claudia Issa, MD, PhD, Rio de Janeiro, Brazil RF: 40W, 2 passes Cosmeceutical: Hyaluronic Acid + Vit C Impact: 60 Hz, 80%, 1 min ]10[

Scars After 4 Tx. Courtesy of: Maria Claudia Issa, MD, PhD, Rio de Janeiro, Brazil RF: 40W, 2 passes Cosmeceutical: Hyaluronic Acid + Vit C Impact: 60 Hz, 80%, 1 min ]11[

Scars After 1 Tx. Courtesy of: Maria Claudia Issa, MD, PhD, Rio de Janeiro, Brazil RF: 45W, 3 passes Cosmeceutical: Triancinolona Acetonide Impact: 60 Hz, 80%, 2 min ]12[

Scars After 1 Tx. Courtesy of: Maria Claudia Issa, MD, PhD, Rio de Janeiro, Brazil RF: 45W, 3 passes Cosmeceutical: Triancinolona Acetonide Impact: 60 Hz, 80%, 2 min ]13[

Scars After 1 Tx Courtesy of: Tania Meneghel, MD, Dermatologist Clínica Renaissance, São Paulo, Brazil ipixel CO2: Medium, 70mJ/Pixel, 0, 2 passes Cosmeceutical: Quercetin Impact: 50Hz, 50%, ]14[

ited Treatment Results Skin Barrier Breakthrough Solution Acne Scars

Acne Scars After 2 Tx Courtesy of: Maria Claudia Issa, MD, PhD, Rio de Janeiro, Brazil RF: 45 W, 3 passes Cosmeceutical: Tretinoin 0.05% Impact: 60 Hz, 80%, 2 min ]16[

Acne Scars After 3 Tx. Courtesy of: Maria Claudia Issa, MD, PhD, Rio de Janeiro, Brazil RF: 45 W, 3 passes Cosmeceutical: Tretinoin 0.05% Impact: 60 Hz, 80%, 2 min ]17[

Acne Scars After 3 Tx Courtesy of: Maria Angelo-Khattar, PhD, Aesthetica Clinic, Dubai RF: 60 W, stationary and ipixel RF (In Motion), 6 passes Cosmeceutical: Dalacine (Clindamycin) ]18[

Acne Scars After 6 Tx Courtesy of: Maria Angelo-Khattar, PhD, Aesthetica Clinic, Dubai RF: 40-50 W (Treatments 1-5), 100 W (Treatment 6), ipixel RF (IN Motion), 7 passes Cosmeceutical: Locoid (hydrocortisone butyrate) Impact: 40 Hz, 50%, 2 min ]19[

Acne Scars 1 week after 1 Tx Courtesy of: Choi Jun, MD, PhD, MayLin Clinic, Seoul, Korea RF: 55-65 W, 4-5 passes Cosmeceutical: PRP Impact: 60 Hz, 50%, 2 min ]20[

Acne Scars After 3 Tx Courtesy of: Michael Shohat, MD, Dermatologist Aesthetic Laser Clinic, Tel Aviv, Israel RF: 45-50 W, 2-3 passe Cosmeceutical: Meso anti Wrinkle,1% HA, MicroAcne kit Impact: 60 Hz, 80%, min ]21[

Acne Scars After 1 Tx Courtesy of: Maria Claudia Issa, MD, PhD, Rio de Janeiro, Brazil ipixel CO2: 60 W cheeks area - 50 mj/pixel, 2 passes, 30 mj/pixel, 1 pass Cosmeceutical: Retinoic acid Impact: 50 Hz, 80% ]22[

Acne Scars After 2 Tx Courtesy of: Maria Claudia Issa, MD, PhD, Rio de Janeiro, Brazil ipixel CO2: 60 W 50 mj/pixel, 2 passes Cosmeceutical: Retinoic acid Impact: 50 Hz, 80% ]23[

ited Treatment Results Skin Barrier Breakthrough Solution Strech Marks

Stretch Marks After 4 Tx Courtesy of: Maria Claudia Issa, MD, PhD, Rio de Janeiro, Brazil RF: 45 W, 3 passes Cosmeceutical: Hyaluronic Acid + Vitamin C Impact: 60 Hz, 80%, 4 min ]25[

