What if you needed only one relatively low-cost energy device in your practice to offer treatments that now require a KTP laser, a pulsed dye laser and a ruby laser? Morgan Gustavsson, a pioneer in intense pulsed light, who has worked with companies including American Medical Bio Care, Candela, Syneron and Venus Concepts, says a new technology dubbed TRASER could make that possible. He and Christopher Zachary, MD, professor and chair of the department of dermatology at the University of California, Irvine, introduced the TRASER concept at the 2011 Controversies in Lasers meeting and subsequently published an article on the technology (“Total Reflection Amplification of Spontaneous Emission of Radiation,” PLoS ONE, April 2012).
In April 2016, the American Society for Laser Medicine and Surgery (ASLMS) presented Paul M. Friedman, MD, with its Best of Cutaneous Applications Abstract Session Award for his clinical trial using TRASER technology for nasal telangiectasias. In a press release from the ASLMS, Dr. Friedman was quoted as saying, “What is really exciting about this technology is its ability to treat a broad range of applications utilizing only one device. In our study, we looked at nasal telangiectasias, which are notoriously difficult to treat, and found greater than 75% improvement after one- and three-month follow-up.”
The TRASER is neither a laser nor an IPL. It is a completely new technology. “It uses Total Reflection Amplification of Spontaneous Emission of Radiation, hence the acronym TRASER,” says Dr. Zachary. “The TRASER is pumped by two or more flashlamps to create spontaneous photon emissions from a fluorescent dye solution or from a crystal dye. TRASER energy is tunable, which means you can vary wavelengths from below 532nm (green) to near infrared. You can also vary pulse widths from 0.45ms to over 100ms, change pulse modes and achieve very high fluences.”
Because it requires no expensive components, such as an optical resonator or output coupler, and needs no filters, frequency-doubling crystals or mirror alignment, a TRASER device should be cheaper to make. Simplicity of design should translate to greater reliability as well.
“It is also more electro-optically efficient than a laser, which means it can produce really high power with even larger spot sizes,” says Dr. Zachary. “A TRASER can be tuned to allow you to do hair removal on the entire back in less than 10 minutes. Since bigger spot sizes mean deeper penetration, you can also coagulate blood vessels from the dermis to the fat layer, which can be critical if you’re working on a port-wine stain. A TRASER can be tuned to make it patient-specific with treatments tailored to the size and depth of blood vessels.”
TRASER devices are not yet commercially available, and it’s unclear when that may happen. “I believe Solta Medical is working on a TRASER device and I think we should begin seeing these in commercial exhibits within the next couple years,” says Dr. Zachary. “However, new technology does take time.” A Valeant spokesperson did confirm that Solta Medical has a TRASER device in development, but the company did not want to comment further at this time.
Until clinical trials are complete, there is also no way to know how effective this technology will be at treating specific indications or how difficult it might be to master such a versatile device.
“The wide array of potential parameters on a TRASER could be confusing, especially for novices,” Dr. Zachary concedes. “Initial models will probably need to be preset to certain parameters to make them easier to follow, but I would hope commercial TRASER devices retain an ability that will allow specialists to use new parameters that could prove more effective for specific indications than currently available laser treatments.”
Linda W. Lewis is the contributing editor of MedEsthetics.
Pictured: Christopher Zachary, MD.