I read one day, I think it was Laser Focus World, about a company called Candela that was using lasers in the orange to treat port-wine stains. I did lots of work on flash lamps before that and I said, "Wait a minute. I think i can do a better job with a broad broadband light source where i have lots of control over wavelength, pulse duration, as well as a big advantage of being able to treat relatively large areas at a short period of time." This is the way i started Lumenis. Hello and welcome back to the technology of beauty where i have the opportunity to interview the movers and shakers of the beauty business and today is no exception in fact today i'm going to be interviewing truly a living legend in the aesthetic industry Shimon Eckhouse has invented so many technologies he's had run companies invented companies and you're going to hear about the many contributions that he has personally made and the people's lives he's influenced i've followed him for more than 25 years he is a living legend and today i want to thank him for joining us he's in haifa israel thank you very much shimon for joining us on this program today thank you dr stevens real pleasure being with you now shimon let's get started if you are shimon then i am grant because we'll start with the fact that shimon is actually a doctor also he's a phd and we'll get to that so first of all shimon uh tell us a little bit about yourself where did you grow up and where did you go to school so actually i grew up in israel i my parents brought me to israel when i was four and a half years old they were holocaust survivors out of europe i grew up in a small place in israel and then went to school in the technion which is one of the well regarded schools of technology in israel and this is where i grew up and i live now and actually haifa israel which is in the north part of the country yes beautiful part i've been there and then subsequently i happen to know you got your phd over here in the united states right in the shadow of my home where i grew up so why don't you tell us about that so i got my phd at uc irvine i came to uc irvine in 1975 so quite a while ago as you may calculate uh the reason i decided to choose irvine in those days can tell you it was about 5000 students so it's a little bit smaller than the 25 or 30 000 that they count today but my thesis advisor was a very famous uh researcher in the area of plasma physics this reason i came here i spent about three years doing my phd and then returned to israel and actually i came back to the u.s once more in 86 for four years but working for a company in san diego called maxwell technologies okay so you were three years at the university of california in irvine and then you went back to israel and came back to san diego and i don't know about that company tell us a little bit about what what you did there technologies sorry for interrupting you maxwell technology is actually specialized in the area of what doing what's called pulse power technology which is how you take energy condense it into a short time to make high power pulses and i've done lots of work in this space during my years in israel of course at maxwell as well and this is the reason i came there because it was a highly regarded company being an israeli citizen i had to really limit myself to what's called civilian projects uh so i've done lots of things in areas such as well logging food processing things like that using the high energies well that's a long way from aesthetics now take us to the start of luminous so actually uh in the early 90s or 1990 i decided to go back to israel with my family and i also made another decision which was to uh become an entrepreneur and this is typically a relatively late age to become an entrepreneur i was 45 years old at that point in time and i read one day i think it was laser focused world about a company called candela that is using lasers the orange to treat port wine stains i did lots of work on flash lamps before that and i said wait a minute i think i can do a better job with a broad broadband light source where i have lots of control over wavelength pulse duration as well as a big advantage of being able to treat relatively large areas at a short period of time this is the way i started and so you mentioned broadband light tell me how you started developing intense pulse light and was it was it that time that you started developing the intense balls yes i wrote my first patent in 1991 okay uh this is like the very first patent on ipl looks quite similar to what i think millions of ipl devices around the world look look look alike it's a flashland with a cooling system around it with a reflector that points the light to the skin of the patient that was basically the idea i talked there a lot about uh doing it for blood vessels because you know this was like where this whole industry started as i'm sure you're very familiar with and also about pigmented lesions i wrote the patent i looked for an investment for about one year and i ended up getting half a million dollars and giving away 50 of the company you're kidding and was that the beginning of luminous that was the beginning yes yes yes for a value of one million you gave away half a value of post money of one million dollars okay and then did you develop co2 lasers also at luminous no no we we i mean this is an interesting story because i started luminous on the ipl concept we brought our first product to the market called photoderm in 1994. we started selling in europe in 95 we got our first fda clearance started selling in the us and that actually became very successful because doctors realized that uh this broadband light source has many many features that are quite unique that are very different than what you do with lasers i'll just tell you a simple anecdote um as you as i'm sure you know when you use pulse dialysis to treat port wine stains you get what's called purpura uh when we developed ipl at the beginning by the way i was worried because we weren't getting purple but we ended up getting blood vessels disappearing and then became quite successful which really in 1996 enabled me to take the company public on nasdaq reached a valuation of about one billion dollars and in 97 i acquired laser industries or sharpened as many people know it and that then you know co2 lasers become became a significant part of our business but i started my career with what i call truly non-invasive energy-based devices okay so then you moved on from there to sharpland is that right yeah shotgun actually became part part of luminous okay we acquired them okay we of course kept on