New Dermatology Applications for Focused Ultrasound

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Denmark-based TOOsonix recently announced the publication of two peer-reviewed studies. One paper found the company’s novel device to be successful in treating skin lesions, including cancer; the other announced results for tattoo ink removal in problematic cases. Read on to learn how TOOsonix is able to use focused ultrasound to treat various depths in the skin without thermal injury to the adjacent, non-target tissue.

High-frequency (20 MHz) High-intensity Focused Ultrasound: New Treatment of Actinic Keratosis, Basal Cell Carcinoma, and Kaposi Sarcoma. An Open-label Exploratory Study.

TOOsonix Actinic Keratosis01Scientists at TOOsonix worked with a dermatologist to investigate whether focused ultrasound could effectively treat skin cancer and actinic keratosis. Eight patients with 215 total lesions underwent up to three treatments on each lesion using probes with different target depths. After 3 to 6 months, the patients with actinic keratosis had a 97% cure rate with no scarring. The patients with basal cell carcinoma and Kaposi sarcoma experienced full healing that was confirmed histologically. This new treatment modality provided better clinical efficacy and lower pain for the patient as well as significantly lower cost for the clinic/hospital than standard treatments performed by photodynamic therapy, radiation therapy, or surgery. Although further studies are needed, these early results show skin cancer and a wide range of premalignant skin conditions as promising new applications for focused ultrasound.

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High‐frequency (20 MHz) High‐intensity Focused Ultrasound: New Ablative Method for Color‐independent Tattoo Removal in 1‐3 Sessions. An Open‐label Exploratory Study.

TOOsonix Tattoo01The TOOsonix group also investigated the use of high-intensity focused ultrasound (HIFU) for ablative tattoo removal. Researchers tested whether HIFU could remove ink from tattoos that did not respond to laser or dermatome shaving. The study included 22 subjects with 67 tattoos in total. Treatments using transducers of different focal depths were administered as synergistic “shoulder‐by‐shoulder” shots of HIFU – or overlapping treatments to ensure full coverage of the target area. Results showed significant reduction in tattoo pigment after one to three treatments, and this was fully independent of the tattoo ink color. In comparison, five to 15 treatments are typically needed for laser tattoo removal, which is also color dependent. In total, 62% of the patients benefitted from the treatment while 28% only had a minor effect. Patients judged the pain level of the treatment to be around 60% of comparable laser treatments.

TOOsonix Tattoo02The research group concluded that 20 MHz of focused ultrasound was a new and effective method for removal of difficult tattoos of any color. They did note, however, that wound healing was longer after HIFU ablation compared to laser treatments, and minor visible changes of skin surface markings or skin thickening were observed in some cases. More studies on conventional tattoo removal without the same problematic starting conditions as those presented in the study will be conducted in the near future.

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