WO2025137497A1

WO2025137497A1 - Methods and systems for treatment of the skin

Info

Publication number: WO2025137497A1
Application number: PCT/US2024/061359
Authority: WO
Inventors: David BOINAGROV; Daniel K. Negus; James L. Hobart
Original assignee: Sciton Inc
Current assignee: Sciton Inc
Priority date: 2023-12-22
Filing date: 2024-12-20
Publication date: 2025-06-26
Anticipated expiration: 2026-06-22

Abstract

In one aspect, methods of treating skin are described herein. Such a method can comprise attaching a tip to a handpiece, wherein the tip comprises a perforated bottom surface and a needle array positioned above the perforated bottom surface when the array is in a retracted configuration and operable to pass through the perforated bottom surface when the array is in an extended configuration. The handpiece comprises an actuator operable to move the needle array between the retracted and extended configurations. The method can further comprises placing the perforated bottom surface of the tip in contact with or adjacent to a region of interest (ROI) on the skin and initiating the actuator to move the needle array from the retracted configuration to the extended configuration, thereby penetrating the skin with the needle array. Triggering can be carried out automatically and/or manually. Cooling may also be used in some embodiments.

Description

METHODS AND SYSTEMS FOR TREATMENT OF THE SKIN

CROSS REFERENCE TO RELATED APPLICATIONS

[0001] This application claims priority under 35 U.S.C. § 119 to U.S. Provisional Patent Application No. 63/613,786, filed December 22, 2023, which is hereby incorporated by reference in its entirety.

FIELD

[0002] The present disclosure relates to systems and methods for the treatment of skin and, in particular, to methods, systems, and devices for treating skin with needle arrays.

BACKGROUND

[0003] In dermatologic treatments, there is a high demand for repair of skin for a variety of skin conditions, including aging, acne scars, wound scars, and sun damage. Common techniques for the treatment of these skin conditions require numerous small treatments over a large treatment area. Unfortunately, it can be difficult for a clinician or user to be aware of where on the skin the clinician has already treated in an efficient manner and to precisely control where treatments are applied. Thus, the mental load of an accurate and concise treatment on the clinician or user is high, with a significant probability for clinician or user error. Additionally, with current techniques, there is the risk for accidental overtreatment of particular areas, which can lead to undesired or excessive skin damage and inefficient treatment. Patient discomfort and lack of treatment efficacy can also be problematic. Consequently, improved methods and systems to facilitate treatment application with greater effectiveness, reduced discomfort, and greater accuracy and less variability, and with less burden to the clinician or user, are needed.

SUMMARY

[0004] In one aspect, methods and systems for treating the skin are described herein. Such methods and systems, in some cases, can provide one or more advantages compared to other methods and systems. For example, in some instances, a method or system described herein can provide improved control of the variability and accuracy of the treatment to the treatment area by the user through an automatic trigger or “autofire” feature of the handpiece, such as may be obtained in some embodiments through manually triggering the handpiece, applying a downward force to the handpiece, or otherwise initiating a “fire” sequence or treatment event. Moreover, in some embodiments, a method or system described herein may provide increased or improved comfort and/or less pain to the subject during treatment and/or after treatment.

[0005] In some embodiments, a method described herein comprises attaching a tip to a handpiece, wherein the tip comprises a perforated bottom surface and a needle array positioned above the perforated bottom surface when the needle array is in a retracted configuration and operable to pass through the perforated bottom surface when the needle array is in an extended configuration. Additionally, the handpiece comprises an actuator operable to move the needle array between the retracted configuration and the extended configuration. In some instances, the method further comprises placing the perforated bottom surface of the tip in contact with or adjacent to a first region of interest (ROI) on the skin, when the needle array is in the retracted configuration. Such a method can further comprise initiating the actuator of the handpiece to move the needle array from the retracted configuration to the extended configuration, thereby penetrating the skin with the needle array in the first ROI. Moreover, in some instances, the method further comprises applying an electric current between the needles of the needle array. [0006] Additionally, in some embodiments, the method further comprises ceasing to apply the electric current between the needles, and moving the needle array back to the retracted configuration from the extended configuration. In some cases, the handpiece can then be moved to a different location, so that the treatment can be performed in an additional location, or series of additional locations. Thus, in some such embodiments, a method described herein further comprises removing the perforated bottom surface of the tip from the first ROI, and placing the perforated bottom surface of the tip in contact with or adjacent to a second ROI on the skin (or an “//th” ROI on the skin, where n can be any integer greater than 1).

[0007] Moreover, in some embodiments, initiating the actuator comprises (1) manually triggering the actuator (e.g., in a manner further described hereinbelow), (2) applying a downward force to the handpiece, or (3) manually triggering the actuator and applying a downward force to the handpiece at the same time. Further, in some instances, initiating the actuator also initiates the application of the electric current.

[0008] In addition, in some cases, a method described herein further comprises cooling the an ROI (e.g., the first, second, and/or //th ROI) at one or more time points, such as (1) while placing the perforated bottom surface of the tip in contact with or adjacent to the first ROI, (2) while initiating the actuator of the handpiece to move the needle array from the retracted configuration to the extended configuration, and/or (3) while penetrating the skin with the needle array in the first ROI. Other aspects and features of some embodiments of methods are further described below.

[0009] Systems for treating skin are also described herein. In some embodiments, a system described herein comprises a removable tip attached to a handpiece and a source of electric current. In some instances, the system further comprises other components, such as a cooling system and/or an actuation trigger, which may be a manual trigger in some cases. In some embodiments, the tip of a system described herein comprises a perforated bottom surface and a needle array positioned above the perforated bottom surface when the needle array is in a retracted configuration and operable to pass through the perforated bottom surface when the needle array is in an extended configuration. In some embodiments, the tip is disposable. In some instances, the handpiece comprises an actuator operable to move the needle array between the retracted configuration and the extended configuration. In other cases, a trigger (e.g., a manual trigger) is operable to initiate actuation of the actuator of the handpiece to move the needle array from the retracted configuration to the extended configuration. In some instances, a manual trigger comprises a button, switch, or pedal. In some such instances, the button, switch, or pedal comprises a digital button, switch, or pedal. In some other such instances, the button, switch, or pedal is pressed with a foot of a user. In some embodiments, the perforated bottom surface of the tip of the system translocates when the bottom surface is pressed against the skin of the subject, and translocation of the perforated bottom surface triggers the actuator.

[0010] These and other embodiments are described in more detail in the detailed description which follows.

BRIEF DESCRIPTION OF THE FIGURES

[0011] Figure 1 schematically illustrates a side view of a tip detached from a handpiece, according to one embodiment described herein.

[0012] Figure 2 schematically illustrates a side view of a tip attached to a handpiece, according to one embodiment described herein. [0013] Figure 3 illustrates a perspective side view of a handpiece with an attached tip according to one embodiment described herein.

[0014] Figure 4 schematically illustrates a handpiece placed on the skin with the perforated bottom touching a region of interest on the skin, according to one embodiment described herein. [0015] Figure 5 schematically illustrates the penetration of the needle array of the handpiece of Figure 4 into the dermis of the skin, according to one embodiment described herein.