selling this you two lasers and alexandrite lasers and some other things they were doing during those days and i stayed with the company until ombre almost the end of 1999 and then left okay well interesting enough my first laser i ever used was in st louis at barnes hospital washington university and it was a pulse dye laser for a port wine stain right here on a child and what he was referring to the purpura is the purple color like eggplant color that one sees and it's interesting you were concerned when you were doing your broadband light or ipl that you didn't see that you were concerned about efficacy isn't that interesting exactly okay because as i'm sure you know it takes a while until the blood vessels really disappear and when you don't see it right away you ask yourself the patients ask you what's going on doctor and it's interesting to me my first laser i purchased after i was done with my training was a sharpland laser both the 40 watt as well as i bought the uh surgeolase xj150 and from that i developed the laser bra so and i followed you and you went from erbium and then alexandrite for hair and so forth now take us to the next company you've started so actually in 2000 this was like a year after i left uh luminous uh i started the company which we called cinderella in those days sy any ron and the basic idea there was that the combination of energy energies can be more effective than just a single one and the product that we developed was really a combination of ipl together with conducted rf as we called it we call the technology elos which stands for electro-optic synergy and again the company grew very fast the fact that we used rf together with light kind of brought us more closely to the skin tightening space if i'm sure you know what i mean and again this was quite successful we took the company public on nasdaq in 2004 a year later we reached a valuation of about one billion dollars a little over that and we kept on growing in 2010 we acquired candela and out of that center on candela yes go ahead which was closing really a big circle because you know as i as i just told you uh the first time i thought about uh aesthetic medicine was when i read about port wine stain and pork wine stains and pulsed by lasers and then we ended up buying cadella which was emotionally and very interesting uh i would call it exercise for myself okay now how long did you stay with that combination the cineron combined with candela so i remember center on candela and and then when did you exit cineron candela so in 2017 apex partners which is one of the well-known private equity funds came to us and proposed to take the company private and we sold the company which was you know a nice uh thing i've been with it for all together over 15 years i thought that's long enough okay so that brings us to does that bring us to softwave or not it does yes actually uh software became is something that i started as part of an incubator that i own it has actually been at about 15 companies that we started over the last six years and software was one of the early ones that we started when a guy came to me with an idea of using a beam of ultrasound to treat what is called hypertension or high blood pressure by doing what's called renal denervation i will not go into all the details of how you do it but it's a really interesting endovascular device as it is called you know in the area of cardiology and i said to him listen what you do is very interesting but i think we can do something much much better with it in the area of skin type that's the way we started so far okay and so software was born then out of your incubator is that correct yes yes and you're using ultrasound energy correct but what we're using is actually a beam of ultrasound that propagates into the skin this is done by using a special design of the transducers and what we also do which is really unique and we believe has lots of potential in it is we call the each of the transducers that is is attached or that is coupled to the skin so it protects the upper layer of the skin so in a way by controlling the frequency the power the design of the transducer and the cooling that the same transducer provides we get a situation where we can cause a nicely controlled injury inside the dermis but you don't see anything on the outside part of the skin you don't do any damage to the epidermis okay it's somewhat analogous then to radiation therapy and the way we're delivering radiation therapy to the tumor and sparing the skin and initially we weren't absolutely right so this this thermal cooling if you will of the external epidermis the outside of the skin is a protectant to the ultrasound thermal energy that in the dermis now for the guests that aren't well versed in this idea of skin tightening with energy based why don't you walk us through the way you see the energy and where it's being delivered we said the dermis and and how does that lead to skin tightening how do we get from energy in the dermis to skin tightening uh so actually and and i will mention this because you have been involved in it you have seen it over the years we started when i say we i mean doctors that do it started doing skin tightening with co2 lasers and i don't think we even knew exactly what we were doing but we knew that it was generating good results and as you are very familiar and you mentioned it at the beginning we did a really full skin resurfacing where we ablated everything we left the layer of the dermis heated to a high enough temperature that it will induce growth of new collagen and ls stain which in those days was a little bit controversial speculative whatever you want to call it we discovered later and this was actually something we discovered with ipl and i can mention that one of the unique things that we didn't expect but discovered with ipl was that the heating effect creates some benefits of getting a better skill not dramatic but you know if you do enough treatments you start seeing the the benefit again the basic idea and we didn't fully understand it as you heat up the dermis to 50 or 40 degrees centigrade you get some kind of an effect of neocologenesis or neo elastogenesis if you want to call it this one and then you know as i'm sure you're very well very familiar with you know fractional co2 lasers came in actually i in 2010 uh in addition to acquisition of the candela we also acquired a very small company in the bay area uh uh called uh with a product that we called profound that was using needles that go into the dermis and once they are in the dermis you flow rf current through them it heats up locally and