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Current Treatments of Acne: Medications, Lights, Lasers, and a Novel 650-Microsecond 1064nm Nd: YAG Laser (Aktuelle Behandlungen von Akne: Medikamente, Licht, Laser und ein neuartiger Nd:YAG-Laser mit einer Pulsdauer von 650 μs und einer Wellenlänge von 1064 nm)

Michael Gold, MD, David J. Goldberg, MD, JD, Mark Nestor, MD, PhD Journal of Cosmetic Dermatology, September 2017, Band 16, Ausgabe 3

Zusammenfassung Die Behandlung von Akne, insbesondere schwerer Akne, bleibt eine Herausforderung für Dermatologen. Therapien umfassen Retinoide, Antibiotika, Hormone, Licht, Laser und verschiedene Kombinationen dieser Modalitäten. Akne wird derzeit eher als chronische Erkrankung angesehen, nicht als ein Leiden in der Jugend. Die geeignete Behandlung hängt vom Patienten und dem Schweregrad der Erkrankung ab. Ziel dieser Studie war es, aktuelle Therapien für Akne aller Schweregrade zu überprüfen und den Nd:YAG-Laser mit einer Pulsdauer von 650 μs und einer Wellenlänge von 1064 nm zur Behandlung von Akne vorzustellen.

1 | EINFÜHRUNG: Akne vulgaris ist der häufigste Grund, warum Menschen einen Dermatologen aufsuchen.1 Akne betrifft 85 % bis 90 % der Teenager, 2 Kinder im Alter von 7 bis 12 Jahren3 und erwachsene Männer und Frauen, einschließlich solcher mit dunkler Haut.4,5 Unter den Erwachsenen, die an Akne leiden, sind 64 % zwischen 20 und 30 Jahre alt, und 43 % sind zwischen 30 und 40 Jahre alt. Die Prävalenz ist bei Frauen höher als bei Männern.68 Gollnick et al.9 und die Globale Allianz zur Verbesserung der Behandlungserfolge bei Akne10 haben nahegelegt, Akne eher als eine chronische Erkrankung zu betrachten und nicht als „einfache, selbstlimitierende Erkrankung, die bei Jugendlichen auftritt“. Diese Behauptung basiert auf den bekannten Merkmalen einer chronischen Erkrankung: ein verlängerter Verlauf, Rezidiv oder Rückfall, langsamer Beginn oder akute Ausbrüche und negative Auswirkungen auf die Lebensqualität. Bis zu 50 % der Betroffenen leiden bis ins Erwachsenenalter an Akne samt ihrer negativen Folgen wie Angst und Depressionen, sozialer Rückzug, Narben und anhaltende Hyperpigmentierung.10 2 | PATHOGENESE VON AKNE: Akne ist eine multifaktorielle Erkrankung der Talgdrüsen-Einheit. Die Entwicklung von Akneläsionen wird auf vier pathogene Faktoren zurückgeführt: Androgen-induzierte Überproduktion von Talg, Besiedelung des Talgdrüsengangs durch Propionibacterium acnes, abnorme Verhornung im Follikel und Ableitung von Entzündungsmediatoren in die Haut.8 Die erste Phase ist die Entwicklung eines Mikrokomedons in der Talgdrüsen-Einheit. Dies ist ein Pfropfen, der sich aufgrund einer erhöhten Produktion von Talg und Keratinozyten bildet, die den Haarfollikel auskleiden. Die Ansammlung von Talg und abgestoßenen Keratinozyten führt zur Bildung größerer, sichtbarer Komedonen. Gleichzeitig besiedelt P. acnes den Talgdrüsengang, was die Freisetzung von Entzündungsmediatoren in das umgebende Gewebe und eine Reaktion immunkompetenter Zellen auslöst. Dies trägt weiter zur Entwicklung von Komedonen bei.8,11 Akne tritt am häufigsten im Gesicht, am Hals, Rücken und auf der Brust auf; all diese Bereiche weisen zahlreiche Talgdrüsen-Einheiten auf.12,13

3 | BEHANDLUNG VON AKNE. Topische Retinoide und antimikrobielle Wirkstoffe wie Antibiotika und Benzoylperoxid (BPO) sind traditionelle Monotherapien für leichte bis mittelschwere Akne.