[0016] Figure 6 schematically illustrates the application of electric current between the needles of a needle array according to one embodiment described herein.

[0017] Figure 7 schematically illustrates coagulation zones around the tips of the needles of a needle array that form because of heat generated by the applied electric current, according to one embodiment described herein.

[0018] Figure 8 schematically illustrates a needle array moved back into the retracted configuration from the extended configuration by the actuator of the handpiece, according to one embodiment described herein.

[0019] Figure 9A illustrates a perspective partial side view of a handpiece with an attached cooling element or cooling pad, according to one embodiment described herein.

[0020] Figure 9B illustrates a perspective side view of a handpiece with an attached cooling element or cooling pad, according to one embodiment described herein.

[0021] Figure 9C illustrates a front view of a handpiece with an attached cooling element or cooling pad, according to one embodiment described herein.

[0022] Figure 9D illustrates a perspective bottom view of a handpiece with an attached cooling element or cooling pad, according to one embodiment described herein.

[0023] Figure 10A illustrates a perspective bottom view of a handpiece with an attached cooling element or cooling pad, according to one embodiment described herein.

[0024] Figure 10B illustrates a perspective side view of a handpiece with an attached cooling element or cooling pad, according to one embodiment described herein.

[0025] Figure 11 schematically illustrates closed circuitry of a tip of a handpiece created by the movement of the perforated bottom when downward force is applied to the handpiece, according to one embodiment described herein. DETAILED DESCRIPTION

[0026] The present invention can be understood in conjunction with specific embodiments thereof as illustrated herein. However, it should be evident that many alternatives, modifications and variations can be produced. In particular, these embodiments are merely illustrative of the principles of the present invention. Accordingly, this disclosure is not intended to embrace all such alternatives, modifications and variations that fall within the spirit and broad scope of the specification and in view of the claims.

[0027] All publications, patents and patent applications mentioned in this specification are incorporated herein in their entirety by reference, to the same extent as if each individual publication, patent, or patent application was specifically and individually indicated to be incorporated herein by reference. In addition, citation or identification of any reference in this application shall not be construed as an admission that such reference is available as prior art to the present invention. To the extent that section headings are used, they should not be construed as necessarily limiting.

[0028] In addition, all ranges disclosed herein are to be understood to encompass any and all subranges subsumed therein. For example, a stated range of “1.0 to 10.0” should be considered to include any and all subranges beginning with a minimum value of 1.0 or more and ending with a maximum value of 10.0 or less, e.g., 1.0 to 5.3, or 4.7 to 10.0, or 3.6 to 7.9. All ranges disclosed herein are also to be considered to include the end points of the range, unless expressly stated otherwise. For example, a range of “between 5 and 10,” “from 5 to 10,” or “5-10” should generally be considered to include the end points 5 and 10.

[0029] Further, when the phrase “up to” is used in connection with an amount or quantity, it is to be understood that the amount is at least a detectable amount or quantity. For example, a material present in an amount “up to” a specified amount can be present from a detectable amount and up to and including the specified amount.

[0030] Additionally, in any disclosed embodiment, the terms “substantially,” “approximately,” and “about” may be substituted with “within [a percentage] of’ what is specified, where the percentage includes 0.1, 1, 5, and 10 percent.

[0031] It is also to be understood that the article “a” or “an” refers to “at least one,” unless the context of a particular use requires otherwise. [0032] Methods and systems for treating the skin are described herein. Such methods and systems, in some cases, can provide one or more advantages and/or benefits compared to other methods and systems. For example, in some instances, a method or system described herein can provide improved control of the variability and accuracy of the treatment to the treatment area by the user through an automatic trigger or “autofire” feature of the handpiece. Moreover, in some embodiments, a method or system described herein may provide improved comfort and/or less pain to the subject during treatment and/or after treatment.

[0033] In one aspect, a method of treating the skin is described herein. In some embodiments, such a method comprises attaching a tip to a handpiece, wherein the tip comprises a perforated bottom surface and a needle array positioned above the perforated bottom surface when the needle array is in a retracted configuration and operable to pass through the perforated bottom surface when the needle array is in an extended configuration, and wherein the handpiece comprises an actuator operable to move the needle array between the retracted configuration and the extended configuration. In some instances, the method further comprises placing the perforated bottom surface of the tip in contact with or adjacent to a first region of interest (ROI) on the skin, when the needle array is in the retracted configuration; initiating the actuator of the handpiece to move the needle array from the retracted configuration to the extended configuration; penetrating the skin with the needle array in the first ROI; and applying an electric current between the needles of the needle array. Additionally, in some embodiments, the method further comprises ceasing to apply the electric current between the needles, and moving the needle array back to the retracted configuration from the extended configuration. Also, in some such embodiments, the method further comprises removing the perforated bottom surface of the tip from the first ROI, and placing the perforated bottom surface of the tip in contact with or adjacent to a second ROI on the skin.

[0034] Additionally, in some such embodiments, removing the perforated bottom surface of the tip from the first ROI, and placing the perforated bottom surface of the tip in contact with or adjacent to a second ROI on the skin is not limited to a first and second ROI on the skin. That is, the foregoing method steps can be repeated more than twice, to treat more than two ROIs. The number of ROIs that can be treated by a method described herein is not particularly limited. In some embodiments, for example, a method described herein comprises removing the perforated bottom surface of the tip from a («-l)th ROI and placing the perforated bottom surface of the tip in contact with or adjacent to a //th region of interest on or adjacent to the skin. In such instances, n is an integer equal to 3 or more. However, n can be an integer ranging from 3 to 500, 3 to 400, 3 to 300, 3 to 200, 3 to 200, 3 to 100, 3 to 50, 3 to 25, or any subrange thereof.

[0035] Additionally, in some embodiments, initiating the actuator comprises (1) manually triggering the actuator, (2) applying a downward force to the handpiece, or (3) manually triggering the actuator and applying a downward force to the handpiece at the same time. In some instances, initiating the actuator also initiates the application of the electric current. Further, in some embodiments, initiating the actuator and/or initiating the application of the electric current is automatically triggered and/or “autofired” as the result of (1) manually triggering the actuator, (2) applying a downward force to the handpiece, or (3) manually triggering the actuator and applying a downward force to the handpiece at the same time.

[0036] Methods and systems described herein may be understood with reference to the figures. An exemplary system (200) according to one embodiment described herein is illustrated in Figure 1. In Figure 1, a tip (202) comprising a needle array (201) and a needle shaft (203) detached from the handpiece (206) is shown. In this embodiment, the tip (202) is a removable, disposable, and sterile tip. Moreover, in this exemplary embodiment, the handpiece (206) comprises a needle shaft receiver (204), an actuator (205), and a cable (207) connecting the handpiece to a console and/or controller further comprising power supplies, a central processing unit, a radiofrequency signal generator, and a touchscreen display (not shown). It is to be understood that in some embodiments, the console or controller may comprise hardware and/or software for directing the actuator (205) of the handpiece (206) to position the needle array (201) in the appropriate configuration (i.e., the extended or retracted configurations).