with this local damage you reduce growth of new collagen in yellowstone and this as i'm sure you know rf micro really became a big thing there are probably 20 companies doing it and i was very familiar with it i was familiar with the degree of effectiveness but i was also familiar with the fact that not every patient whether it's a it's a woman or a man likes to be pricked in his face you know a few thousand times uh there are some you know there is significant downtime because you do create some injury on the upper layer of the skin so when this guy came to me with this ultra sound idea i said wait a minute you can do something very similar to what you do with other cooling technologies where you can protect the epidermis and still create the right parameters inside the dermis and what we actually do in software is we create we have an array of seven transducers that are coupled to the skin the doctor just puts it on on the skin when the coupling is right you radiate the ultrasound energy it is absorbed in the skin the epidermis itself is protected because we cool it with the same transducer that also radiates the energy and by choosing the frequency the power the geometrical dimension we create an injury inside the dermis which is actually a thermal injury with temperatures of 60 to 70 degrees centigrade at a depth of about 1.5 millimeters the beauty of it is we do and and you know
i can tell you some of the people that sell our products say we are better than rf michael kneeling i say let's say we are as good as rf micro building but if we are able to do it without injuring the upper layer of the epidermis that's a good enough story and we have lots of data that really supports the fact that we can do a treatment with zero downtime to patients okay full disclosure i have had a sound wave treatment of my forehead my cheeks and my neck just recently okay in the last month uh i'm going to jump back to profound you were involved with profound when you had center on candela i was the i had the good fortune felipe chazan allowed me to have when he was running uh cineron candela the profound and there's no question in my mind that it's very effective it's needles it's rf and there's many needles in our sf as we know and they are effective right and they can debate about which one's more effective and so forth and what the depth of the needles and if it's insulated or not insulated and on and on and on and uh right in any event i think we can agree uh that profound is effective in tightening absolutely i promoted it for many years right one of the downsides of profound the main downside downtown aside for me and for my patients was pain and how do you mitigate the pain we knew it worked but it was painful and i think that was the downfall frankly a lot of the rf devices now are less painful and they may well be less effective we're not going to debate that on this program but i'd like you since you uniquely are involved in software which is a transcutaneous not percutaneously it's a transcutaneous delivery of energy protecting the epidermis versus profound which is an rf different energy source also rf versus ultrasound that's delivered through these uh needles could you con compare and contrast them a little more for our listeners absolutely thank you thank you very much you know the experience we had was profound taught us where we need to be in terms of the temperature that we reach how long the heating is is lasting and where you need to do it to get the best results that's kind of three basic parameters when when profound was started by the way in the very days they tried to use 72 73 degrees which was too high because it ended up causing permanent damage and really desiccating uh collagen which we don't really don't want to do and and what you actually tried when when philippe did it on you or tried it on you or let you try it on someone else was exactly these parameters it is to create temperatures of about between 60 to 70 degrees for about four seconds at a depth of 1.5 millimeters in the derms that's the base these are the basic parameters of profound i am not shy to tell you that when we started software i told the engineer that i worked with this is what we need to reach a temperature in the range of 60 to 70 to be able to do it at a depth of about 1.5 millimeter but to do millimeters but to do it without damaging anything on the upper layer of the skin and you know i can tell you because as i said a few minutes ago i promoted profound because i thought it's a great product it's a great product when i compare the two we have at least the same quality of results as you can get with profound one of the reasons by the way is that what we do which is unique the way we do our transducers create one a damaged pattern which is parallel to the surface of the skin rather than being perpendicular and more than that we are able in a procedure of about 30 minutes to do i would say between four to five times more heating of collagen to these temperatures then what you can do is profound we do probably 10 to 20 times more than what you can do with our other rf micro bleeding devices so so there i feel on a very solid ground because everything that we are doing is based on what we have seen there on the basic scientific level the beauty of it is that we do it without downtime to the patient without damage to the epidermis i see and that's a very big difference there's no question are there any other companies in this space vis-a-vis that are heating to 60 to 70 degrees transcutaneously without needles the closest one to what we do is mertz which required ulterra i'm sure uh you're familiar with ultra i don't know if you experienced it but i have i'm sure you know i have it i own it so actually what we do in a way is similar from the point of view of the form of energy but very different from the point of view of how we make sure the energy is doing it at the right place without damaging the upper layer of the epidermis now the the challenge with haifu which is what uh what uh ulterra is using or what's now is using is that it is haifu is very nice if you try to get deep into tissue and then you can do like a cone that has a small angle of convergence if you try to do the same thing when you are very close to the surface of the skin you need to be very have a very flat angle of convergence and that makes it a little bit more difficult the end result of this is yes you can get the right parameter range you cannot do the same volumes that we do we do much more volume in terms of how much of the the dermis itself we heat up and there is more pain associated because