|Fourth Amendment to the September 7, 2004 Joint Development and License Agreement Between Palomar Medical Technologies, Inc. and
Johnson & Johnson Consumer Companies, Inc. (the Agreement)

Whereas, pursuant to the Agreement, the parties are engaged in a collaboration to develop, clinically test and potentially
commercialize home-use, light-based devices for (i) reducing or reshaping body fat including cellulite; (ii) reducing appearance of
skin aging; and (iii) reducing or preventing acne; and

Whereas, the parties desire to modify certain provisions of the Agreement in order to  **; and

Whereas, the parties desire to modify certain provisions of the Agreement in order to
Allow JJC to terminate the Agreement during the Optimization Period.

Now, Therefore, in consideration of the foregoing premises, the mutual promises and covenants of the parties contained herein, and
other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties hereto, intending to
be legally bound, do hereby agree as follows effective on the 22nd day of August 2007:


1.       **

2.       **


3.       ARTICLE III.E.3 is hereby amended and replaced with the following:
|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

|3. |  | Optimization
Period.
|-- |  | --------------------

|a) |  | JJC
shall fund Palomars efforts during the Optimization Period with Optimization Payments
paid on a                   Calendar Quarterly basis.  As of the Effective Date, the
Parties believe that the Optimization Payments set forth                   in Appendix F,
and as defined in ARTICLE VI.A.3, reflect a reasonable estimate of the costs to complete
the                   Optimization Period for the ** Initial Products that enter into the
Optimization Period.  The cost of the                   activities to be conducted by
Palomar during the Optimization Period is a rough estimation and not final.  The
                  Optimization Payments, as mutually agreed to during the ** for each
Initial Product as provided in ARTICLE                   III.E.2.a) and as provided for
in the R&D Plan, shall be fixed and final, subject only to changes thereto by the
                  R&D Committee thereafter as provided in ARTICLE III (taking into
account ARTICLE III.C.4.c)).  **
|-- |  | -----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

|b) |  | During
the Optimization Period, ** Palomar shall work to complete the
deliverables to be set forth in the R&D Plan, as  modified for the Optimization Period, for each Initial Product that enters
the Optimization Period.  Palomar shall notify JJC in writing of the date of its completion of the
                  Optimization Period for each such Initial Product.
|-- |  | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

|**Omitted pursuant to request for
confidential treatment by  Palomar Medical Technologies, Inc. and filed separately with
the SEC.
|----------------------------------------------------------------------------------------------------------------------------------

|c) |  | The
Optimization Period shall end on the Optimization Completion Date **
|-- |  | ------------------------------------------------------------------------

|4.       Article VI.A.3.b is hereby amended and replaced with the following:
|----------------------------------------------------------------------------

|b) |  | The
R&D Committee may direct a portion of any such Optimization Payments related to the
allocation of                   tasks during the Optimization Period for an Initial
Product to others, including contract manufacturers, PROVIDED                  that
such portions so directed do not exceed the amounts expressly agreed-to in the R&D Plan
for such purpose.
|-- |  | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

| |  | In  the
event that, by termination of this Agreement or one or more of the Field(s) by either JJC
pursuant to                   ARTICLE X.D or by Palomar pursuant to ARTICLE X, an Initial
Product is no longer part of this Agreement before the                   final
Optimization Payment becomes due for such Initial Product, JJC shall be obligated to pay
Palomar the next two                   Optimization Payments that would have been due
(absent such termination) following such termination for such                   Initial
Product on the schedule set forth herein.  However, in the event that such termination is
prior to the last                   to occur of ** JJC shall be obligated to pay Palomar
only one Optimization Payment that would have been due (absent                   such
termination).
| |  | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

| |  | In the
event that this Agreement is terminated by JJC pursuant to ARTICLE X.B.2 before the final
Optimization                   Payment(s) becomes due for all Initial Products, JJC shall
have no further obligation from and after the date on                   which JJC
provides to Palomar written notice of such termination to pay Palomar any additional
Optimization                   Payments.
| |  | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

|5.       Article VI.A.4 is hereby amended and replaced with the following:

**Omitted pursuant to request for
confidential treatment by  Palomar Medical Technologies, Inc. and filed separately with
the SEC.
|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

|4. |  | Commercialization
Payment.  For the first Initial Product in each Field that JJC agrees to
                  commercialize, JJC shall pay Palomar $1,500,000 as a Commercialization
Payment within ** after the completion of                   the Optimization Period.
|-- |  | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

|6.              Article X.D is hereby amended and replaced with the following:
|------------------------------------------------------------------------------

|D. |  | JJCs
Right to Terminate for Convenience.  JJC shall have the right to terminate this Agreement
in                   full, or on a Field-by-Field basis, upon **prior written notice to
Palomar specifying the scope of the termination                   and received by Palomar
at any time after August 22, 2007 and before the end of the Optimization Period
applicable                   to the Initial Product that is the subject of any such
terminated Field.  Neither Party shall have any other right                   to
terminate this Agreement for convenience.
|-- |  | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

|                                   | 
|---------------------------------- | 
|PALOMAR MEDICAL TECHNOLOGIES, INC. | 
|/s/ Joseph P. Caruso               | 
|Name: Joseph P. Caruso             | 
|Title:  CEO                        | 
|Date:  August 22, 2007             | 

|                                                                                                                                 | 
|-------------------------------------------------------------------------------------------------------------------------------- | 
|JOHNSON & JOHNSON CONSUMER COMPANIES, INC., acting through its division JOHNSON & JOHNSON CONSUMER & PERSONAL PRODUCTS WORLDWIDE | 
|/s/ Peter Luther                                                                                                                 | 
|Name: Peter Luther                                                                                                               | 
|Title:   President of Beauty Care North America                                                                                  | 
|Date:   August 21, 2007                                                                                                          | 

|**Omitted pursuant to request for
confidential treatment by  Palomar Medical Technologies, Inc. and filed separately with
the SEC.








Exhibit A

**Omitted pursuant to request for
confidential treatment by  Palomar Medical Technologies, Inc. and filed separately with
the SEC.






LIBC/3101537.2
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------