[0037] In Figures 2 and 3, a tip (202) with perforated bottom surface (210) is attached to the handpiece (206) through the needle shaft (203) and needle shaft receiver (204). Treatment parameters, such as needle penetration depth, radiofrequency energy, and radiofrequency pulse duration, may be entered via a touchscreen on the console or controller. As shown in Figure 4, while in the retracted conformation for the needle array (201), the handpiece (206) is brought to the skin (100) of a subject with the perforated bottom surface of the tip (202) in contact with a region of interest on the skin (100). In this embodiment, the handpiece (206) is held at a right angle to the skin (100). [0038] Upon the system operator initiating the actuator (205) of the handpiece (206), as shown in Figure 5, the actuator (205) in the handpiece (206) moves to the extended configuration, and the needle array (201) penetrates the skin (100) of the first ROI to the selected depth. Specifically, in this embodiment, the needle array penetrates the epidermis (101) and dermis (102) of the skin (100) but not the subcutaneous tissue (103). Then, as shown in Figure 6, radiofrequency electric current from the console is delivered to the needle array (201), which results in radiofrequency electric current flowing (shown as arrows in Figure 6) between the needles of the needle array (201) in the skin (100). In some embodiments, the electric current flowing in the skin generates heat in the skin (100), which raises the skin’s temperature. In some embodiments, this temperature increase results in areas of tissue coagulation (301) around the tips of the needles of the needle array (201) in the skin (100), as shown in Figure 7. It is to be understood that the extent of the heating of the tissue adjacent to the tips of the needles can affect the degree of tissue coagulation.

[0039] When treatment finishes, the electric current ceases, and the actuator (205) in the handpiece (206) pushes the needle array (201) out of the skin (100), returning the needle array (201) back to the retracted configuration, as displayed by Figure 8. Then, the system operator moves the handpiece (206) with the tip (202) to a different place on the skin and repeats pulse delivery. After the treatment on the subject is completed, the system operator may remove the single-use disposable tip (202) and discard the tip (202) as medical waste.

[0040] Moreover, systems and/or methods described herein, in some instances, may incorporate cooling. Not intending to be bound by theory, it is believed that cooling may decrease, reduce, and/or minimize the level of discomfort and/or amount of pain experienced by the subject during and/or after the penetration of the skin by the needle array and/or applying an electric current between the needles of the needle array. In some cases, pain may be partially or fully the result of the penetration of the skin by the needle array. However, in some implementations, pain may be partially or fully the result of heat caused by the electric current between the needles of the needle array. In some embodiments, cooling the skin and/or ROI may cool the skin and/or ROI before and/or during treatment by 15°C-50°C, 15°C-45°C, 15°C-40°C, 15°C-35°C, 15°C-30°C, 15°C-25°C, 15°C-20°C, 20°C-50°C, 20°C-45°C, 20°C-40°C, 20°C- 35°C, 20°C-30°C, 20°C-25°C, 25°C-50°C, 25°C-45°C, 25°C-40°C, 25°C-35°C, 25°C-30°C, 30°C-50°C, 30°C-45°C, 30°C-40°C, 30°C-35°C, 35°C-50°C, 35°C-45°C, 35°C-40°C, 40°C- 50°C, 40°C-45°C, or 45°C-50°C, as compared to performing the treatment without cooling. [0041] Such cooling may be carried out in any manner not inconsistent with the technical objectives of the current disclosure. In some cases, methods described herein may comprise cooling the first ROI (1) while placing the perforated bottom surface of the tip in contact with or adjacent to the first ROI, (2) while initiating the actuator of the handpiece to move the needle array from the retracted configuration to the extended configuration, and/or (3) while penetrating the skin with the needle array in the first ROI. Thus, it is to be understood that in some cases, cooling the first ROI may occur before the penetration of the skin, during the penetration of the skin, and/or while applying the electric current. Moreover, it is also to be understood that in some embodiments, a second ROI or a //th region of interest may be cooled in a similar manner. [0042] Cooling may be carried out using any component not inconsistent with the technical objectives of the current disclosure. For example, in some implementations, cooling may be carried out with a cooling system. Any cooling system not inconsistent with the technical objectives of the current disclosure may be used. An exemplary embodiment of a cooling system is illustrated in Figures 9A-9D. In this exemplary embodiment of a cooling system, a cooling system comprises a chiller system (not shown) and a circulator pump (not shown) that are attached to a coolant tube or line (211) that acts as a conduit for the circulation of a coolant and/or heat transfer fluid from a chiller system by the circulator pump. Any coolant and/or heat transfer fluid not inconsistent with the technical objectives may be used. For example, in some embodiments, a coolant may comprise water, a glycol (e.g., ethylene glycol or propylene glycol) and water mixture, mineral oil, or a dielectric fluid. Additionally, in this exemplary embodiment of a cooling system, a cooling pad or cooling element (212) is positioned on the handpiece (206), and coolant tubes or lines (211) of the cooling system are attached to the handpiece and secured via a casing (213). It is to be understood that in some implementations, a cooling pad or cooling element (212) may be used to cool the one or more ROIs (1) while placing the perforated bottom surface of the tip in contact with or adjacent to the relevant ROI or ROIs, (2) while initiating the actuator of the handpiece to move the needle array from the retracted configuration to the extended configuration, and/or (3) while penetrating the skin with the needle array in the relevant ROI or ROIs. [0043] Regarding the figures of the cooling system specifically, a partial side perspective view and a side perspective view of a cooling system are shown in Figures 9A and 9B, respectively, illustrating the handpiece (206) with an attached tip (202) and a cooling element or cooling pad (212) with an attached casing (213) partially covering the coolant lines (211). Figures 9C and 9D illustrate, respectively, a front view and a bottom view, of the handpiece (206) with the attached cooling pad and casing (213) partially covering the coolant lines (211). It is to be understood that in some cases, a coolant line, coolant lines, and/or coolant line casing may be detachable from a handpiece described herein, such as the coolant lines (211) and casing (213) shown in Figures 9A-9D. However, in some embodiments, a coolant line or coolant line casing may be non-detachable from the handpiece.

[0044] Moreover, in Figure 9C, a front view of the handpiece (206) of the system (200) is ilustrated, showing that the shape of the cooling element (212). In this exemplary embodiment, the cooling element (212) is a U-shape. As shown in Figure 9C, the perforated bottom surface (210) of the tip (202) of the handpiece sits or is positioned within the valley of the U-shape of the cooling element (212). However, it is to be understood that the shape of the cooling element or cooling pad is not particularly limited. For example, in some instances, the shape of the cooling element or cooling pad may be a circle, square, rectangle, or irregular shape. In some embodiments, the perforated bottom of the tip of the handpiece may sit or be positioned partially or wholly within the dimensions of the shape of the cooling element or cooling pad. In contrast, in some instances, the perforated bottom of the tip of the handpiece may simply sit next to or be adjacent to the entirety of the cooling element or cooling pad.

