Publications
Title Publication Date
FotoFacial™ is a Pulsed Light Patient Pleaser Skin & Allergy News Oct,1999
Non-Ablative Laser Treatment of Wrinkles Cosmetic Dermatology Jan, 2000
A non-surgical way to remove wrinkles Philstart.com Sep, 2000

Photorejuvenation of the skin using the FotoFacial™ Procedure  (Study)

ADDITIONAL INFORMATION ON THE FOTOFACIALTM PROCEDURE

Skin & Allergy News     Oct,1999

Rosacea, Facial Erythema, Telangiectasias

‘FotoFacial’ Is a Pulsed Light Patient Pleaser

By Erik L. Goldman

New York Bureau

Athens~ A series of full-faced exposures with the PhotoDerm intense pulsed light systems is effective for treating Rosacea, chronic facial erythema, and minor telangiectasias, with the added benefit of a resurfacing effect, Dr. Patrick Bitter Jr. said at the 20th Congress of the International Society for Dermatologic Surgery.    Dr. Bitter who pioneered and trademarked this approach, terms the technique “FotoFacial.”  He has found it to be a major patient pleaser.

 “The name differentiates it from laser ablation or resurfacing, which scare some patients,” said the Campbell, California, private practitioner.  The technique has a major advantage over laser approaches in that there is usually no visible surface injury, minimal discomfort, and no patient “downtime.”    In evaluating the FotoFacial technique, Dr. Bitter has had to rely on patient satisfaction and clinical examination, since there are no clinically useful and reliable objective measures of flushing or Rosacea severity. 

He reported the results obtained in a series of 30 patients with chronic flushing, rosacea, or telangiectasias who underwent a full course of five treatments.     All of the patients said they had obtained some improvements in their appearance, with 32% reporting that they were “very much improved.”   The remainder stated they were “much improved.”    Thirty-six percent said they were “extremely satisfied” with the procedure, and none said they were dissatisfied.     Fifty-six percent of the patients with chronic erythema reported a 75% or greater reduction in visible symptoms; the same percentage of rosacea patients said they had a 75% or greater reduction in redness.     Forty-nine percent of the telangiectasia patients had a 75% or greater reduction in visible vessels after treatment with PhotoDerm.

            Many patients also saw a marked reduction in pore size, greater skin smoothness, and a reduction in the depth and number of fine wrinkles.  In effect, FotoFacial is a non-laser resurfacing and rejuvenation procedure.     Histologically, the intense pulsed light generates considerable new collagen formation. 

In addition to the indication for erythematous conditions, Dr. Bitter has also found FotoFacial useful for “cleaning up” after laser resurfacing or dermabrasion.     FotoFacial involves five 20-minuate treatment sessions, in which the patient’s full face is exposed to the pulsed light source.  Dr. Bitter recommends 3-week intervals between sessions. 

To obtain optimal results, the instrument settings are very precise.  He uses a 550-nm cutoff filter, with a double-pulse setting.  The first pulse I 2.4 milliseconds, followed 10 milliseconds later by a second pulse of 2.4-4 milliseconds.     “These are very short pulses and delay time,” he said.  Total fluence is in the range of 30-36J/cm2.

“I know of no other therapy that can improve flushing and rosacea to this degree,” he said, noting that histologically, the pulsed light effectively obliterates both small and large surfaces.     FotoFacial is extremely safe and well tolerated, he said.     The light exposure does cause a transient darkening of freckles or other highly pigmented features, but usually resolves within a week.

Roughly half of all patients will experiment some mild post exposure swelling, which resolves in 24 hours.  A small percentage of patients will have mild scabbing, that resolves in 2-4 days.  He has not seen any major adverse effects.    The only significant downside is the cost, said Dr. Bitter.  The pulsed light technology is quite expensive.  A new PhotoDerm intense pulsed light system from ESC Medical Systems in Needham, Massachusetts, costs around $130,000.

In an interview, he said he bills for the FotoFacial as a cosmetic procedure, even though in cases of rosacea or telangiectasias, there is what some people would consider a medical indication.    Although it gives long-lasting results in chronic erythematous conditions, it is not known whether or not FotoFacial will be a permanent solution, Dr. Bitter said.    The symptoms of rosacea remain improved for at least a year after the last treatment session.

The main advantage of this technique is that from the patient’s positions, there is very little burden in terms of time or discomfort.    The sessions seldom take more than 30 minutes, and they do not require anesthesia.  Patients can return to work right away; there is no prolonged healing period--as there is with laser resurfacing or dermabrasion—in which they must curtail their social activities.

