# US 10,500,413 B2 · Method and apparatus for treatment of cutaneous and subcutaneous conditions > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 10,500,413 B2 - Document ID: US10500413B2 - Status: Granted - Kind: B2 - Application number: 15/402,693 - Filed: 2017-01-10 - Published: 2017-06-29 - Granted: 2019-12-10 - Earliest claimed: 2002-06-19 - Assignees: Palomar Medical Technologies, Inc. - Applicants: Palomar Medical Technologies, LLC - Inventors: Gregory B. Altshuler; Konstantin Prikhodko; Andrei V. Belikov; Ilya Yaroslavsky - Web page: https://patentgrep.com/patent/US10500413B2 ## CPC - A61B 5/6843: {Monitoring or controlling sensor contact pressure} - A61B 18/203: {applying laser energy to the outside of the body} - A61N 1/20: continuous direct currents - A61N 1/328: {for improving the appearance of the skin, e.g. facial toning or wrinkle treatment} - A61N 5/0616: {Skin treatment other than tanning} - A61N 5/0625: {Warming the body, e.g. hyperthermia treatment} - A61N 7/00: Ultrasound therapy (lithotripsy A61B17/22, A61B17/225; massage using supersonic vibration A61H23/00 {; using ultrasound for introducing media into the body A61M37/0092}) - A61B 18/14: Probes or electrodes therefor - A61B 2018/00005: {Cooling or heating of the probe or tissue immediately surrounding the probe} - A61B 2018/00011: {with fluids} - A61B 2018/00452: {Skin} - A61B 2018/00458: {Deeper parts of the skin, e.g. treatment of vascular disorders or port wine stains} - A61B 2018/00476: {Hair follicles} - A61N 1/32: alternating or intermittent currents {(applying electric fields by inductive or capacitive coupling A61N1/40; microwave apparatus A61N5/02)} - A61N 5/0613: {Apparatus adapted for a specific treatment} - A61N 2005/0659: {infrared} - A61N 2007/0008: {Destruction of fat cells} - A61N 2007/0034: {Skin treatment} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B) ## Abstract The present invention provides method and apparatus for treating tissue in a region at depth while protecting non-targeted tissue by cyclically applying cooling to the patients skin, and preferably to the region, and by applying radiation to the patient's skin above the region to selectively heat tissue during and/or after cooling is applied. At least one of cooling and radiation may be applied by successively passing a continuous output applicator over the patient's skin. Treatment may also be enhanced by applying mechanical, acoustic or electrical stimulation to the region. ## Claims ### Claim 1 A non-invasive method for treating a patient's skin at a depth comprising: providing an applicator; applying electromagnetic radiation to skin surface, using the applicator, during a heating phase to increase a temperature of a target region at depth below the skin surface to be in a range from 42° C. to 47° C., wherein said target region comprises tissue about dermis-hypodermis junction; cooling patient's skin surface below a damage temperature during a cooling phase; reducing or removing energy applied from the applicator during the cooling phase following the heating phase such that the temperature of the target region decreases to a temperature above a first temperature; and repeating the heating phase and the cooling phase to cycle the temperature of the target region to non-invasively effect fat reduction during a total treatment time of at least 20 minutes, wherein the temperature of the target region is maintained above the first temperature during the step of repeating the heating phase and the cooling phase. ### Claim 2 (depends on 1) The method of claim 1, wherein a combined duration of the heating phase and cooling phase is less than 11 seconds. ### Claim 3 (depends on 1) The method of claim 1, wherein a combined duration of the heating phase and cooling phase is in a range from 5 seconds to 11 seconds. ### Claim 4 (depends on 1) The method of claim 1, wherein the target region is at a depth of 2.5 mm below the skin surface. ### Claim 5 (depends on 1) The method of claim 1, wherein the heating phase and cooling phase are cycled a sufficient number of times to induce new collagen generation in target region the patient's skin. ### Claim 6 (depends on 1) The method of claim 1, wherein the electromagnetic radiation comprises optical energy. ### Claim 7 (depends on 6) The method of claim 6, wherein the optical energy has at least one wavelength in the range from 800 nm to 1800 nm. ### Claim 8 (depends on 1) The method of claim 1, wherein the step of cooling the patient's skin occurs during the heating phase. ### Claim 9 (depends on 1) The method of claim 1, wherein the heating phase and the cooling phase are performed by scanning the applicator over the patient's skin surface. ### Claim 10 (depends on 1) The method of claim 1, wherein the heating phase and the cooling phase are performed by the applicator, wherein the applicator is a stationary applicator. ### Claim 11 (depends on 1) The method of claim 1, wherein the target region is at a depth between 2.5 mm and 7.5 mm. ### Claim 12 (depends on 1) The method of claim 1, wherein said cosmetic treatment comprises tightening of the skin. ### Claim 13 (depends on 1) The method of claim 1, wherein the first temperature is 40° C. ### Claim 14 (depends on 1) The method of claim 1, wherein the first temperature is a discomfort temperature. ### Claim 15 (depends on 1) The method of claim 1, wherein the first temperature is a damage temperature. ### Claim 16 A non-invasive method for treating a patient's skin at a depth comprising: providing a stationary applicator; applying electromagnetic radiation to skin surface, using the stationary applicator, during a heating phase to increase a temperature of a target region at depth below the skin surface to be in a range from 42° C. to 47° C., wherein said target region comprises tissue about dermis-hypodermis junction; cooling patient's skin surface, using the stationary applicator, below a damage temperature during a cooling phase; reducing or removing energy applied from the applicator during the cooling phase following the heating phase such that the temperature of the target region decreases to a temperature above a first temperature; and repeating the heating phase and the cooling phase to cycle the temperature of the target region to non-invasively effect a fat reduction, wherein heating phase and cooling phase are a cycled during a total treatment time of at least 20 minutes, wherein the temperature of the target region is maintained above the first temperature during the step of repeating the heating phase and the cooling phase.