[0045] Further, in Figure 9C, the cooling element (212) is formed from a high thermal conductivity metal or alloy. For example, in some instances, the cooling element may be formed from aluminum or copper. However, the identity of the material (i.e., the metal or alloy) that forms the cooling element or cooling pad is not particularly limited.

[0046] Another exemplary embodiment of a system (200) comprising a handpiece (206) is illustrated in Figures 10A and 10B. Figure 10A shows a bottom perspective of an exemplary embodiment of a handpiece (206) with an attached tip (202) and a smaller cooling element or cooling pad (212) with an attached case (213) with coolant lines (211). Figure 10B illustrates a side perspective view of the handpiece (206) with a smaller cooling element or cooling pad (212). Thus, it is to be understood that the cooling element or cooling pad may have any size not inconsistent with the technical objectives of the present disclosure, where the “size” is understood to refer to the surface area of the cooling pad or cooling element that comes in contact with the skin. In some cases, the size of the cooling element or cooling pad may be between 1 cm² and 100 cm² or any subrange thereof. In some embodiments, for instance, the size of the cooling element or cooling pad may be between 1 cm² and 100 cm², 1 cm² and 90 cm², 1 cm² and 80 cm², 1 cm² and 70 cm², 1 cm² and 60 cm², 1 cm² and 50 cm², 1 cm² and 40 cm², 1 cm² and 30 cm², 1 cm² and 20 cm², 1 cm² and 10 cm², 1 cm² and 5 cm², 5 cm² and 100 cm², 5 cm² and 90 cm², 5 cm² and 80 cm², 5 cm² and 70 cm², 5 cm² and 60 cm², 5 cm² and 50 cm², 5 cm² and 40 cm², 5 cm² and 30 cm², 5 cm² and 20 cm², 5 cm² and 10 cm², 10 cm² and 100 cm², 10 cm² and 90 cm², 10 cm² and 80 cm², 10 cm² and 70 cm², 10 cm² and 60 cm², 10 cm² and 50 cm², 10 cm² and 40 cm², 10 cm² and 30 cm², 10 cm² and 20 cm², 20 cm² and 100 cm², 20 cm² and 90 cm², 20 cm² and 80 cm², 20 cm² and 70 cm², 20 cm² and 60 cm², 20 cm² and 50 cm², 20 cm² and 40 cm², 20 cm² and 30 cm², 30 cm² and 100 cm², 30 cm² and 90 cm², 30 cm² and 80 cm², 30 cm² and 70 cm², 30 cm² and 60 cm², 30 cm² and 50 cm², 30 cm² and 40 cm², 40 cm² and 100 cm², 40 cm² and 90 cm², 40 cm² and 80 cm², 40 cm² and 70 cm², 40 cm² and 60 cm², 40 cm² and 50 cm², 50 cm² and 100 cm², 50 cm² and 90 cm², 50 cm² and 80 cm², 50 cm² and 70 cm², 50 cm² and 60 cm², 60 cm² and 100 cm², 60 cm² and 90 cm², 60 cm² and 80 cm², 60 cm² and 70 cm², 70 cm² and 100 cm², 70 cm² and 90 cm², 70 cm² and 80 cm², 80 cm² and 100 cm², 80 cm² and 90 cm², or 90 cm² and 100 cm². Other sizes may also be used.

[0047] Moreover, in some embodiments, a cooling system may comprise a facemask in place of a cooling pad or cooling element to provide cooling. In some instances, a facemask may comprise a coolant tube or line that acts as a conduit for the circulation of a coolant and/or heat transfer fluid from a chiller system by a circulator pump. It is to be understood that in implementations of methods and/or systems described herein, a facemask may provide cooling before treating one or more ROIs. Further, in some instances, a facemask may be fully or partially removed to provide treatment to one or more ROIs. In some embodiments, the facemask may have any size (that is, the surface area of the facemask that comes in contact with the skin) not inconsistent with the technical objectives of the current disclosure. In some cases, the size of the facemask may be between 100 cm² and 500 cm², 100 cm² and 450 cm², 100 cm² and 400 cm², 100 cm² and 350 cm², 100 cm² and 300 cm², 100 cm² and 250 cm², 100 cm² and 200 cm², 100 cm² and 150 cm², 150 cm² and 500 cm², 150 cm² and 450 cm², 150 cm² and 400 cm², 150 cm² and 350 cm², 150 cm² and 300 cm², 150 cm² and 250 cm², 150 cm² and 200 cm², 200 cm² and 500 cm², 200 cm² and 450 cm², 200 cm² and 400 cm², 200 cm² and 350 cm², 200 cm² and 300 cm², 200 cm² and 250 cm², 250 cm² and 500 cm², 250 cm² and 450 cm², 250 cm² and 400 cm², 250 cm² and 350 cm², 250 cm² and 300 cm², 300 cm² and 500 cm², 300 cm² and 450 cm², 300 cm² and 400 cm², 300 cm² and 350 cm², 350 cm² and 500 cm², 350 cm² and 450 cm², 350 cm² and 400 cm², 400 cm² and 500 cm², 400 cm² and 450 cm², or 450 cm² and 500 cm².

[0048] Moreover, in some instances, a cooling system described herein may comprise one or more heat pipes. It is to be understood for reference purposes herein, that in some cases, a heat pipe is a heat-transfer device. In some instances, a heat pipe comprises a sealed pipe and/or tube comprising a casing with a wick and a vapor cavity filled with a working fluid. In some embodiments, a heat pipe has a copper casing with water as the working fluid and sintered copper as the wick material. In some instances, a heat pipe has an aluminum casing with ammonia as the working fluid and sintered aluminum as the wick material. However, the identity of the material of the casing and the wick material and the identity of the working fluid are not necessarily limited. It is to be understood that in some implementations, one or more heat pipes may be adjacent to a cooling pad or cooling element described herein.

[0049] Certain other components of methods and systems according to the present disclosure will now be described in more detail.

[0050] It is to be understood that methods and systems described herein can be used to treat any treatment area or portion of a subject or a patient, without particular limitation. For instance, in some cases, the treatment area is located on the face of the subject. In other aspects, the treatment area is located on the neck, chest, back, or legs of the subject.

