Abstract:
A photoepilation device including a compact hand piece applicator and a portable electronics module for use in a non-medical setting. The hand piece, which contains no electrical signals, allows the user to focus on individual hair follicles by observing a magnified image provided on a semiconductor display. The image from the hand piece is transported to a remote CCD through a coherent imaging fiber. which also delivers the therapeutic energy pulse from a remotely located source to the localized target. Destruction of pluripotential follicular stems cells found in the hair bulb and bulge regions is possible via a single low power laser diode. Control of pulse width and spot size attains a range of fluence levels up to 85 J·cm −2 .

Description:
PRIORITY 
     This application claims priority to U.S. Provisional Application No. 60/977,851, filed Oct. 5, 2007, the content of which is incorporated herein by reference. 
    
    
     BACKGROUND OF THE INVENTION 
     1. Field of the Invention 
     The present invention relates generally to selective and extended photothermolysis for cosmetic, health and dermatology conditions, and more particularly, to a portable device for photo-inducing damage to cellular structures for hair removal. 
     2. Brief Description of the Background Art 
     Electromagnetic energy, particularly in the optical band of 400 nm to 1200 nm, has been used for treatment of many skin related diseases as well as for cosmetic procedures, such as, hair removal, spider veins, tattoos, port wine stains, skin rejuvenation and photodynamic therapy. Laser and light-based removal of hair, both in men and women, is widely accepted as a successful approach. In today&#39;s market place, manufacturers have focused on four laser-based systems: 1) alexandrite (755 nm); 2) neodymium-doped yttrium aluminum garnet (1064 nm); 3) laser diodes (810 nm); and 4) a broad band Intense Pulsed Light (IPL) source. Generally, these systems provide reduction in the growth cycle of removed hair. Multiple treatments have been found to improve upon longevity of the hair free period. An endpoint for an acceptable treatment requires destruction of pluripotential follicular stem cells and not merely evaporation of the hair shaft. 
     Recent data suggests that the stem cells are found in upper bulb and bulge regions of the hair follicle. Indeed there may be other areas not yet identified. Laser Hair Removal (LHR) procedures must target these regions of the stem cells, as they are responsible for hair growth. Several techniques have been developed for destruction of stem cells. 
     Laser ablation, not typically used for photoepilation, uses high energy short pulses to raise the temperature of the stem cell above that required for evaporation, however, the target and the absorber must be collocated. Selective Photothermolysis (SP) exploits dissimilar absorption coefficients of the photo absorbers and surrounding tissue. However, use of SP for destroying the stem cells responsible for hair growth is compounded because the photo-absorbing chromophore, melanin, is found both in the follicular stem cells and the epidermis. Melanin has a broad absorption spectrum and is responsible for pigmentation of the hair shaft and skin. SP techniques are effective if a concentration of melanin is higher, by a factor of five, in the target area. These techniques work particularly well for dark hair on light skin. However, unavoidable absorption of photons in the epidermis leads to heat, which needs to be removed to avoid damage to the epidermis. Consequently, innovative hand-pieces which chill the epidermis during treatment have been developed. 
     Destruction of cells through thermal denaturing requires that a target temperature exceeding 70° C. within the Thermal Relaxation Time (TRT) of the tissue. For the hair shaft, the TRT is in the range of 35 to 50 ms. Pulse widths exceeding the TRT permit diffusion of heat into surrounding tissue preventing the denaturing temperature from being reached due to heat leakage. Typically, LHR devices target about a ˜1 cm 2  area of the skin, which is bombarded with photons. Some photons are absorbed in the epidermis, while the remaining migrate, via scattering, through the dermis and reach the melanin rich hair shaft and bulb region, where absorption leads to elevation of tissue temperature causing cell destruction. The photons scattered in the backward direction return back to the epidermis resulting in fluence levels exceeding the incident fluence. 
     Based on photon transport theory and clinical data, an optimum set of parameters can be established for a particular device. Unfortunately, these parameters are patient dependent and use of LHR devices remains an art. 
