# US 10,765,467 B2 · Medical systems, methods, and devices for hypopigmentation cooling treatments > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 10,765,467 B2 - Document ID: US10765467B2 - Status: Granted - Kind: B2 - Application number: 15/257,827 - Filed: 2016-09-06 - Published: 2017-03-09 - Granted: 2020-09-08 - Earliest claimed: 2015-09-04 - Assignees: R2 Technologies, Inc. - Applicants: R2 Technologies, Inc. - Inventors: Jesse Rosen; Kevin Springer; Kristine Tatsutani; Michael O'Neil - Web page: https://patentgrep.com/patent/US10765467B2 ## CPC - A61B 18/0206: {ultrasonic, e.g. for destroying tissue or enhancing freezing} - A61B 18/203: {applying laser energy to the outside of the body} - A61B 2018/00458: {Deeper parts of the skin, e.g. treatment of vascular disorders or port wine stains} - A61B 2018/00994: {combining two or more different kinds of non-mechanical energy or combining one or more non-mechanical energies with ultrasound} - A61B 2018/0237: {with a thermoelectric element in the probe for cooling purposes} - A61B 2018/2023: {Self-contained devices, i.e. with power supply in the hand-piece} - A61F 2007/0052: {for treatment of skin or hair} - 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: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C) - 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 Embodiments of the present invention generally relate to methods, devices, and systems for reducing a pigmentation of a skin of a patient. In some embodiments, freezing of the skin may be desirable to effect the hypopigmentation of the skin of the patient. Generally, embodiments may limit supercooling (or promote freezing) of the skin of the patient during a cooling treatment. In some embodiments, coupling fluids are provided to reduce a thermal contact resistance between a cooling treatment probe and the skin of the patient to improve cooling treatment. Optionally, a fluid carrier may be provided to help retain the coupling fluid at the treatment site. In some embodiments, the coupling fluid may include ice nucleating agents to promote ice crystal formation in the coupling fluid during cooling treatment. The ice crystal formation in the coupling fluid may progress into the skin to limit supercooling of the skin during treatment. ## Claims ### Claim 1 A method of altering pigmentation in a skin of a patient, the method comprising: applying a coupling fluid to a treatment area on a surface of the skin of the patient, the coupling fluid including an ice nucleating agent configured to promote ice formation in the coupling fluid and to limit supercooling of the skin in the treatment area; applying a cooling treatment to the treatment area with the applied coupling fluid present, wherein the cooling treatment promotes ice crystal formation external to the skin in the coupling fluid before supercooling of the skin of the patient in the treatment area, and wherein the ice crystal formation external to the skin in the coupling fluid propagates through the coupling fluid and then across the skin of the patient during the cooling treatment. ### Claim 2 (depends on 1) The method of claim 1, wherein the ice nucleating agent comprises a bacteria, a fungi, soot, or dust. ### Claim 3 (depends on 1) The method of claim 1, wherein the ice nucleating agent comprises a protein, lipoprotein, or a long-chain aliphatic alcohol or amino acid. ### Claim 4 (depends on 1) The method of claim 1, further comprising abrading or piercing the treatment area prior to applying the cooling treatment. ### Claim 5 (depends on 4) The method of claim 4, wherein abrading or piercing the treatment area comprises abrading or piercing the treatment area using a microderm abrasion roller or a laser. ### Claim 6 (depends on 1) The method of claim 1, wherein applying the coupling fluid to the treatment area on the skin of the patient comprises applying a fluid carrier to the treatment area of the skin, the fluid carrier configured to retain the coupling fluid at the treatment area. ### Claim 7 (depends on 6) The method of claim 6, wherein the fluid carrier has a uniform thickness. ### Claim 8 (depends on 6) The method of claim 6, wherein the fluid carrier comprises a fabric material. ### Claim 9 (depends on 1) The method of claim 1, wherein the coupling fluid comprises an aqueous fluid comprising a thickening agent that increases viscosity of the aqueous fluid. ### Claim 10 (depends on 1) The method of claim 1, wherein applying the cooling treatment comprises contacting a treatment surface of a cooling probe with the coupling fluid at the treatment area, wherein the cooling probe comprises a vibrator for facilitating ice formation. ### Claim 11 (depends on 10) The method of claim 10, wherein the vibrator comprises an ultrasound transducer. ### Claim 12 (depends on 1) The method of claim 1, wherein applying the cooling treatment comprises contacting a treatment surface of a cooling probe with the coupling fluid at the treatment area, wherein the treatment surface of the cooling probe comprises a textured surface having recessed areas configured to retain ice crystals. ### Claim 13 A method of altering pigmentation in a skin of a patient, the method comprising: applying a fluid carrier and a coupling fluid to a treatment area on a surface of the skin of the patient, the coupling fluid configured to promote ice formation and to limit supercooling in the skin of the treatment area, the fluid carrier retaining the coupling fluid at the treatment area; applying a cooling treatment to the treatment area of the skin to promote ice crystal formation external to the skin in the coupling fluid retained by the fluid carrier before supercooling of the skin, and wherein the ice crystal formation external to the skin in the coupling fluid propagates through the coupling fluid and then across the skin of the patient during the cooling treatment. ### Claim 14 (depends on 13) The method of claim 13, further comprising abrading or piercing the treatment area prior to applying the cooling treatment. ### Claim 15 (depends on 13) The method of claim 13, wherein the fluid carrier has a uniform thickness. ### Claim 16 (depends on 13) The method of claim 13, wherein the fluid carrier comprises a fabric material.