[0051] The total treatment area of a method and/or system described herein can be any size not inconsistent with the technical objectives of this disclosure. For example, the total treatment area can have an area of 10 mm² to 1,000 cm²; 20 mm² to 1,000 cm²; 30 mm² to 1,000 cm²; 40 mm² to 1,000 cm²; 40 mm² to 1,000 cm²; 50 mm² to 1,000 cm²; 60 mm² to 1,000 cm²; 70 mm² to 1,000 cm²; 80 mm² to 1,000 cm²; 90 mm² to 1,000 cm²; 100 mm² to 1,000 cm²; 200 mm² to 1,000 cm²; 300 mm² to 1,000 cm²; 400 mm² to 1,000 cm²; 500 mm² to 1,000 cm²; 600 mm² to 1,000 cm²; 700 mm² to 1,000 cm²; 800 mm² to 1,000 cm²; 900 mm² to 1,000 cm²; or 1 cm² to 1,000 cm². [0052] Similarly, the size of a region of interest of a method and/or system described herein may vary. Any size not inconsistent with the objectives of the disclosure may be used. In some cases, for example, the size of the region of interest is between 0.1 mm² and 10 cm² or any subrange thereof. In some embodiments, for instance, the size of the region of interest comprises between 0.1 mm² and 10 cm², 0.1 mm² and 9 cm², 0.1 mm² and 8 cm², 0.1 mm² and 7 cm², 0.1 mm² and 6 cm², 0.1 mm² and 5 cm², 0.1 mm² and 4 cm², 0.1 mm² and 3 cm², 0.1 mm² and 2 cm², 0.1 mm² and 1 cm², 0.1 mm² and 0.5 cm², 0.1 mm² and 0.25 cm², 0.25 cm² and 10 cm², 0.25 cm² and 9 cm², 0.25 cm² and 8 cm², 0.25 cm² and 7 cm², 0.25 cm² and 6 cm², 0.25 cm² and 5 cm², 0.25 cm² and 4 cm², 0.25 cm² and 3 cm², 0.25 cm² and 2 cm², 0.25 cm² and 1 cm², 0.25 cm² and 0.5 cm², 0.5 cm² and 10 cm², 0.5 cm² and 9 cm², 0.5 cm² and 8 cm², 0.5 cm² and 7 cm², 0.5 cm² and 6 cm², 0.5 cm² and 5 cm², 0.5 cm² and 4 cm², 0.5 cm² and 3 cm², 0.5 cm² and 2 cm², 0.5 cm² and 1 cm², 1 cm² and 10 cm², 1 cm² and 9 cm², 1 cm² and 8 cm², 1 cm² and 7 cm², 1 cm² and 6 cm², 1 cm² and 5 cm², 1 cm² and 4 cm², 1 cm² and 3 cm², 1 cm² and 2 cm², 2 cm² and 10 cm², 2 cm² and 9 cm², 2 cm² and 8 cm², 2 cm² and 7 cm², 2 cm² and 6 cm², 2 cm² and 5 cm², 2 cm² and 4 cm², 2 cm² and 3 cm², 3 cm² and 10 cm², 3 cm² and 9 cm², 3 cm² and 8 cm², 3 cm² and 7 cm², 3 cm² and 6 cm², 3 cm² and 5 cm², 3 cm² and 4 cm², 4 cm² and 10 cm², 4 cm² and 9 cm², 4 cm² and 8 cm², 4 cm² and 7 cm², 4 cm² and 6 cm², 4 cm² and 5 cm², 5 cm² and 10 cm², 5 cm² and 9 cm², 5 cm² and 8 cm², 5 cm² and 7 cm², 5 cm² and 6 cm², 6 cm² and 10 cm², 6 cm² and 9 cm², 6 cm² and 8 cm², 6 cm² and 7 cm², 7 cm² and 10 cm², 7 cm² and 9 cm², 7 cm² and 8 cm², 8 cm² and 10 cm², 8 cm² and 9 cm², or 9 cm² and 10 cm². Other sizes may also be used. Additionally, the region of interest may have a characteristic shape. The characteristic shape may be any shape not inconsistent with the objectives of this disclosure. For example, in some embodiments, the characteristic shape of the region of interest comprises a circle, a square, a rectangle, a polygon, or some other shape.

[0053] It is to be understood that a needle array of a method and/or system described herein can be an arrangement (e.g., an ordered arrangement) of a plurality of needles. For example, a needle array may comprise between 25 and 1000 needles or any subrange thereof. In some cases, the needle array may comprise between 25 and 1000 needles, 25 and 900 needles, 25 and 800 needles, 25 and 700 needles, 25 and 600 needles, 25 and 500 needles, 25 and 400 needles, 25 and 300 needles, 25 and 200 needles, 25 and 100 needles, 25 and 75 needles, 25 and 50 needles, 50 and 1000 needles, 50 and 900 needles, 50 and 800 needles, 50 and 700 needles, 50 and 600 needles, 50 and 500 needles, 50 and 400 needles, 50 and 300 needles, 50 and 200 needles, 50 and 100 needles, 50 and 75 needles, 75 and 1000 needles, 75 and 900 needles, 75 and 800 needles, 75 and 700 needles, 75 and 600 needles, 75 and 500 needles, 75 and 400 needles, 75 and 300 needles, 75 and 200 needles, 75 and 100 needles, 100 and 1000 needles, 100 and 900 needles, 100 and 800 needles, 100 and 700 needles, 100 and 600 needles, 100 and 500 needles, 100 and 400 needles, 100 and 300 needles, 100 and 200 needles, 200 and 1000 needles, 200 and 900 needles, 200 and 800 needles, 200 and 700 needles, 200 and 600 needles, 200 and 500 needles, 200 and 400 needles, 200 and 300 needles, 300 and 1000 needles, 300 and 900 needles, 300 and 800 needles, 300 and 700 needles, 300 and 600 needles, 300 and 500 needles, 300 and 400 needles, 400 and 1000 needles, 400 and 900 needles, 400 and 800 needles, 400 and 700 needles, 400 and 600 needles, 400 and 500 needles, 500 and 1000 needles, 500 and 900 needles, 500 and 800 needles, 500 and 700 needles, 500 and 600 needles, 600 and 1000 needles, 600 and 900 needles, 600 and 800 needles, 600 and 700 needles, 700 and 1000 needles, 700 and 900 needles, 700 and 800 needles, 800 and 1000 needles, 800 and 900 needles, or 900 and 1000 needles. [0054] Further, a needle array used in a method or system described herein may have any shape not inconsistent with the objectives of this disclosure. For example, in some embodiments, the shape of the needle array comprises a circle, square, or a rectangle. Moreover, any distance between adjacent needles in the needle array not inconsistent with the objectives of this disclosure may be used. In some cases, for instance, the spacing between adjacent needles is between 0.1 cm and 2 cm, 0.1 cm and 1.5 cm, 0.1 cm and 1.0 cm, 0.1 cm and 0.75 cm, 0.1 cm and 0.5 cm, and 0.1 cm and 0.25 cm, 0.25 cm and 2.0 cm, 0.25 cm and 1.5 cm, 0.25 cm and 1.0 cm, 0.25 cm and 0.75 cm, 0.25 cm and 0.5 cm, 0.5 cm and 2.0 cm, 0.5 cm and 1.5 cm, 0.5 cm and 1.0 cm, 0.5 cm and 0.75 cm, 0.75 cm and 2.0 cm, 0.75 cm and 1.5 cm, 0.75 cm and 1.0 cm, 1.0 cm and 2.0 cm, 1.0 cm and 1.5 cm, or 1.5 cm and 2.0 cm. Also, in some instances, the distance between needles that are adjacent within the needle array need not be the same. For example, the needle array may comprise pairs of needles separated by one spacing and other pairs separated by a larger or smaller spacing.

