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Page 1
Syneron patent pending technology
1
Electro-Optical Synergy (ELOS) Technology for
Aesthetic Medicine The significance of skin
temperature monitoring during skin treatment
Michael Kreindel, Ph.D
Introduction
The use of pulsed electromagnetic energy, in the red
and near infra-red (NIR) ranges of the
electromagnetic spectrum, has become very common
in recent years. The light sources that are used for
these application are either monochromatic lasers in
the wavelength range of 694 to 1064nm or filtered
flash lamp sources that operate in the range of 600 to
1300nm using a wide filtered spectrum. The principle
of operation of both types of pulsed light sources is
very similar and it is based on applying the pulsed
light to up to a few cm
2
of the skin. Light photons
that interact with skin can be either scattered or
absorbed. Since the scattering coefficient is typically
10 to 100 times larger than the absorption coefficient
the photons quickly lose their original direction of
propagation and penetrate through the skin in a
diffusion-like penetration process. Photons are
eliminated only after they undergo an absorption
event in which all of the energy of the photon is
absorbed in a chromophore of the skin (such as
melanin, hemoglobin or oxy-hemoglobin) and all of
its energy is transformed into heat. If enough heat is
generated in the target tissue (hair follicle, shaft or
bulge in the case of hair removal applications), and
the target reaches a high enough temperature, it can
be permanently damaged, thus enabling hair removal.
The understanding of light interaction with tissue is
quite difficult and our ability to model it is somewhat
limited for two main reasons:
1. The exact optical and thermodynamic properties
of human skin are not well understood and it is
quite complex to consider them in a realistic
mathematical model.
2. Even if a good optical and thermodynamic model
exists, one has to take into account the variation
in optical and other properties from one patient
to another and even variations of properties from
one area of the skin to another on the same
patient.
This situation becomes quite a challenge for the
physicians treating patients for hair removal by using
light. This is because they are in a very narrow
operational regime that on the one hand ensures
patient safety, and on the other hand uses a high
enough energy to achieve a long clinical effect.
The only real form of energy that is being used is
thermal, and the most important parameter for both
safety and efficacy is temperature. Hence, the key
question is:is their any reliable way by which we can
measure temperature in real time (during the pulse)?
Monitoring skin surface temperature with infrared
sensor appears to be the most logical way to measure
skin heating.. This method is based on measurements
of thermal infrared radiation from the skin surface in
the range of 4µ to 12µ. Because of strong absorption
of this radiation by tissue, the depth of skin
temperature monitoring is limited by 10-20µ. This
upper part of skin usually consists of a layer of dead
cells, called stratum corneum. The thermal and
optical properties of this layer differ from the living
tissue and its temperature does not provide enough
information for skin safety. An additional problem is
that using skin moistening for effective thermal and
optical coupling decreases the reliability of measured
data.
Therefore, a new effective method of skin heating
monitoring should be developed.
In spite of the disadvantages of the method, it helps
to understand the influence of different treatment
parameters on skin heating.