Stretch Marks After Courtesy of: Maria Claudia Issa, MD, PhD, Rio de Janeiro, Brazil RF: 45 W,3 passes Cosmeceutical: Hyaluronic Acid + Vitamin C Impact: 60 Hz, 80%, 4 min ]26[

Stretch Marks After 4 Tx Courtesy of: Maria Claudia Issa, MD, PhD, Rio de Janeiro, Brazil RF: 45 W 2 crosses (4passes) in motion tip Cosmeceutical: tretinoin 0,05% Impact: 60 Hz 80% ]27[

Stretch Marks After 1 Tx Courtesy of: Michael Shohat, MD, Dermatologist Aesthetic Laser Clinic, Tel Aviv, Israel RF: 55W, 2 passes Cosmeceutical: Meso Striae kit Impact: 60 Hz, 50%, 5 min ]28[

Stretch Marks After 3 Tx Courtesy of: Michael Shohat, MD, Dermatologist Aesthetic Laser Clinic, Tel Aviv, Israel RF: 55W, 3 passes Cosmeceutical: Meso Striae kit Impact: 80 Hz, 50%, 3 min ]29[

Stretch Marks 14 days after 2 Tx Courtesy of: Igor Pinson, MD, PhD, Dermatologist, Moscow, Russia RF: 45 W, 3 passes Cosmeceutical: Hyaluronic Acid + Vitamin C ]30[

Stretch Marks After 2 Tx Courtesy of: Maria Claudia Issa, MD, PhD, Rio de Janeiro, Brazil RF: 45 W Cosmeceutical: Tretinoin 0.05% Impact: 50 Hz, 80%, 1 min ]31[

Stretch Marks After 1 Tx Courtesy of: Maria Claudia Issa, MD, PhD, Rio de Janeiro, Brazil ipixel CO2: 60 W, 60 mj/pixel + 1 pass with the 7x7 tip ]32[

Stretch Marks After 1 Tx Courtesy of: Dong-Hye Suh, MD, Dermatology, Arumdaun Nara Dermatologic Clinic, Korea RF: 40-45 W Cosmeceutical: PRP Impact: 50 Hz, 50% ]33[

ited Treatment Results Skin Barrier Breakthrough Solution Skin Rejuvenation

Skin Rejuvenation 1 week after 2 Tx Courtesy of: Maria Claudia Issa, MD, PhD, Rio de Janeiro, Brazil RF: 40 W, 3 passes Cosmeceutical: Retinoic Acid 0,05% Impact: 60 Hz, 80%, 60 sec periocular +120 sec-malar and mandibular ]35[

Skin Rejuvenation After 4 Tx Courtesy of: Maria Claudia Issa, MD, PhD, Rio de Janeiro, Brazil RF: 40 W, 3 passes Cosmeceutical: Anti-Wrinkle+Retinoic Acid (RA) Impact: 60 Hz, 80%, 1 min ]36[

Skin Rejuvenation After 3 Tx Courtesy of: Maria Claudia Issa, MD, PhD, Rio de Janeiro, Brazil RF: 45 w Cosmeceutical: Tretinoin 0,05%+ HÁ 5% + VIT C 5% Impact: 60 Hz, 80% ]37[

Skin Rejuvenation After 2 Tx Courtesy of: Maria Claudia Issa, MD, PhD, Rio de Janeiro, Brazil RF: 40W, 2 passes Cosmeceutical: Vit C + Hyaluronic Acid Impact: 60 Hz, 80%, 1 min ]38[

Skin Rejuvenation After 4 Tx Courtesy of: Maria Angelo-Khattar, PhD, Aesthetica Clinic, Dubai RF: 60 W, 2 stationary passes Cosmeceutical: Vitamin C, Alphalipoic acid, Zinc, Silicium and Manganese Impact: 60 Hz, 60%, 2 min ]39[

Skin Rejuvenation After 2 Tx Courtesy of: Maria Angelo-Khattar, PhD, Aesthetica Clinic, Dubai RF: 55 W, 3 passes Cosmeceutical: Vitamin C, Alphalipoic acid, Zinc, Silicium and Manganese Impact: 60 Hz, 60%, 2 min ]40[

Skin Rejuvenation After 3 Tx Courtesy of: Maria Angelo-Khattar, PhD, Aesthetica Clinic, Dubai RF: 50W, 4 passes stationary Cosmeceutical: Vitamin C, Alphalipoic acid, Zinc, Silicium and Manganese Impact: 60 Hz, 60%, 2 min ]41[