[0055] In addition, needles of the needle array of a method and/or system described herein can have any size or width not inconsistent with the objectives of this disclosure. For example, the needles may have a width (e.g., diameter, as opposed to length) between 500 pm and 1000 pm, 600 pm and 1000 pm, 700 pm and 1000 pm, 800 pm and 1000 pm, 900 pm and 1000 pm, 500 pm and 900 pm, 600 pm and 900 pm, 700 pm and 900 pm, 800 pm and 900 pm, 500 pm and 800 pm, 600 pm and 800 pm, 700 pm and 800 pm, 500 pm and 700 pm, 600 pm and 700 pm, or 500 pm and 600 pm. Needles of a needle array described herein may also have any length not inconsistent with the objectives of the present disclosure, such as a length of up to 10 cm or up to 5 cm. Further, in some embodiments, needles of the needle array may have different lengths to penetrate the skin at more than one depth by the same array at the same. Alternatively, in other instances, the needles of the needle array may be uniform or substantially uniform in length.

[0056] Additionally, in some embodiments, one or more needles of the needle array of a method and/or system described herein may be hollow. In some instances, a hollow needle may be conductive or nonconductive for the electrical current. In some cases, a hollow needle may be used to deliver liquid or aqueous solutions, such as those comprising pharmaceutical compositions, to the skin during treatment.

[0057] It is to be understood that the “retracted” configuration of the needle array is the position the needle array is in when the actuator is in its original or home position and the needle array cannot penetrate the skin when the perforated bottom of the tip is in contact with the skin. Additionally, it is to be understood that the “extended” configuration of the needle array is any position in which the needle array is translocating down toward and/or through the perforated bottom of the tip. Further, in some implementations, a needle array of methods and/or systems described herein may have one or more extended configurations. Thus, it is to be understood that in some embodiments, a first extended configuration corresponds to a first depth, a second extended configuration corresponds to a second depth, and/or an nth extended configuration corresponds to an nth depth.

[0058] In some embodiments of methods and/or systems described herein, the tip is disposable. Additionally, in some embodiments, the tip is sterile. In some cases, the tip is both sterile and disposable. In some instances, the tip is discarded after moving the needle array back to the retracted configuration from the extended configuration after a treatment area has been treated (or after the overall treatment is complete for a given patient, such that a new tip can be used on a new or different patient).

[0059] Moreover, as described herein, in some instances, the actuator of a handpiece can be triggered during a method according to the present disclosure. In some embodiments, manually triggering the actuator comprises pressing a manual trigger. Thus, in some implementations, the manual trigger may be operable to initiate actuation of the actuator of the handpiece to move the needle array from the retracted configuration to the extended configuration. In some cases, a manual trigger comprises a button, switch, or pedal. In some instances, the button, switch, or pedal comprises a digital button, switch, or pedal. In some embodiments, the button, switch, or pedal is pressed with a foot of a user. It is to be understood that any way to manually trigger the actuator not inconsistent with the objectives of the present disclosure may be used. Many suitable ways to manually trigger the actuator and many manual triggers will be readily apparent to those of ordinary skill in the art.

[0060] It is further to be understood that “manually” triggering an event or component (such as an actuator) can in some cases comprise triggering the event or component by carrying out an act or step (such as pressing a button or depressing a foot pedal) whose only or primary function is to trigger the event or component, as opposed to also carrying out another useful or relevant function, such as contacting a handpiece with a patient’s skin or disposing the handpiece in a certain location on a patient’s skin. Thus, in some embodiments, a “manual” triggering event is an intentional triggering by the human user at a specific time and/or place, based on a decision by the human user to “fire” the needle array. “Automatically” triggering an event or component (such as an actuator), in contrast, can in some instances comprise triggering the event or component by carrying out an act or step whose only or primary function is not to “fire” the needle array, but instead to achieve some other necessary or useful step, such as placing the handpiece on or near the skin of the patient, or “scanning” the handpiece over the skin of the patient (e.g., to cover a certain treatment area). Thus, in some cases, an “automatic” triggering event is a triggering that the human user does not necessarily specifically intend or even know in advance will occur at a specific time and/or place. Instead, in some instances, an “automatic” triggering event can be an event that a system described herein carries out automatically on its own (without intentional and specific intervention by a human user) when a certain condition is met (such as placement of the handpiece in a certain location or application of force to the handpiece).

[0061] Moreover, in some instances, applying downward force to the handpiece comprises pressing the perforated bottom surface of the tip against the skin of the subject. In some such instances, pressing the perforated bottom surface of the tip against the skin of the subject causes the perforated bottom surface to translocate, and translocation of the perforated bottom surface triggers the actuator. This translocation is an automatic trigger to initiate the actuator to move the needle array from the retracted configuration to the extended configuration. In such a movement, as shown in the non-limiting example of Figure 11, the perforated bottom surface (210) of the tip (202) can move upward to contact switches (208) and convey an electrical signal to the handpiece to initiate the actuator and automatically trigger the extended configuration of the needle array and/or apply the electric current. In the non-limiting example of Figure 11, the contact pressure moves the switch actuator. In some cases, this switch actuator moves by about 0.3 mm. However, it is to be understood that the switch actuator may move by any amount not inconsistent with the technical objectives of the current disclosure. In this embodiment, this movement activates two tactile electric switches (208) on the printed circuit board (209) adjacent the top of the perforated bottom, transferring the electric signal to the system. In some embodiments, the system can have one or multiple tactile switches, which can be triggered by single or multiple moving parts. In this example, the signal to the system automatically triggers the actuation of the needle array into the extended configuration and the application of electric current.

[0062] Methods described herein comprise penetrating the skin with a needle array. In some cases, penetrating the skin with the needle array comprises penetrating the skin at a particular needle penetration depth. In some such instances, the needle array, for example, can penetrate or be inserted into the skin to a depth of at least 10 pm, at least 50 pm, at least 100 pm, at least 150 pm, between 10 pm and 10 mm, between 100 pm and 5 mm, between 100 pm and 2 mm, between 100 pm and 1 mm, between 500 pm and 1 mm, between 500 pm and 2 mm, or between 1.5 mm and 2 mm. Moreover, needle penetration depth can vary to penetrate different layers of the skin with the needle array. In some embodiments, penetrating the skin with the needle array comprises penetrating the epidermis with the needle array. In some instances, penetrating the skin with the needle array comprises penetrating the dermis with the needle array. In some instances, penetrating the skin with the needle array comprises penetrating the subcutaneous tissue or subcutaneous layer of the skin with the needle array.

[0063] It is to be understood that in some instances, the needle penetration depth of methods and/or systems described herein may be the same needle penetration depth for a plurality of ROIs. That is, in some embodiments of methods and/or systems herein, the needle penetration depths used at a first ROI, a second ROI, or an zzth ROI may be the same or substantially the same (i.e., within 5% or 10%). However, in some instances, the needle penetration depths used for a plurality of ROIs may be different. As previously described, in some instances of methods and/or systems described herein, a needle array may have one or more extended configurations. Thus, it is also to be understood that in some embodiments, methods and/or systems described herein may penetrate the skin at different depths (e.g., a first depth, a second depth, and/or an //th depth) using the one or more extended configurations.