there is still lots of ultrasound power that the upper layer of the skin feels and if you use ulterra i'm sure you're i don't know how long you followed them but you know they started out with more aggressive parameters they went down because it was so aggressive from the point of view of pain but this is this one is closest is closest to ours and i think it is a very good technology i mean and i'll be even more explicit on that i give them lots of credit for coming up with the idea that ultrasound can be a very good technology of creating heat inside the skin the big difference is the way we do it is different than what they do and yours is delivered at one and a half millimeters correct that's right yeah right and that so that's where your focal point is or that's where your delivery is exactly and they have the focus but yes this is where the energy is yes that's what i meant i know it's not actually focused interesting so theirs is haifu and yours is it's not high energy focus it's actually a beam of ultrasound i see what we create you know i hope we'll bring you one day to israel and we'll show you it's a very nice parallel beam that doesn't diverge and really it goes all the way to the depths we want the frequency is chosen so it doesn't go too deep because we don't want to heat that to hit nerve we don't want to eat blood blood vessels we don't want to hit the bones which you can do if you are too too deep um and then by the cooling we make sure there's nothing happening on the upper layer of that's very interesting so it's a much broader application of the energy isn't it all right all right but i think i heard him yeah we do a full face and neck full face and 30 minutes full face and neck in about 45 minutes yes i can attest to that but i think i heard in that last answer i'll have to go back and and watch this but i think i heard an invitation to israel you absolutely heard it right then he'd be more than delighted to have i'm going to hold you to that not on business just on pleasure fantastic we will go to the countryside i love israel it's one of the most beautiful places i've ever been right okay well we've been through a lot we've talked about skin tightening we've talked about the beginning of intense pulsed light the cineron story the cineron candela story the acquisition of sharpland you've been to the states and educated uh once or your phd and then back to san diego you've seen a lot sir you have seen uh so many energy-based technologies and there you're sitting there i'd like to ask you something because i can see behind you i think i see your crystal ball could you please look into your crystal ball and tell me what we're going to be seeing or at least what you see shimon over the next few years two even as far out as a decade but kind of let me look let all of us hear what you see in your crystal ball please so actually and of course i'll try and focus on aesthetic medicine and doing other things as well but in the area of aesthetic medicine i think the combination of the demand from patients which i'm sure are much more aware of than i am but you know we are all aware of it i will keep on growing there's no doubt about that because you know i don't want to talk about zoom boom and many other things that everybody is talking about but in addition to that you know and this is a big revolution in in the 30 years that i've been in this industry when we started and did you know skin rejuvenation was photo facial as we used to call it in those days yes on the face of a patient she wouldn't share it with anyone in the world maybe with her husband maybe not these days you know they do it and they put it on facebook or tiktok or instagram or whatever the case may be in this social you know media kind of uh craziness if you want to call it or wonderful thing if you want to call it this way is really driving the market to whole new directions combined with that i believe the sophistication of patients as well as our sophistication keeps on moving forward like doing what we do in software the ability to do this damage and the patient walks back home and nobody knows that he or she were treated i believe is a great thing the i believe that we will keep on improving this significantly because we keep on get getting much better understanding of the biology of the skin you know pcr is the word that you'll ask any uh citizen in the western world if he knows what pcr is that he will say of course covey but you know that there is something called pcr but what we do today in sequencing didn't exist 30 or 20 or even 10 years ago and when you combine that with the way you watch technology forward i believe we can end up with much better ways of predicting the results of treatments that we are doing in aesthetic medicine and you know i i look we do lots of work on on treating patients taking biopsies and understanding what's going on internally and it's amazing and you know these were speculations 20 years ago now there are really scientific facts so that's very exciting well thank you very much i would entirely agree with you and we've been on parallel tracks for those 25 to 30 years and it's been so exciting and i it's just such an honor for me to be able to interview you and meet you i wish you were here in our studio but i'll take this zoom and i'll meet you in haifa and uh we'll go on i'd love to see the histology i want to see the neocologenesis i've never heard the word neo-elastogenesis but it works for me i do understand and when you upset those fibroblasts they pump out that collagen elastin as we saw when we were doing co2 lasers and back to the beckman institute and all the various things that we all lived through and here we are using rf and ultrasound and various energy sources to heat the fibroblasts irritate it and have it pump out this new collagen and elastin and i'm very excited to get to know more about softwave i think it's a very exciting area uh and uh i look forward to learning more and seeing how it works on my face as i mentioned i've been treated of course it's like sure absolutely well thank you very much uh you're very welcome simone and i look forward to seeing you and i'd like to thank all of you for joining us again on this exciting episode of the technology of beauty where we've had the opportunity to get to know shamone eckhaus clearly a pioneer in the field of energy-based improvement in aesthetics still going strong i can't wait to see what his next invention is thank you all very much for joining us and thank you once again shimon be good thank you all the best have a good day thank you sir you too you
2022-01-29