Mathematical Modelling of the Optimum Pulse Structure for Safe and Effective Photo Epilation Using Broadband Pulsed

Light
Caerwyn Ash PhD1, Kelvin Donne PhD2, Gwenaelle Daniel PhD2, Godfrey Town2, Marc Clement PhD1
1. School of Medicine, Swansea University, Swansea SA2 8PP 2. University of Wales, Cardiff, CF10 3NS

2010

Statement of Disclosure The following potential conflict of interest relationships are germane to our presentation: Salary and test equipment loan: CyDen Ltd., Wales Travel grant: Swansea University, Wales

2010

IPL Pulse Structure Categories (time vs. wavelength)

Free Discharge

Square Pulse

Close Pulse Stacking

Spaced Pulse Stacking

Ash C, Town G, Bjerring P, (2008), Relevance of the Structure of Time Resolved Spectral Output to Light Tissue Interaction Using Intense Pulsed Light (IPL), Lasers in Surgery and Medicine 40:8392

Reference sources for Monte Carlo model parameters

P Bjerring, K Donne, M Clement, M Kiernan, The Importance of Temporal Profile in Selective Non-Ablative Wrinkle Reduction using 585nm Light, 2002, White Paper S Kimel, LO Svaasand, MJ Hammer-Wilson, JS Nelson. Influence of wavelength on response to laser photothermolysis of blood vessels: Implications for port wine stain laser therapy. Lasers in Surgery and Medicine, 2003;33(5):288 295. GW Lucassen, W Verkruysse, M Keijzer, MJ van Gemert. Light distributions in a port wine stain model containing multiple cylindrical and curved blood vessels. Lasers in Surgery and Medicine 1996;18(4):345 357. TJ Pfefer, JK Barton, DJ Smithies, TE Milner, JS Nelson, MJ van Gemert, AJ Welch. Modeling laser treatment of port wine stains with a computer-reconstructed biopsy. Lasers in Surgery and Medicine 1999;24(2):151166. MJ van Gemert, GW Lucassen, AJ Welch. Time constants in thermal laser medicine: II. Distributions of time constants and thermal relaxation of tissue. Phys Med Biol 1996; 41(8):1381 1399. W Verkruysse, GW Lucassen, JF de Boer, DJ Smithies, JS Nelson, MJ van Gemert. Modelling light distributions of homogeneous versus discrete absorbers in light irradiated turbid media. Phys Med Biol 1997;42(1):51 65. T Binzoni, TS Leung, R Giust, D Rufenacht, AH Gandjbakhche. Light transport in tissue by 3D Monte Carlo: Influence of boundary voxelization. Comput Meth Prog Bio 2008;89:14 23. R Steiner, D Russ, W Falkenstein, A Kienle, Optimisation of Laser Epilation by Simulation of the Thermal Laser Effect, Laser Physics Vol 11, Vol 1, 2000, P 146-153. G Shafirstein, L Buckmiller, M Waner, W Bumler, Mathematical Modelling of Selective Photothermolysis to aid the Treatment of Vascular Malformations and Hemangioma with Pulsed Dye Laser, Lasers Med Sci Volume 22, Number 2 / June, 2007. W Baumler, E Vural, M Landthaler, F Muzzi, G Shafirstein, The Effects of Intense Pulsed Light (IPL) on Blood Vessels Investigated by Mathematical Modeling, Lasers in Surgery and Medicine, Volume 39 Issue 2, Pages 132 139. F Sun, A Chaney, R Anderson, G Aguilar, Thermal Modelling and Experimental Validation of Human Hair and Skin Heated by Broadband Light, Lasers in Surgery and Medicine 41:161169 (2009)

Materials and Methods

5m cell size Cartesian coordinate grid Values of tissue properties taken from abundance of peer reviewed literature 1107 photons Spectrum equals 10J/cm2

Physical Constants used for the various tissue layers

Materials and Methods

We modelled the IPL spectrum as 600 differently coloured lasers (500 to 1,100nm) of different intensities of 1nm bandwidth and fluence simultaneously. Absorption by tissue chromophores taken from literature
a (melanin)( ) (1.7 1012 -3.48) SL Jacques. Origins of tissue optical properties in the UVA, visible and NR regions. In: Alfano RR, Fujimoto JG,
editors. Advances in optical imaging and photon migration, Vol. 2.Washington, DC:OSA; 1996:364370.