3.1 | Retinoide: Die Mitglieder der Globalen Allianz10 erklären, dass Retinoide als Grundlage für die Behandlung aller Aknepatienten, mit Ausnahme derjenigen mit der schwersten Erkrankung, angesehen werden sollten. Topische Retinoide (z. B. Tretinoin, Tazaroten, Adapalen) helfen, die abnormale Differenzierung zu normalisieren und

Gold MGoldberg DJNestor MSCurrent treatments of acne: Medications, lights, lasers, and a novel 650-μs 1064-nm Nd: YAG laser (Aktuelle Behandlungen von Akne: Medikamente, Licht, Laser und ein neuartiger Nd:YAG-Laser mit einer Pulsdauer von 650 μs und einer Wellenlänge von 1064 nm)J Cosmet Dermatol2017;16:303318https://doi.org/10.1111/jocd.12367

Table of Contents

Laser Optical Engineer

Aerolase is the fastest growing medical laser company, serving the high growth dermatology and aesthetic laser market. Nestled in the picturesque Hudson Valley in Tarrytown, NY, the location is also ideal for access to NY City and other areas of the Northeast and Mid-Atlantic U.S. We are hiring in many areas and currently seek laser optical engineers with a passion for creating new things. The company offers a friendly, team-oriented work environment and competitive compensation including salary, bonus, stock options, 401k, and health/dental/life insurance plans.

About the Team:

  • We are a diverse team of friendly, creative hard-working people with a passion for achieving our objectives
  • We are creative, hands-on and innovative with a strong orientation toward high customer satisfaction
  • We have created a very team-spirited company culture and believe it is important to have open and effective cross-functional collaboration and communications – and enjoy our work!

About the Role:

We’re looking for an enthusiastic, creative and detail-oriented problem solver to help support the production, service and repair of our unique solid-state laser devices.

Must have expertise working with assembly and/or development of small, sensitive, high precision instruments, preferably solid-state laser technology, with a high caliber technology company.  We prefer design and hands-on experience in multiple laser technologies including solid state lasers, semiconductor lasers, non-linear optical materials and devices, optical benches, and beam directors. Experience with the technical aspects of developing laser and laser-based products is strongly preferred.

Candidates should have proven ability to address complex challenges with ingenuity and innovation, and capability to work independently to manage multiple simultaneous tasks, and see all tasks to completion. Also should have the ability to work well in a collaborative multidisciplinary team environment, define and analyze system performance specifications, and ensure adherence to those specifications in the application environment.

  • Perform sensitive manual optical assembly of lasers.
  • Test, troubleshoot repair and assemble lasers, subassemblies and various components, including high-voltage laser power supplies and other electronics.
  • Support the development and implementation of test fixtures, equipment, procedures and documentation for the engineering and operations functions.
  • Support product design and development activities related to new products and product improvements.
  • Support development and maintenance of quality and regulatory documents and procedures.
  • Provide customer technical support as needed including product service, maintenance, and troubleshooting.
  • With suppliers, act as a technical and operational liaison as needed.
  • Maintain thorough, complete and accurate written records; comply fully with the company’s quality system and any regulatory requirements.
  • Follow safety rules for working with high-voltages and high-power lasers.
  • Perform other duties as completion of responsibilities necessitates or as assigned by supervisor.
  1. Minimum 5 years of experience in an engineering role involving sensitive high precision instruments, preferably involving solid state lasers.
  2. Theoretical and practical knowledge and skills of adequate policies and procedures for the control of laser hazards and high voltage hazards, using relevant protective equipment, ensuring adequate safety education and training of other personnel.
  3. Understanding of system and component design, testing and troubleshooting.
  4. Enjoy working with your hands/mechanical ability.
  5. Strong analytical and problem solving skills.
  6. Proven technical and project management skills.
  7. Experience with manufacturing within a Quality Management System (especially medical).
  8. Strong interpersonal and communication skills.
  9. Self-motivated, detail oriented and well organized. Ability to make decisions and work independently Strong work ethic and desire to help the company successful by producing a reliable product.
  10. Not afraid to ask questions and make suggestions for improvement.
  11. Be able to work under pressure due to customer demands.
  12. Strong computer skills (Windows™ software).
  13. Ability to successfully manage multiple projects and daily responsibilities. Ability to discern and appropriately communicate sensitive issues.
  14. Ability to walk, stand, bend, reach, stoop/squat, and crouch. Ability to carry heavy items.
  15. Will require working indoors and outdoors – work environment includes the office, the production areas, mechanical rooms, and customer and supplier facilities. Also includes regular contact with high-voltage equipment and laser light emissions.

