Home Devices for Aesthetic Treatment

September 2014
Home Devices for Aesthetic Treatment
Kevin C. Smith, MD, FRCPC
Under properly controlled conditions with properly chosen subjects, some at-home devices
“work”. That is to say that they can produce “a statistically significant degree of improvement
in a carefully chosen patient population”.
BUT my patients don’t just want “a statistically significant degree of improvement”. My
patients want real, obvious improvement.
For example, a lot of skill and experience is necessary in office practice to consistently obtain
good results with existing hair removal technology. The same can be said of intense pulsed
light for photorejuvenation, vascular lasers, and treatment of acne, etc.
In our practice, we realize that for each type of medical treatment there is a range of
outcomes. So far, consumers are not being shown information or sets of pre- and postphotos which would help them understand that there is a range of outcomes, even when
standardized treatments are applied to a homogenous looking group of people.
It is difficult in office practice to create and apply patient inclusion and exclusion criteria for
various treatments which we administer. Patients will have a VERY difficult time applying
inclusion and exclusion criteria to themselves, in order to determine whether a particular
device and treatment protocol will be SAFE AND EFFECTIVE in their particular case.
Further, it takes considerable effort in our clinics to control operator-dependent variables
when treatment is administered, in addition to monitoring and maintaining operator
proficiency. Patients using home devices will have VERY SERIOUS problems conducting
treatments consistently and exactly as they should in order to obtain high efficacy.
Devices will of course be designed to satisfy regulatory requirements, but devices may be built
in ways which invite and facilitate hardware and software hacks so that the user can easily
exceed the licensed parameters of the device.
Patients do not want “….a statistically significant degree of improvement” Patients want
obvious improvement, and objective evidence like pre- and post-treatment photos.
Patients are sick to death of being systematically and deliberately misled and ripped off by
non-physicians, and by home device companies. The level of trust for over-the-counter and
non-specialist treatments has never been lower [and rightly so!].
In order for consumers to say: “Yes this works!”
A device must
• •Make it easy for a potential purchaser to determine whether or not the device is likely
to be beneficial for that individual
• Must be designed in a way that will produce a high probability of successful treatment,
and a low chance of inappropriate use
If patients have a bad or unsatisfactory experience, for example with home laser hair removal
or home IPL, some consumers may decide laser hair removal or IPL is a rip-off and never
have proper, effective medically supervised treatment.
Most of my patients have a limited budget of time and money. Time and money wasted on
home devices [and on cosmeceuticals] is not available for our services. The disappointments
and malfunctions of these devices will degrade the reputations of those who sold these things
to their patients.
Editorial Board /
Conseil de rédaction
National editor/
Rédacteur en chef
Charles W. Lynde, MD
Markham, ON
Chief Executive Officer /
Chef de la direction
Chantal Courchesne
Ottawa, ON
Regional editors /
Rédacteurs régionaux
Robert Jackson, MD
Ottawa, ON
Paul Kuzel, MD
Edmonton, AB
Benjamin Barankin, MD
Toronto, ON
Ian Landells, MD
St. John’s, NL
G. Daniel Schachter, MD
Toronto, MD
Marc Bourcier, MD
Moncton, NB
Catherine McCuaig, MD
Montréal, QC
Victoria Taraska, MD
Winnipeg, MB
Peter R. Hull, MD
Saskatoon, SK
Kathleen Moses, MD
Ottawa, ON
Catherine Zip, MD
Calgary, AB
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CHANTAL COURCHESNE
CHIEF EXECUTIVE OFFICER / CHEF de la DIRECTION
425-1385 rue, Bank Street, Ottawa, ON K1H 8N4
Tel: (613) 738-1748 / 1-800-267-3376 | Fax: (613) 738-4695
[email protected]