Materials and Methods

Following establishment of the photon distribution using the Monte Carlo technique, the temperature distribution at any instant may be calculated by numerically solving the timedependent thermal diffusion equations. The temperature of the skin is governed by the following bio-heat equation

Where T (x,y,z,t) is the local temperature in the tissue (K), is the thermal diffusivity of the tissue = [k/c] c is the specific heat (J kg-1 K-1), is the mass density, (kg m-3), k is the thermal conductivity of the tissue, (W m-1 K-1), Q (x,y,z,t) is the volumetric thermal source term, (W m-3) t is the time (seconds),

Modelled Representation IPL Pulse types

Results

Rate of modeled follicular temperature increase against time for different pulse structures Free discharge, Square Pulse and Close Pulse Stacking system attain temperatures above 70C Spaced pulse stacking system suggests that the device would need to deliver a greater fluence to attain similar results than the other systems as much energy is lost during the prolonged off time between pulses. Spaced pulse stacking systems may require more internal water-cooling and active or parallel skin surface cooling to generate and deliver energy safely.

Results

Rate of epidermal temperature increase against time for different pulse structures
Longer pulse structures allow the epidermal layer to cool during the pulse Skin temperatures for all four systems indicating the peak temperature for the free discharge system produced the highest absorbed temperatures thus probably causing greater patient discomfort. Such systems probably use active or parallel cooling of the skin to prevent adverse reactions such as erythema, hyperpigmentation.

Discussion
Systems were compared in this study with equal fluence of 10J/cm2 Controlled repeatable and consistent delivery of optical energy was shown by square pulse and close pulse stacking temporal profiles This controlled delivery will also provide repeatable clinical results shot-to-shot. Whereas the free discharge systems, although simple in their technology, inherently vary shot-to-shot and may cause disparity during treatment and during the lifetime of the device*. The Monte Carlo model used for this study is two dimensional (2D) in its representation of the light-tissue interaction. However, in reality the interaction of light with hair follicles is in three dimensions (3D) This may explain the retained temperatures within the temperature modelling and during exposure. The model is representative for a broad field as approximately the same amount of photons jump into as out of the azimuthal plane. It has long been assumed that the optical properties of the various tissue layers do not change during exposure to light. This may not be the case as during exposure absorption of optical energy by chromophores cause heating and mechanically modify some biological targets. Spectral Jitter during the pulse duration has not been considered Assumed constant treatment area for all devices

Project future Improvements

Further development of Computer simulation will make possible open access to software to predict system performance based on measured output IPL parameters Joint Collaboration with School of Computer Science, department of bioengineering and access to IBM Blue Ice supercomputer to model tissue in 3D with a 1um cell size using parallel processing to increase speed of results.

IBM Blue Ice

Conclusion
The value of comparing the physics of light-tissue interaction against different parameters is of significance to clinicians and system designers. The mathematical model assists in identifying positive theoretical options and avoids experimental repetition. Mathematical modeling also facilitates viewing photon deposition through skin and final depth in tissue. Computer modeling of different pulse profiles indicates square pulse and close pulse stacking of sub-pulses are the most efficient in delivering optimal light doses to achieve sufficient thermal transient in the follicle for effective hair reduction.

Thank You

Many thanks to the Faculty of Applied Design and Engineering at Swansea Metropolitan University for their time and effort in producing the Monte Carlo Software Travel grant from Swansea University to attend ASLMS