[0064] Additionally, in some implementations of methods and/or systems described herein, a ROI (e.g., a first ROI) may be treated using a plurality of needle penetration depths. For example, in some embodiments, methods described herein may comprise penetrating the skin with the needle array in the first ROI, at a first depth corresponding to the first extended configuration. In some cases, methods may comprise applying an electric current between the needles of the needle array at the first depth, and initiating the actuator of the handpiece to move the needle array from the first extended configuration to a second extended configuration, at a second depth in the first ROI corresponding to the second extended configuration. In some instances, methods may comprise applying an electric current between the needles of the needle array at the second depth. In some instances, the first depth and the second depth are different. It is also to be understood that in some cases, other depths corresponding to additional extended configurations (such as an //th depth corresponding to an /th extended configuration) may also be contemplated. Additionally, in such methods and systems, in some instances, the electric current applied at the first depth and the electric current applied at the second depth (or any other depth contemplated, such as a third depth) may be the same or substantially the same (within 5% or 10%). However, in some embodiments, the electric current may be different. For example, in some embodiments, the electric current applied at the second depth may have a different current, pulse width, or power than that of the electric current applied at the first depth.

[0065] Turning to the electric current of methods and/or systems described herein, the electric current may be any electric current not inconsistent with the objectives of the present disclosure. For example, in some instances, the electric current is an AC or DC electric current. Moreover, the configuration of the electric current applied to the needle array is not particularly limited. For example, in some cases, the electric current is not applied to all needles in the needle array. In some such embodiments, the electric current is applied to particular needles or particular groups, pairs, and/or combinations of needles within the needle array.

[0066] It is also to be understood that the source of electric current is not particularly limited. Many suitable sources of electric current will be readily apparent to those of ordinary skill in the art. current. For example, in some embodiments, the source of electric current is a radiofrequency electric current source. In such embodiments, radiofrequency electric current is applied to the needles of the needle array in bipolar mode. In other embodiments, radiofrequency electric current is applied to the needles of the needle array in monopolar mode. In some other embodiments, the radiofrequency electric current source is controlled in a manner such that the amount of radiofrequency current and how long the radiofrequency current is applied between the needles of the needle array is controlled when applying an electric current between the needles of the needle array. Any length of time for the application of the electric current not inconsistent with the objectives of the present disclosure may be used. In some cases, applying an electric current between the needles comprises applying electric current in one or more pulses. In some implementations, a pulse has a pulse width. It is to be understood for reference purpose herein, that in some cases, a pulse width comprises the length of time for a pulse to remain at its maximum amplitude (e.g., maximum power) or at non-zero amplitude. In some preferred embodiments, a pulse width lasts 200 ms or longer, 300 ms or longer, 400 ms or longer, 500 ms or longer, 600 ms or longer, 700 ms or longer, 800 ms or longer, or 900 ms or longer. In some embodiments, a pulse width lasts between 200 ms and 1 s, 200 ms and 900 ms, 200 ms and 800 ms, 200 ms and 700 ms, 200 ms and 600 ms, 200 ms and 500 ms, 200 ms and 400 ms, 200 ms and 300 ms, 300 ms and 1 s, 300 ms and 900 ms, 300 ms and 800 ms, 300 ms and 700 ms, 300 ms and 600 ms, 300 ms and 500 ms, 300 ms and 400 ms, 400 ms and 1 s, 400 ms and 900 ms, 400 ms and 800 ms, 400 ms and 700 ms, 400 ms and 600 ms, 400 ms and 500 ms, 500 ms and 1 s, 500 ms and 900 ms, 500 ms and 800 ms, 500 ms and 700 ms, 500 ms and 600 ms, 600 ms and 1 s, 600 ms and 900 ms, 600 ms and 800 ms, 600 ms and 700 ms, 700 ms and 1 s, 700 ms and 900 ms, 700 ms and 800 ms, 800 ms and 1 s, 800 ms and 900 ms, or 900 ms and 1 s.

[0067] Moreover, a pulse described herein may have any power and/or average power not inconsistent with the technical objectives of the current disclosure. For example, in some preferred embodiments, a pulse may have a power of 25 W or less, 20 W or less, 15 W or less, 10 W or less, or 5 W or less. In some embodiments, a pulse may have a power of between 5 W and 25 W, 5 W and 20 W, 5 W and 15 W, 5 W and 10 W, 10 W and 25 W, 10 W and 20 W, 10 W and 15 W, 15 W and 25 W, 15 W and 20 W, or 20 W and 25 W.

[0068] Further, the voltage of the applied electric current is not necessarily limited. For example, in some preferred embodiments, the voltage of the applied electric current is no greater than 20 V, no greater than 30 V, no greater than 40 V, no greater than 50 V, no greater than 60 V, or no greater than 70 V between the needles. Moreover, in some implementations, the voltage of the applied electric current between the needles is between 20 V and 70 V, between 20 V and 60 V, between 20 V and 50 V, between 20 V and 40 V, between 20 V and 30 V, between 30 V and 150 V, between 30 V and 125 V, between 30 V and 70 V, between 30 V and 60 V, between 30 V and 50 V, between 30 V and 40 V, between 40 V and 70 V, between 40 V and 60 V, between 40 V and 50 V, between 50 V and 70 V, between 50 V and 60 V, or between 60 V and 70 V.

[0069] Not intending to be bound by theory, it is believed that the use of a power, pulse length, and/or voltage described hereinabove may provide more effective and/or more comfortable treatment.

[0070] Additional exemplary embodiments contemplated herein are as follows.

[0071] Embodiment 1. A system for treating skin of a subject in need thereof, the system comprising: a removable tip attached to a handpiece; wherein the tip comprises a perforated bottom surface and a needle array positioned above the perforated bottom surface when the needle array is in a retracted configuration and operable to pass through the perforated bottom surface when the needle array is in an extended configuration; and wherein the handpiece comprises an actuator operable to move the needle array between the retracted configuration and the extended configuration; and a source of electric current.

[0072] Embodiment 2. The system of Embodiment 1, wherein the system further comprises a cooling system operable to cool a first region of interest (RO I) on the skin (1) while placing the perforated bottom surface of the tip in contact with or adjacent to the first ROI, (2) while initiating the actuator of the handpiece to move the needle array from the retracted configuration to the extended configuration, and/or (3) while penetrating the skin with the needle array in the first ROI.

[0073] Embodiment 3. The system of Embodiment 1 or Embodiment 2, wherein the system further comprises a manual trigger operable to initiate actuation of the actuator of the handpiece to move the needle array from the retracted configuration to the extended configuration.

[0074] Embodiment 4. The system of Embodiment 3, wherein the manual trigger comprises a button, switch, or pedal.

[0075] Embodiment 5. The system of Embodiment 4, wherein the button, switch, or pedal comprises a digital button, switch, or pedal.

[0076] Embodiment 6. The system of Embodiment 4 or Embodiment 5, wherein the button, switch, or pedal is pressed with a foot of a user.