     A typical laser diode system will have a variable fluence between 20 to 60 J·cm −2 , a pulse width in the range of 5 to 500 ms, and a treatment spot size of ˜1 cm 2 . The peak power of the source, which determines the size of the LHR system, is proportional to the product of fluence and spot area and inversely proportional to the pulse width. For example, a 100 μs pulse with a spot area of 1 cm 2  requires a peak pulse power of 20 kW for a fluence of 20 J·cm 2 . Consequently, this leads to bulky and expensive machines, which need full medical facilities for operation. While the large diameter reduces treatment time and increases penetration depth into the dermis, it lacks the capability to selectively remove hair from a given area, i.e. to reduce hair density. 
     Another approach for permanent hair removal is based on Extended Selective Photothermolysis (ESP). The target to be denatured can be separated from a photo-absorber, known as a heat source. A closer study of the underlying thermal diffusive processes has led to use of longer pulses to produce a hot spot in the melanin rich hair shaft. The longer laser pulse produces a hot spot, which begins to heat the surrounding tissue, including the hair bulb and bulge. Pulse width is determined by the TRT and the Thermal Damage Time (TDT). Recent studies have indicated, particularly for techniques using the hair shaft for heat transmission, that a longer pulse width up to 1.5 s may be acceptable, which substantially decreases the peak power requirement. Several LHR systems with peak power up to 200 W using laser diode arrays are now on the market. 
     Other procedures for efficiently using the available photons in LHR devices include the use of highly reflective and thermally conductive applications to the skin prior to laser treatment. Ultrasonic massaging increases penetration of a dye into the epidermis. Pre-treatments can be used with any of the light-based techniques to enhance efficacy of hair removal, but adds extra time and cost to the treatment. 
     U.S. Pat. No. 7,118,563 to Weckwerth, the disclosure of which is incorporated herein by reference, discloses a rechargeable device suitable for providing therapeutic energy. However, the minimum spot size of 0.25 cm 2  is too large for targeting single hair follicles and causes a reduction in the peak power requirement. The system disclosed by Weckwerth also lacks any imaging device for identifying a treatment area. 
     U.S. Pat. No. 7,220,254 to Altshchuler, the disclosure of which is incorporated herein by reference, teaches that existing technology can be packaged into a self-contained hand-held device for delivery of therapeutic energy to a skin treatment area and can be visualized by an image capturing system integrated into the hand-held device. The device combines discrete optical and electronic components to illuminate an area of the skin to facilitate imaging by a Charge Coupled Device/Complementary Metal Oxide Semiconductor (CCD/CMOS) device. Imaging and treatment optical paths are separated by a beam splitter. A more compact and user-friendly hand-held device, with few components, would be more desirable, particularly for the home market. 
     In fact, in keeping with this concept, U.S. Pub. No. 2007/0198004 Altschuler et al., the disclosure of which is incorporated herein by reference, addresses some of the above problems in disclosing a tethered hand-piece which may be more appropriate for the home market. However, conventional photo cosmetic devices do not include imaging capability and use lower power EMR sources having prolonged exposure times. For hair removal, such devices recommend power levels in the range of 20-500 W, which is not attainable by a single laser diode. 
