Purchasing
New Equipment

E very year at the American Academy of Dermatology (AAD) meeting, I wander the technical exhibits looking for new toys. At the beginning, I was content to purchase new surgical equipment but as time went on, my habit grew to be more expensive. Soon I was buying new surgical tables and lights. Before long, I was buying lasers as if they would actually fulfill all of the promises of the salespeople. As time went on, I got a little jaded and put the brakes on technology spending. Recently, however, I have started to look at some new toys. Among the items I have strongly considered are a fractional resurfacing device, a radiofrequency device and an intense pulsed light (IPL) system. While I have not purchased the first two items yet, I have recently purchased an IPL system (see Pulsed Light System Comparison Chart on pp. 23 to 24) and it exceeds my expectations. And, I’ve learned that there are some important points to research before buying any new technology. My Purchasing Experience Intense pulsed light is a non-laser light source. The system I purchased is a Medilux by Palomar. When I began evaluating IPL systems, this device seemed like it could do everything, including treating acne, warts, unwanted hair, fine lines, solar lentigines, telangiectasias and a whole variety of other problems. Before buying the device, I took a “test drive.” During a demonstration, I treated one of my staff members who had rosacea and significant photodamage. I knew that, at best, I would have a free treatment for my staff and, at worst, I would need to get some cover makeup for her; but I had no real intention of spending more than $40,000 for a new toy. What happened over the week following the treatment, while not miraculous, was significant. The telangiectasias and hyperpigmentation quite rapidly faded. My nurse began to tell patients about the treatment, and the patients wanted to be treated. Even though I didn’t yet own the device, I did have a waiting list. With a waiting list about 20 patients long, I decided I could not go too far wrong. So I bought the Medilux. Expectations Versus Reality When the device arrived, I was impressed with the service and training that Palomar provided. The Medilux comes with several handpieces that give you the ability to have several devices in one box. There are specific wavelengths for different indications. To date, I am very pleased with the treatment of telangiectasias and hyperpigmentation. Patients are thrilled with the visible changes that occur following treatment, and they like the decreased downtime compared with prior treatments. I think that the acne treatment handpiece does an average job of treating mild to moderate acne, but it works quite well when used with 5-aminolevulinic acid (5-ALA) for photodynamic therapy. IPL is a fairly good device for photorejuvenation, and I think that in conjunction with ALA it will be better than most of the alternatives presently available. I’m not impressed with how the device treats unwanted hair and find that my alexandrite system is superior. Unlike most technology that I’ve purchased, I think this device offers me and my patients advantages that make it worthwhile for my practice. IPL appears to be a technology that will be upgradeable with newer handpieces. And, patients love the treatments, as they can see results almost immediately. Buying a System Whatever device it is you are considering, here is some advice to help you purchase a product that meets or exceeds your expectations. • Ask about warranty information and upgrades. These are important as you can be sure that the day after you purchase something, the company will introduce the next generation to the consumer market and patients will ask for it. • Make sure that the company you purchase from has a strong reputation. Check with other dermatologists who have used the product to make sure the company services its machines. • Compare pricing, but make sure that you are comparing similar devices. Check the wavelengths offered and indications for which each is approved. • Try before you buy. As I did before purchasing the IPL system, you should use the device in a demonstration to make sure it does what you want it to do. • Finally, consider the company’s sales philosophy. I think it behooves the cosmetic dermatology community to purchase products from companies that don’t actively market to non-specialists, which can hurt patients and can also dilute our specialty.