BS. in Physics, Mechanical or Optical Engineering, Master’s Degree preferred

  • We are a diverse team of friendly, creative hard-working people with a passion for achieving our objectives
  • We are creative, hands-on and innovative with a strong orientation toward high customer satisfaction 
  • We have created a very team-spirited company culture and believe it is important to have open and effective cross-functional collaboration and communications – and enjoy our work!

We’re looking for an enthusiastic, creative and detail-oriented problem solver to help support the production, service and repair of our unique solid-state laser devices.

Must have expertise working with assembly and/or development of small, sensitive, high precision instruments, preferably solid-state laser technology, with a high caliber technology company.  We prefer design and hands-on experience in multiple laser technologies including solid state lasers, semiconductor lasers, non-linear optical materials and devices, optical benches, and beam directors. Experience with the technical aspects of developing laser and laser-based products is strongly preferred.  

Candidates should have proven ability to address complex challenges with ingenuity and innovation, and capability to work independently to manage multiple simultaneous tasks, and see all tasks to completion. Also should have the ability to work well in a collaborative multidisciplinary team environment, define and analyze system performance specifications, and ensure adherence to those specifications in the application environment.

  • Perform sensitive manual optical assembly of lasers.
  • Test, troubleshoot repair and assemble lasers, subassemblies and various components, including high-voltage laser power supplies and other electronics.
  • Support the development and implementation of test fixtures, equipment, procedures and documentation for the engineering and operations functions.
  • Support product design and development activities related to new products and product improvements.
  • Support development and maintenance of quality and regulatory documents and procedures.
  • Provide customer technical support as needed including product service, maintenance, and troubleshooting.
  • With suppliers, act as a technical and operational liaison as needed.
  • Maintain thorough, complete and accurate written records; comply fully with the company’s quality system and any regulatory requirements.
  • Follow safety rules for working with high-voltages and high-power lasers.
  • Perform other duties as completion of responsibilities necessitates or as assigned by supervisor.
  1. Minimum 5 years of experience in an engineering role involving sensitive high precision instruments, preferably involving solid state lasers.
  2. Theoretical and practical knowledge and skills of adequate policies and procedures for the control of laser hazards and high voltage hazards, using relevant protective equipment, ensuring adequate safety education and training of other personnel.
  3. Understanding of system and component design, testing and troubleshooting.
  4. Enjoy working with your hands/mechanical ability.
  5. Strong analytical and problem solving skills.
  6. Proven technical and project management skills.
  7. Experience with manufacturing within a Quality Management System (especially medical).
  8. Strong interpersonal and communication skills.
  9. Self-motivated, detail oriented and well organized. Ability to make decisions and work independently Strong work ethic and desire to help the company successful by producing a reliable product.
  10. Not afraid to ask questions and make suggestions for improvement.
  11. Be able to work under pressure due to customer demands.
  12. Strong computer skills (Windows™ software).
  13. Ability to successfully manage multiple projects and daily responsibilities. Ability to discern and appropriately communicate sensitive issues.
  14. Ability to walk, stand, bend, reach, stoop/squat, and crouch. Ability to carry heavy items.
  15. Will require working indoors and outdoors – work environment includes the office, the production areas, mechanical rooms, and customer and supplier facilities. Also includes regular contact with high-voltage equipment and laser light emissions.