     SUMMARY OF THE INVENTION 
     The present invention discloses a compact hand piece applicator for LHR, including a Coherent Imaging Fiber (CIF); a fiber optic ON/OFF switch; optical fibers for white light illumination; a chilled air delivery system; imaging optics; and an extender for scanning a treatment spot. The CIF serves a dual purpose. The CIF: 1) provides an image of a target area, for example, a hair follicle; and 2) delivers therapeutic energy from a remote optical source to the target area. The spatial cross-sectional distribution of the therapeutic laser energy can be shaped by exciting appropriate pixels in the CIF, for example, a circular spot or a donut shaped spot. The hand-piece provides the ability to alter a size of the target area, which is generally smaller than a diameter of the hair follicle. A Laser Diode (LD) having a wavelength in the range 750 to 850 nm, provides a broad range of pulse widths applicable to SP or ESP. A power level of the optical source can be increased through use of multiple single LDs or a single laser diode array. The fiber optic switch, which can be replaced by an optical microphone, initiates the delivery of the laser diode energy pulse or pulses. Absence of electrical signals in the hand piece offers added safety to a home user. Further the invention includes a portable electronic system, which provides all controls necessary to operate the system and to interface with other computing devices. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The above and other objects, features and advantages of certain embodiments of the present invention will be more apparent from the following detailed description taken in conjunction with the accompanying drawings, in which: 
         FIG. 1  is a block diagram of a portable laser hair removal system, according to an embodiment of the present invention; 
         FIG. 2  is a schematic of a fiber optic hand piece applicator of the portable laser hair removal system of  FIG. 1 , according to an embodiment of the present invention; 
         FIG. 3  provides a cross-sectional view of an optical switch of the portable laser hair removal system of  FIG. 1 , according to an embodiment of the present invention; 
         FIG. 4  is a cross-sectional view of a hair follicle with direct illumination of a hair shaft, according to an embodiment of the present invention; 
         FIG. 5  is a cross-sectional view of the hair follicle with direct illumination of an inner root shaft using a donut beam, according to an embodiment of the present invention; 
         FIG. 6  is a timing diagram for dual pulse treatment, according to an embodiment of the present invention; 
         FIG. 7  is a schematic of a dual laser diode illumination scheme, according to an embodiment of the present invention; 
         FIG. 8  provides schematics for producing a scanning spot on a target, according to an embodiment of the present invention; and 
         FIG. 9  is a schematic of the fiber optic hand piece applicator, according to an embodiment of the present invention. 
     
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 
     The following detailed description of preferred embodiments of the invention will be made in reference to the accompanying drawings. In describing the invention, explanation about related functions or constructions known in the art are omitted for the sake of clearness in understanding the concept of the invention, to avoid obscuring the invention with unnecessary detail. 
     Embodiments of the present invention provide a portable and inexpensive apparatus for locating and capturing an image of a small treatment area, typically, about 250 microns in diameter. Further, the apparatus, typically less than 15 mm in diameter, delivers optical energy from a remote source to a target area, preferably smaller than a size of the image. The small size the apparatus is particularly useful for treatment areas that require a reduction of hair density and not indiscriminate hair removal. In a preferred embodiment, the apparatus includes a hand piece mounted on a robotic arm for automated laser hair removal. 
     Additionally, the small treatment laser spot can be scanned across the target area to synthesize a larger treatment area. Referring to  FIG. 1  a miniature Hand Piece Applicator (HPA)  100  is connected to an electronic console  102  by a the flexible umbilical cord  101 . The HPA  100  can be operated either in manual mode or as part of a robotic arm for automated treatment. In the manual mode, the HPA  100  is moved along the surface of a treatment area  103 , while viewing a color image  104  on a display screen  105 , until a particular target  106 , for example a hair follicle, is located. At this point the color image  104  can be captured and stored in an embedded processor system  107 . Referring to  FIG. 2 , the image capture system comprises of two optical imaging stages: the first stage uses a microlens  201  to form a primary image  207  of the treatment area  103  at the distal end  109  of the Coherent Imaging Fiber (CIF)  108 , which transports the image  207  to CIF&#39;s  108  proximal end  110 ; an aspheric lens  111  forms a magnified image  104  of the CIF&#39;s proximal end on to the surface of the CCD/CMOS device  112 . Magnification of the primary image  207  is adjustable through a height of opaque baffle  118 . A dichroic beam splitter  119  separates low energy visible imaging path from the high laser pulse delivery path. 
     Illumination of the treatment surface  106  is achieved by coupling an output from white light emitting diodes  113  and  114  to the proximal end of multimode optical fibers  115  and  116 , which transport the light to the HPA  100  through the umbilical cord  101 . Intensity of illumination is controlled through a ON/OFF optical switch control module  121 . 