Dr. Bitter has received payment for serving as a preceptor for ESC Medical Systems.

 

 
August 31, 2000
Thursday
Lifestyle Features

A non-surgical way to remove wrinkles
8/31/00

Most of us would normally associate aging with the appearance of wrinkles on one’s face. Fact is, even young people can have a furrowed complexion, depending on the vast amount of sun exposure they’ve had. But fret not when you notice those curves on your face. Now, a new breakthrough promises to make young and old faces alike both wrinkle- and pigments-free.

An offshoot of the PhotoDerm MultiLight System, the FotoFacial treatment can be used in any part of the skin. However, it is especially effective in improving the appearance of the face, neck and chest. By using pulses of visible light, it effectively improves facial redness and flushing or dilated capillaries.

Developed and first introduced by board-certified dermatologist Dr. Patrick Bitter, Jr., this first-of-a-kind skin improvement machine in the Philippines uses a non-invasive method to rejuvenate and improve skin conditions with no "downtime" – meaning the treatment will not interfere with one’s schedule or lifestyle. This non-surgical process is more commonly called "photorejuvenation."
No Hiding Or Disruption Of Schedules
Because our face is the most exposed part of our body, it is more prone to photo-aging due to severe UV damage. Sun exposure causes our skin to develop premature wrinkles, making it appear dull and dry. Freckling and irregular pigmentation are also erased by this machine, making one’s complexion taut and tighter. According to Dr. Toby Abaya of Clinica Manila, treatment normally takes five sessions for optimal results. The treatment evens out skin tones and reduces open pores.

People suffering from rosacea and those with early aging changes on their skin are the best candidates for the FotoFacial treatment. Occurring mostly in adults, rosacea appears mainly on the cheeks and nose, which become abnormally red and flushed. These rashes tend to spread or become more prominent after eating hot or spicy food, or drinking alcohol or beverages containing caffeine. Basically, rosacea is most common among women over 30 years old. The treatment also improves the breakouts of common chronic facial conditions.

This non-surgical process proves especially convenient for people who don’t have the luxury of time for laser resurfacing or chemical peels, which tend to be ineffective. "And with the FotoFacial treatment, there is no hiding or disruption of one’s schedule. Life goes on after only a few minuets of skin treatment with this machine," Abaya explains.
Easy Skin Treatment
Prior to treatment, Dr. Abaya usually instructs the patient to apply a topical anesthetic cream. Used 30 to 60 minutes before treatment, the anesthetic cream is especially recommended for people with sensitive skin. Dr. Abaya then adjusts and controls the light, heat and energy level of the computer that will help rejuvenate the patient’s skin during the actual process.

Because the treatment involves high-powered visible light which can be harmful to the naked eye, the patient is asked to wear protective eye gear. After applying a colorless gel on the machine’s square nozzle, Dr. Abaya then directly places the device on the outer layer of the skin to be treated. Operating on the basis of timed cues from the computer, Dr. Abaya treats the skin patch by patch. A series of light pulses induces the skin to become firm and stretched.

Dr. Abaya initially treats half of the patient’s face. After covering half of the patient’s face with the gel, he then scraps it out with the help of a spatula and places it in a plastic cup. The patient’s treated facial skin shows a significant reduction of wrinkles, redness and flushing. The patient’s face also appears smoother, finer and lighter compared to the untreated part.

A mild amount of discomfort can be expected while undergoing treatment but according to Dr. Abaya, this is bearable. He only takes approximately another 15 minutes to repeat the procedure on the remaining untreated part.
Smoother Finish
After the first treatment, treated skin appears smoother and with a more even tone. These improvements are gradual and will be more visible after each treatment. "Freckles may come out during treatment but these will become lighter," Dr. Abaya said. The skin may also appear red and flushed while tiny capillaries may be more visible. Brown spots generally appear darker. All these changes gradually fade over a period of hours to a few days. Depending on the condition of the skin, some patients may require additional treatments apart from the recommended five.

Patients with treated skin are advised not to expose themselves to direct heat such as saunas. Only tepid water should be used to clean the face. There should also be no hard scrubbing of one’s face, while women can apply makeup immediately after treatment.

Interested patients may visit Dr. Abaya at Clinica Manila, second level, Bldg. A, SM Megamall or call 638-69-31 or an appointment/consultation, or e-mail multilight@ poboxes.com.