Page 2
Syneron patent pending technology
2
The connection between the impedance of
the skin and its temperature
Skin impedance characterizes skin conductivity,
which is electrolytic. That means that electrical
current is conducted by the ions of salts contained in
the tissue. As for all electrolytes, skin impedance is a
function of temperature [1]. The ability to measure
skin impedance during treatment creates the unique
potential for monitoring of skin heating during the
treatment. The dependence of skin impedance on
temperature is described by the equation:
aT
R
R
+
=
1
0
(1)
Where a is the temperature coefficient of impedance,
which is equal to 2% per °C [2] and R
0
is initial
impedance.
Skin impedance can be calculated through the
measurements of electrical current and voltage using
Ohm law.
I
V
R =
(2)
Experimental evaluation of skin impedance behavior
was conducted using an RF generator that produced
1MHz radio-frequency current with maximal power
(P) up to 100W. RF current was used for both
measurement and skin heating. RF energy was
applied to an area (S) of 2cm
2
. RF penetration depth
(d) is 4mm. Volumetric RF energy density applied to
the skin can be estimated as
d
S
tP
E
p
=
(3)
for pulse duration (t
p
) of 150ms. Energy density
absorbed by the skin is about 20J/cm
3
.
Temperature behavior is described by the heat
conductivity equation
d
S
P
dt
dT
c
=
ρ
(4)
Where t is time, c is the specific heat of the skin,
which is a little bit lower than that of water and can
be estimated as 3.6 J/g K, and ρ is skin mass density
that can be assumed as 1g/cm
3
. Solving Eq. 4 and
inserting Eq.1 into it, the impedance decrease during
the RF pulse is calculated by
ρ
c
S
d
t
P
a
R
R
+
=
1
1
0
(5)
Skin impedance behavior measured in vivo and
calculated with Eq. is presented in Figure 1.
Normalized Impedance
0.85
0.9
0.95
1
0
25
50
75
100
125
150
Time, ms
Measurements
Theory
Figure 1. Impedance behavior during RF pulse.
Measured data corresponds to eq. 2 predicting an
impedance decrease of 10%. Thus, RF energy can be
used for skin heating and for heating control.
Monitoring of skin heating by light using
impedance measurements
Another very important question relates to the
possibility of using skin impedance monitoring for
control of skin heating by lasers or incoherent light
sources broadly used in aesthetic medicine.
For the experiment, a filtered light produced byflash
lamp was used. The light spectrum was 680-980mn.
Output power was 2KJ and pulse duration 30ms. The
irradiated area was 2cm
2
and penetration depth was
about 2.5mm.
Pulses of light and RF energy were applied in parallel
as shown Figure 2.

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Syneron patent pending technology
3
LIGHT
RF
Time
Figure 2. Schematic arrangement of Light and RF
pulses
Light pulse duration is 30ms with power of 2000W,
while RF power is 100W, with a pulse duration of
150ms.
Skin impedance was measured during light and RF
pulses. The results for dark skin (type IV according to
Fitzpatrick) are presented in Figure 3.
Normalized Impedance
0.6
0.8
1
0
30
60
90
120
150
Time, ms
LIGHT
RF
Figure 3. Dark skin impedance behavior under
combination of light and RF pulses
One can see that during the light pulse, impedance
drops dramatically by 20% over the course of 30ms,
because of the strong skin heating by light. Then,
impedance decrease slows down. During the
subsequent 120ms, impedance drops down by 8%
due to soft heating by the RF energy.
It is a logical assumption that light skin should be
heated less by light while the effect of RF energy
stays the same. Therefore, impedance drop during the
light pulse will be less than during the RF pulse
impedance decrease will be about 8%.
Figure 4 presents impedance behavior under the same
combination of light and RF pulses.
Normalized Impedance
0.6
0.8
1
0
30
60
90
120
150
Time, ms
LIGHT
RF
Figure 4. Light skin impedance behavior under a
combination of light and RF pulses.
Impedance decrease during light pulse is twice less
for light skin (type I according to Fitzpatrick) than for
dark skin. Impedance decrease during RF pulse is in
the same range.
The results of measuring skin heating and impedence
show a correlation between skin heating and
impedance behavior. Higher heating causes a
stronger impedance drop and vice versa.
Conclusion
Measurement of skin impedance provides
information about skin heating that can be used for
cooling and heating control.
The main advantage of the method is the ability it
affords to measure skin impedance with sub-
millisecond resolution.
Skin impedance gives integrated information from
the entire skin zone where RF current flows.
Penetration of the RF current can be optimized by
choosing the geometry of electrodes. Penetration
depth of the RF current can be estimated as the half
distance between the two electrodes of a bipolar
system.

Page 4
Syneron patent pending technology
4
References
1. S. Gabriel, et al., The dielectric properties of
biological tissues: III. Parametric models for
dielectric spectrum of tissues. Phys. Med. Biol.
41: 2271-2293, 1996
2. Francis A. Duck, Physical properties of tissue.
Academic press limited, 1990, p. 173