     An optical system responsible for delivering a high energy Therapeutic Laser Pulse (TLP) to the target  106  uses the same CIF  109  described above for capturing the image of the target. In the manual mode, transmission of the TLP is initiated by a user command, which is generated by an ON/OFF optical switch  120  mounted in the HPA  100 . Upon receiving ON signal from the LED driver assembly, the embedded processor system  107  sends out a programmed series of pulses to a Laser Diode (LD) driver  126 , which drives the LD  127 , which is pigtailed to a multimode fiber  128 , the output from the distal end is imaged to the proximal surface  110  of the CIF  109  via a source imaging aspheric lens  129  and a dichroic mirror  119 . The electro-mechanical shutter  133  prevents accidental leakage of the high laser energy, and its operation is synchronized with the ON/OFF pulse. A proximal image of the TLP is transported to the distal end  109  of the CIF  108  in the HPA  100 . In this manner, the TLP is delivered precisely to the target  106  with negligible energy leakage beyond the treatment area  103 . Pulse parameters are adjustable through the embedded processor system  107 . 
     The optical switch  120 , also discussed in regard  FIG. 3 , modulates an optical signal to define its ON/OFF states. A modulated signal from the control module  121  drives Light Emitting Diode LED  122 , which is pigtailed to an optical fiber  125 . During the ON state, the modulated optical signal from the HPA  100  is returned back to the control module  121  via an optical fiber  124  which is pigtailed to a photodetector  123 , typically, a pin photodiode. The received optical signal is detected and sent to the embedded processor system  107 , which uses the ON state to generate the TLP with a preset width and amplitude, and the OFF state is used for shutting down the high power laser diode  127 . The ON/OFF signal can be used to provide authentication codes to prevent accidental or unauthorized use of the HPA. The HPA  100  also provides chilled air directed at the treatment area  103 . The chilled air is delivered through two stainless steel micro-tubes  131  and  132  from a chilled air source controller  133 . 
     Referring to  FIG. 2A ,  FIG. 2A  illustrates a cross-section of the HPA  100  constructed from a cylindrical stainless steel housing  200 . For aesthetic purposes, the HPA  100  may be further encased in a specialized molding (not shown). The CIF  108  is located in a central region of the HPA  100 , surrounded by a ring containing tubing and optical fibers, as discussed below. The CIF  108  typically has a diameter of 700 microns and 50,000 individual pixel elements each having a diameter of 4.5 microns. The distal end  109  of the CIF  108  is positioned in a front conjugate plane of microlens assembly  201 . As illustrated in  FIG. 2B , the microlens assembly  201  forms a de-magnified primary image  207  of the target  106  on the distal end  109  of the CIF  108 . The primary image is transported to the proximal end  110  as discussed above. The primary image size  207  can be adjusted by changing the height of the baffle  117 . Plurality of multimode optical fibers  114  and  115  provide white light illumination  203 , to enhance quality of a captured image. The stainless steel micro-tubes  131  and  132  are used for transporting chilled air to the treatment area  103 . Stainless steel conduit  203  is used for holding multimode optical fibers  124  and  125  used in the optical switch  120  illustrated in  FIG. 3 , while spare stainless steel channel  204  may be used for mounting other sensors, for example, a thermistor for monitoring the target temperature. 
     During the treatment mode, the CIF  108  delivers the optical energy to the target  106 . As illustrated in  FIG. 2B , it is possible to define any arbitrary spatial distributions  205  and  206  by exciting the appropriate pixels at the proximal end  110  of the CIF  108 . The microlens assembly  201  produces the desired spatial image on the target  106 . The optical energy is delivered to the treatment area  103  for a programmed precise time and the laser diode  124  is disabled until the optical switch  120  is enabled. 