Skin Rejuvenation 1 week after 1 Tx Courtesy of: Maria Claudia Issa, MD, PhD, Rio de Janeiro, Brazil RF: 40W, 3 passes Cosmeceutical: Meso DMAE Impact: 60 Hz, 80%, 2 min ]42[

Skin Rejuvenation After 3 Tx Courtesy of: Maria Angelo-Khattar, PhD, Aesthetica Clinic, Dubai RF: 60W, 3 stationary passes and 2 IN Motion passes Cosmeceutical: Vitamin C, Alphalipoic acid, Zinc, Silicium and Manganese Impact: 60 Hz, 60%, 2 min ]43[

Skin Rejuvenation After 2 Tx Courtesy of: Yitzchak Ramon, MD, Elisha Hospital & Rambam Health Care Campus, Haifa, Israel ipixel CO2: Low mode 50 mj/pixel, 2 passes Cosmeceutical: ProfoundPixel SR kit Impact: 60 Hz, 60%, 1 min ]44[

Skin Rejuvenation After 2 Tx Courtesy of: Yitzchak Ramon, MD, Elisha Hospital & Rambam Health Care Campus, Haifa, Israel RF: 60 W, 4 passes Cosmeceutical: ProfoundPixel SR kit Impact: 60 Hz, 80%, 1 min ]45[

Skin Rejuvenation After 2 Tx Courtesy of: Yitzchak Ramon, MD, Elisha Hospital & Rambam Health Care Campus, Haifa, Israel RF: 40 W, 6 passes Cosmeceutical: ProfoundPixel SR kit Impact: 45 Hz, 80%, 1 min ]46[

Skin Rejuvenation After 2 Tx Courtesy of: Yitzchak Ramon, MD, Elisha Hospital & Rambam Health Care Campus, Haifa, Israel RF: 55 W, 4 passes Cosmeceutical: ProfoundPixel SR kit Impact: 45 Hz, 60%, 1 min ]47[

Skin Rejuvenation After 7 Tx Courtesy of: YoungSeung Jeon, MD, Dermatologist, Arumdaun Clinic Jeju, Korea RF: ipixel RF, 50 W, 4 passes Cosmeceutical: PRP Impact: 50 Hz, 50%, 4 min ]48[

ited Treatment Results Skin Barrier Breakthrough Solution Melasma

Melasma After 3 Tx Courtesy of: Igor Pinson, MD, PhD, Dermatologist, Moscow, Russia RF: 45-50 W Cosmeceutical: Melasma Kit Impact: 45 Hz, 50%, 1 min ]50[

Melasma After 2 Tx Courtesy of: Igor Pinson, MD, PhD, Dermatologist, Moscow, Russia RF: 45-50 W Cosmeceutical: Melasma Kit Impact: 45 Hz, 50%, 1 min ]51[

Melasma After 1 Tx Courtesy of: Michael Shohat, MD, Dermatologist Aesthetic Laser Clinic, Tel Aviv, Israel ipixel CO2: High power, 15 mj/pixel, 2 passes Cosmeceutical: 4% Hydroquinone gel Impact: 50 Hz, 40%, 2 min ]52[

Melasma After 1 Tx Courtesy of: Michael Shohat, MD, Dermatologist Aesthetic Laser Clinic, Tel Aviv, Israel ipixel CO2: High power, 20 mj/pixel, 2 passes Cosmeceutical: 4% Hydroquinone gel Impact: 50 Hz, 40%, 2 min ]53[

Melasma After 1 Tx Courtesy of: Michael Shohat, MD, Dermatologist Aesthetic Laser Clinic, Tel Aviv, Israel ipixel CO2: High power, 10 mj/pixel, 2 passes Cosmeceutical: Bleaching gel Impact: 50 Hz, 20%, 2 min ]54[

Melasma After 1 Tx Courtesy of: Tania Meneghel, MD, Dermatologist Clínica Renaissance, São Paulo, Brazil ipixel CO2: High power, 70 mj/pixel, 1 pass, Spacing 1 Cosmeceutical: Vitamin C, kojic acid, tranexamic acid, Mg Sulfate Impact: 50 Hz, 50% ]56[