Early this year, “Making a comeback” on the music chart becomes an issue once again in the music industry. Isn’t it encouragement and love for the uncompensated efforts? “Everything that can be invented has been invented.” As the sentence quoted by Charles H. Duell from the US Patent and Trademark Office (USPTO) in the late 1800s, finding the hidden diamond in the rough that has already been invented but has not been attracted much attention is a whole new thrill.
In February 2013, a cryoneurolysis device that was approved for wrinkle treatment in the EU was introduced on the International Master Course on Aging Science (IMCAS), the largest anti-aging conference in the world. The kick-off of this device was very impressive, but unfortunately, it failed to settle in the US market - the largest one, and gradually disappeared from the memory.
I have explained in the previous article that freezing can be used for skin treatment and nerve tissues are sensitive to freezing. Freezing was used not only in ancient Egypt and Persia, but in Napoleon’s campaign in Moscow in 1812 to reduce surgical pain. A nerve tissue exposed to freezing develops axonotmesis (the damage to the axon and myelin, but endoneurium, perineurium, and epineurium are intact) and Wallerian degeneration(an active process of degeneration when a nerve fiber is injured that the distal part of the axon gets further damages).
“Cryoneurolysis” is the treatment using this principle. Nitrous oxide (N2O) that has its boiling point of -88.5°C, damages the nerve fiber selectively while the neighboring connective tissues are preserved. Using the needle filled with N2O, “Focused Cold Therapy™” can freeze the nerves of the treatment site and allow to paralyze the motor nerves as well as sensory nerves.
A presentation was made at the 73rd Annual Conference of the American Academy of Dermatology in 2015, held in San Francisco, that “Cryoneurolysis” applied to the temporal branch of the facial nerve has shown one level improvement in forehead wrinkle in 96.9% of the patients and has no side effects other than temporary bruise and swelling.
However, this device has some unfortunate limitations including that it needs to identify the exact location of the nerve for effective treatment, and the effect lasts only about 3-4 months due to nerve regeneration. In addition, it requires relatively expensive consumables compared with the Botulinum toxin, which shows a great effect in wrinkle treatment and decreased cost gradually.
Currently, this device has been approved and used for pain management, especially for knee pain in the US market. But it might become a good alternative to botulinum toxin in some cases with patients who need paralysis but hate a toxin itself, have antibodies to botulinum toxin, or do not want side effects due to diffusion like ptosis. Of course, the high cost of the consumables should be the challenge left to be solved.