       FIG. 3  is illustrates a cross-sectional view of the optical switch  120  in the HPA  100 . Two multimode optical fibers  124  and  125  are mounted in the stainless micro-tubing  203 . A modulated optical signal emanates from a distal end of fiber  125 . In the OFF state, illustrated in  FIG. 3A , an optical signal  300  enters a slab waveguide  301  and is lost. In the ON state, as illustrated by  FIG. 3B , the optical signal  300  enters the slab waveguide  301 , and some of the optical signal leaves the slab waveguide  301 , entering the fiber  129 . The optical signal is detected by the photodetector  123  in  FIG. 1 . The optical switch  120  defaults to the OFF state until moved to the ON state by the user. Activation of the optical switch  120  will produce a TLP of preset width and repetition rate. This feature adds another layer of safety. 
       FIG. 4  shows a cross-section of a hair follicle  400 , which resides in the following three layers of the skin: 1) the epidermis  401 ; 2) the dermis  402 ; and 3) the hypodermis  403 . During the anagen phase of the hair growth cycle, capillaries  404  provide nutrients to the bulb region  405 , which encompasses the dermal papilla  406 . During this phase of the hair growth cycle, the bulb region  405  is located 2 to 4 mm below the epidermis  401 . The hair shaft  407  and the Inner Root Sheath (IRS)  408  grow together from the bulb region  405  upward toward the sebaceous gland  409 . Each of the various follicular compartments arises from the germinative cell pool at the base of the bulb region  405 . An inner most layer of the Outer Root Sheath (ORS)  410  provides a slippage plane. The ORS  410  remains behind and is continuous with the epidermis  401 . The IRS  408  disintegrates just below the sebaceous gland  409  and the sheath-free hair shaft  407  exits the pilary canal  411 . The bulge region  412 , the putative site of follicular stem cells and the bulb region  405  contain melanocytes, which give the hair shaft  407  its color. The bulge region  412  and the bulb region  405  are the primary targets for photothermolysis as they exhibit a broad absorption spectrum in the visible and near infrared regions. Melanocytes are composed of eumalanin, which is brownish-black, and phuemelanin, which is reddish. Photons from the TLP are delivered to the bulge region  412  and the bulb region  405  in order to cause cell destruction. SP methods of photoepilation bombard a large area of the epidermis  401  in order to increase the probability of reaching target areas. Photons in the TLP are lost due to reflection at the epidermis  401 , absorption in the epidermis  401 , and scattering in the dermis  402 . The probability of photons reaching intended targets is extremely low, requiring high surface fluence values and large treatment area sizes. In addition, deeper targets, such as the hair follicle  400 , are only reachable at longer wavelength (750-1000 nm). However, the absorption of melanin drops of at longer wavelengths, requiring even higher fluences. 
     Decreasing a requirement for peak power through a reduced spot size of the TLP pulse is not a viable solution as the photons migrate out of the target zone very rapidly. Moving to a smaller spot size demands new delivery methods for reaching the intended targets. Three optical delivery techniques are provided which target individual hair follicles, typically with a spot size smaller than 10 −4  cm 2 . One of these is the ESP, which uses heat diffusion to reach the intended targets by creating hot spots in easily accessible parts of the hair follicle, mainly the hair shaft  407 . However, delivering the TLP directly to the hair shaft  407 , which has a nominal diameter of 80 μm, requires precise spatial location. Imaging and sensor techniques have been proposed for achieving this goal, but all of the proposed solutions include scanning functionality in the hand piece, something that should be avoided if the device is to be utilized in non-medical facilities. 