BS. in Physics, Mechanical or Optical Engineering, Master’s Degree preferred

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Hyperpigmentation

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Photos Courtesy of Jennifer Parker-Porter, MD.

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Vascular Lesions

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Photos Courtesy of Michael Gold, MD.

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Rosacea / Redness

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Hair Removal

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PFB

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Scars

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Autoimmune Disorders

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Skin Rejuvenation

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Acne

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Photos Courtesy of Michael Gold, MD.

Learn more about treating acne today.

Staff Accountant / Junior Accountant

Aerolase Corporation, a leading aesthetic laser innovator, seeks a Staff Accountant / Junior Accountant. Having made the Inc. 5000 list as one of the world’s fastest growing private companies as well as annual best-in-class product awards, Aerolase has transformed the market with products that provide uniquely tolerable treatments to the patients and exceptionally high ROI for the practitioners. The company offers competitive and an exciting high-growth company culture.

Duties:

• Provide support to the Controller and the management team
• Maintain day-to-day financial accounting functions, including A/P, A/R, expense tracking
• Support the month-end close process, ensuring accurate and timely monthly, quarterly, and year-end financial statements.
• Uploading annual budget and tracking actual to budget variances
• Use of financial reporting software
• Support external auditors and other required outside reporting requirements
• Participation in quarterly inventory reconciliations
• Assist team with projects such as policy creation, system implementation, client support etc.

• Some experience with and strong understanding of the monthly close process and technical accounting
• Detailed oriented, with ability to see the big picture
• Self-starter who can work independently and employ time management skills to meet deadlines.
• Knowledge of MS Excel (V-lookup, formulas, pivot tables).
• Strong interpersonal and communication skills
• Sound judgment and problem-solving skills

• Bachelor’s or master’s degree in Accounting a MUST, good understanding of GAAP
• 1-3 years’ experience in an accounting function (including internship)
• General Ledger/Operational Accounting experience
• Knowledge of Quickbooks or other reporting software a plus (more the better)
• Industry experience a plus

Senior Accountant

Aerolase Corporation, a leading aesthetic laser innovator, seeks a Senior Accountant. Having made the Inc. 5000 list as one of the world’s fastest growing private companies as well as annual best-in-class product awards, Aerolase has transformed the market with products that provide uniquely tolerable treatments to the patients and exceptionally high ROI for the practitioners. The company offers competitive and an exciting high-growth company culture.

Duties:

• Provide support to the Controller and the management team
• Own day-to-day financial accounting functions, including A/P, A/R, expense tracking
• Assist in establishing and maintaining policies & procedures in accordance with GAAP and Aerolase policy
• Key contributor to the month-end close process, ensuring accurate and timely monthly, quarterly, and year-end financial statements.
• Assist in the preparation of management reports – (cash management, various projections, month end reporting package)
• Involvement with the annual budget process
• Use of financial reporting software
• Support external auditors and other required outside reporting requirements
• Prepare and submit payroll
• Participation in quarterly inventory reconciliation to the perpetual
• Ad hoc projects

• Strong knowledge of the monthly close process and technical accounting

• Detailed oriented, with ability to see the big picture

• Experience in continuous improvement and accounting best practices

• Self-starter who can work independently and employ time management skills to meet deadlines.

• System savvy – ability to learn new financial software

• Intermediate knowledge of MS Excel (V-lookup, formulas, pivot tables).

• Global consolidations experience a plus

• Strong interpersonal and communication skills

• Sound judgment and problem-solving skills

• Bachelor’s or master’s degree in Accounting a MUST, good understanding of GAAP

• 3+ years’ experience working as a staff/senior accountant

• General Ledger/Operational Accounting experience a must

• Extensive knowledge of Quickbooks and other reporting software

• Prior involvement with system implementation

• Prior public accounting experience (any size firm) a plus

• Industry experience a plus

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