     One possible strategy, illustrated in  FIG. 4 , is to illuminate the hair shaft  407  with a Gaussian laser spot  413 , with a diameter slightly smaller than a diameter of the hair shaft  407 , typically about of 80 μm and the pilary canal  411  has an opening with a nominal diameter of 200 μm. The hair shaft  407  is a highly absorbing medium and has no useful optical guiding properties. In “Characterization of human scalp hairs by optical low-coherence reflectometry,” Opt. Let., 20, 6, 524-526 (1995) by Wang et al., optical low-coherence reflectometry measurements of longitudinal scans of dark and light hair are provided. Wang et al. reported that a refractive index of the hair shaft increased from 1.57 for blond hair to 1.59 for black hair. From the data of Wang et al., an attenuation coefficient for black and blond hair was estimated to be 34.5 mm −1  and 3.2 mm −1 , respectively. From these measurements, made at 850 nm, effective penetration depths of 29 μm and 310 μm for black and blond hair, respectively, was determined. These measurements indicate that the hair shaft is not an optical fiber waveguide. Thus, photons incident on the hair shaft are absorbed within this short layer, causing a localized hot spot  414 . By using lower fluences and longer pulse widths (500 ms), the dermal papilla  405  and bulb region  406  can be heated to denaturing temperatures by allowing the heat to diffuse down the hair shaft  407  as indicated by  415 . 
       FIG. 5  shows a second illumination strategy, which deposits photons in melanin rich sites of the hair shaft  407  by using an optical guiding channel created by a concentric structure of the hair shaft  407 , the IRS  408 , and the ORS  410 . Specifically, the hair shaft  407 , the IRS  408 , and the ORS  410  form a three layer waveguide. Entrance to the three layer waveguide is through the pilary canal  411 . The IRS  408 , which is sandwiched between the ORS  410  and the hair shaft  407 , below the sebaceous gland  409 , has a refractive index that is larger than that of the ORS  410  but lower than that of the hair shaft  407 . The three layers form a leaky waveguide, with the photons being absorbed on a hair shaft surface  502  and reflected from an ORS surface  501 . A donut shaped TLP  500  is matched to a size of the pilary canal  411 , which has inner diameter bounded by the hair shaft  407  and a nominal ring thickness 30-40 μm. Photons enter the pilary canal  411 , which may contain an oil substance excreted by the sebaceous gland  409 , enter the IRS  408  below the sebaceous gland  409 , and are guided through the leaky modes to the melanin rich bulb region  405  containing the stem cells to be destroyed. As these photons travel in the IRS  408  some are likely to be absorbed by the melanocytes in the bulge region  412 . The fluence levels may be lower as none of the incident photons are absorbed by the epidermis  401  or the dermis  402 . Consequently the epidermis  401  should experience minimum heat stress. In this configuration pulse widths should correspond to the TRT of the bulb region  405 . 
     A third illumination strategy can be a combination of both those described above. A short pulse width donut beam can be superimposed on a long pulse width Gaussian beam toward the end of the short pulse width donut beam&#39;s duration, as indicated by the timing diagram in  FIG. 6 . This strategy allows the hair shaft&#39;s  407  temperature to be elevated by the extended TLP directed at the hair shaft  407 , followed by the donut shaped pulse just prior to the termination of the Gaussian pulse. The Gaussian pulse may have a pulsed width in the range of 100 to 500 ms, while the donut shaped pulse width is between 5 and 50 ms. In principle, the two laser diodes  701  and  702  may have different wavelength and deliver different fluence levels, which could be matched for the hair color. 
     Referring to  FIG. 7 , Laser Diode (LD 1 )  701  is pigtailed to a single multimode fiber  703  which forms a central part of the distal end  706  of a fiber optic assembly  705 . Laser Diode (LD 2 ) is pigtailed to plurality of multimode fibers  704  which are arranged in an annular pattern  707  surrounding the single multimode fiber  703 . In this way, LDs  701  and  702  may either have identical or dissimilar spectral and power properties. The distal end  706  can be integrated with the source aspheric imaging lens assembly  129  illustrated by  FIG. 1 . 
     There may be instances when a larger spot is required. As discussed above, with reference to  FIGS. 2A and 2B , it is possible to produce any arbitrary illumination shape. For example, an elliptical spot which increases the spot dimension along one axis, while keeping the area small could be used. However, there may be instances when this approach is also not adequate. In such situations a large treatment area can be synthesized by scanning the small spot over the target area. U.S. Pat. No. 7,101,365 to Sharon, the disclosure of which is incorporated herein by reference, describes a manual means to pivot an entire hand piece to obtain a limited scan. While Altshuler (discussed above) and U.S. Pat. No. 5,860,967 to Zavisian, the disclosure of which is incorporated herein by reference, include a 2-D scanning mechanism in the hand piece. Embodiments of the present invention achieve desired scanning of the target  106  by scanning an image of the source at the proximal end  110  of the CIF  108 . 
     Referring to  FIG. 8A , dots  801  and  802  show two arbitrary positions of the TLP on the treatment area  103 .  FIG. 8B  illustrates positions of the corresponding dots  801  and  802  on the proximal end  110  of the CIF  108 . A target scan path corresponds to a scanned source image on the proximal end  110 . 
     The scanned image can be generated in number of ways.  FIG. 8C  illustrates a 2-D mechanical scanner using mirrors  803  and  804 . A laser source beam  805  bounces off the mirrors  803  and  804  to define a scan path  806 .  FIG. 8D  illustrates an alternative means of obtaining the source scan, using a 1×N fiber optic switch. In other words, output of an input fiber  807  can be directed to any one of output fibers  808  by means of, for example, a rotating concave mirror  809 . Other types of switches may be used. The output fibers  808  form the distal end  706  of the fiber optic bundle  705  described in  FIG. 7 . An important difference between the Sharon and Altshuler schemes is that all scanning components are in the electronic console  102 , none of the scanning components are in the HPA  100 . This ensures a compact and safe hand piece suitable for non-medical facilities. 
     There are certain situations when indiscriminate hair removal using a large diameter spot is not desirable. As an example, for cosmetic purposes, patients may require an alteration of the hair density in certain parts of the human anatomy rather than total hair removal. For such applications a LHR system must be capable of targeting individual hair follicles. The HPA  100  described above can be used on a robotic platform to remove hair from any random location. One such embodiment includes a 3-D vision system capable of creating a digital map of a surface to be treated. Appropriate software algorithms that analyze hair distribution and hair angle determine optimum location information of hair follicles to receive laser treatment. The location information drives the robotic arm to automatically complete the treatment. Safety features, built around limit switches, ensure that the high energy spot remains within the treatment area. 
     Another preferred embodiment of the HPA  100  is illustrated by  FIG. 9 . The CIF  108  is surrounded by a plurality of multimode fibers  901  which are used for delivering high energy optical pulses to the hair follicle. Output of the multimode fibers  901  is combined into a single spot at an entrance to the target  106 . A radially bi-focal lens  902  provides disparate magnifications for the CIF  109  and the multimode fibers  901 . The multimode fibers  901  can be used to increase the target fluence by using a plurality of optical sources at the same emission wavelength, or alternatively, sources with output at different wavelengths could be combined to enhance efficacy of the treatment. 
     An example of a fluence calculation in a preferred embodiment is as follows. An expected fluence F t  [J·cm −2 ] at the target  106  of area A t  [cm 2 ] to the power P f  emanating from a pigtailed laser diode assembly  129  is given by Equation (1): 
                     F   t     =     η   ⁢           ⁢         P   r     ⁢     σ   T         A   T                 (   1   )               
where η represents all the transmission losses from the output of the fiber assembly  129  to the laser spot illuminating the treatment area  106  and σ T  is the pulse width or duration of the optical energy pulse which can be easily controlled between 100 μs to 1 s. Using a conservative estimate of η=0.85, P f =200 mW, A t =10 −4  cm 2 , which is a typical diameter of the hair shaft, and σ T =50 ms, F t =85 J·cm 2  is obtained. Thus, the fluence can be controlled through a combination of parameters, P f , σ T , and A T .
 
     While the invention has been shown and described with reference to certain embodiments of the present invention thereof, it will be understood by those skilled in the art that various changes in from and details may be made therein without departing from the spirit and scope of the present invention as defined by the appended claims and equivalent thereof.