[0077] Embodiment 7. The system of any of Embodiments 3-6, wherein: the perforated bottom surface of the tip translocates when the bottom surface is pressed against the skin of the subject; and translocation of the perforated bottom surface triggers the actuator.

[0078] Embodiment 8. The system of any of Embodiments 1-7, wherein: the source of electric current is operable to apply an electric current between the needles in one or more pulses, and the one or more pulses have a power or average power of 25 W or less and a pulse width of 200 ms or longer.

[0079] Embodiment 9. The system of any of Embodiments 1-8, wherein the source of electric current is operable to apply an electric current between the needles at a voltage of no greater than 70 V between the needles.

[0080] Embodiment 10. The system of any of Embodiments 1-9, wherein the actuator is operable to move the needle array between the retracted configuration and a plurality of differing extended configurations.

[0081] Embodiment 11. The system of any of Embodiments 1-10, wherein the tip is disposable.

[0082] Embodiment 12. A method of treating skin of a subject in need thereof, the method comprising: attaching a tip to a handpiece, wherein the tip comprises a perforated bottom surface and a needle array positioned above the perforated bottom surface when the needle array is in a retracted configuration and operable to pass through the perforated bottom surface when the needle array is in an extended configuration, and wherein the handpiece comprises an actuator operable to move the needle array between the retracted configuration and the extended configuration; placing the perforated bottom surface of the tip in contact with or adjacent to a first region of interest (ROI) on the skin, when the needle array is in the retracted configuration; initiating the actuator of the handpiece to move the needle array from the retracted configuration to the extended configuration; penetrating the skin with the needle array in the first ROI; and applying an electric current between the needles of the needle array, wherein initiating the actuator comprises (1) manually triggering the actuator, (2) applying a downward force to the handpiece, or (3) manually triggering the actuator and applying a downward force to the handpiece at the same time.

[0083] Embodiment 13. The method of Embodiment 12, wherein manually triggering the actuator comprises pressing a button, switch, or pedal.

[0084] Embodiment 14. The method of Embodiment 13, wherein the button, switch, or pedal comprises a digital button, switch, or pedal.

[0085] Embodiment 15. The method of Embodiment 13 or Embodiment 14, wherein the button, switch, or pedal is pressed with a foot of a user.

[0086] Embodiment 16. The method of any of Embodiments 12-15, wherein applying downward force to the handpiece comprises pressing the perforated bottom surface of the tip against the skin of the subject.

[0087] Embodiment 17. The method of Embodiment 16, wherein: pressing the perforated bottom surface of the tip against the skin of the subject causes the perforated bottom surface to translocate; and translocation of the perforated bottom surface triggers the actuator.

[0088] Embodiment 18. The method of any of Embodiments 12-17, wherein the method further comprises cooling the first ROI (1) while placing the perforated bottom surface of the tip in contact with or adjacent to the first ROI, (2) while initiating the actuator of the handpiece to move the needle array from the retracted configuration to the extended configuration, and/or (3) while penetrating the skin with the needle array in the first ROI.

[0089] Embodiment 19. The method of any of Embodiments 12-18, wherein applying the electric current between the needles comprises applying electric current in one or more pulses, and wherein the one or more pulses have a power or average power of 25 W or less and a pulse width of 200 ms or longer.

[0090] Embodiment 20. The method of any of Embodiments 12-19, wherein applying the electric current between the needles comprises applying a voltage of no greater than 70 V between the needles.

[0091] Embodiment 21. A method of treating skin of a subject in need thereof, the method comprising: attaching a tip to a handpiece, wherein the tip comprises a perforated bottom surface and a needle array positioned above the perforated bottom surface when the needle array is in a retracted configuration and operable to pass through the perforated bottom surface when the needle array is in an extended configuration, and wherein the handpiece comprises an actuator operable to move the needle array between the retracted configuration and the extended configuration; placing the perforated bottom surface of the tip in contact with or adjacent to a first region of interest (ROI) on the skin, when the needle array is in the retracted configuration; initiating the actuator of the handpiece to move the needle array from the retracted configuration to the extended configuration; penetrating the skin with the needle array in the first ROI; applying an electric current between the needles of the needle array; and cooling the first ROI (1) while placing the perforated bottom surface of the tip in contact with or adjacent to the first ROI, (2) while initiating the actuator of the handpiece to move the needle array from the retracted configuration to the extended configuration, and/or (3) while penetrating the skin with the needle array in the first ROI.

[0092] Embodiment 22. The method of Embodiment 21, wherein applying the electric current between the needles comprises applying electric current in one or more pulses, and wherein the one or more pulses have a power or average power of 25 W or less and a pulse width of 200 ms or longer.

[0093] Embodiment 23. The method of Embodiment 21 or Embodiment 22, wherein applying the electric current between the needles comprises applying a voltage of no greater than 70 V between the needles.

[0094] Embodiment 24. A method of treating skin of a subject in need thereof, the method comprising: attaching a tip to a handpiece, wherein the tip comprises a perforated bottom surface and a needle array positioned above the perforated bottom surface when the needle array is in a retracted configuration and operable to pass through the perforated bottom surface when the needle array is in an extended configuration, and wherein the handpiece comprises an actuator operable to move the needle array between the retracted configuration and the extended configuration; placing the perforated bottom surface of the tip in contact with or adjacent to a first region of interest (ROI) on the skin, when the needle array is in the retracted configuration; initiating the actuator of the handpiece to move the needle array from the retracted configuration to the extended configuration; penetrating the skin with the needle array in the first ROI; and applying an electric current between the needles of the needle array, wherein applying the electric current between the needles comprises applying electric current in one or more pulses, and wherein the one or more pulses have a power or average power of 25 W or less and a pulse width of 200 ms or longer.

[0095] Embodiment 25. The method of Embodiment 24, wherein applying the electric current between the needles comprises applying a voltage of no greater than 70 V between the needles.

[0096] Embodiment 26. A method of treating skin of a subject in need thereof, the method comprising: attaching a tip to a handpiece, wherein the tip comprises a perforated bottom surface and a needle array positioned above the perforated bottom surface when the needle array is in a retracted configuration and operable to pass through the perforated bottom surface when the needle array is in an extended configuration, and wherein the handpiece comprises an actuator operable to move the needle array between the retracted configuration and the extended configuration; placing the perforated bottom surface of the tip in contact with or adjacent to a first region of interest (ROI) on the skin, when the needle array is in the retracted configuration; initiating the actuator of the handpiece to move the needle array from the retracted configuration to the extended configuration; penetrating the skin with the needle array in the first ROI; and applying an electric current between the needles of the needle array, wherein applying the electric current between the needles comprises applying a voltage of no greater than 70 V between the needles.

[0097] Embodiment 27. The method of any of Embodiments 12-26, wherein initiating the actuator also initiates application of the electric current.

[0098] Embodiment 28. The method of any of Embodiments 12-27, wherein the method further comprises: ceasing to apply the electric current between the needles; and moving the needle array back to the retracted configuration from the extended configuration.

[0099] Embodiment 29. The method of Embodiment 28, wherein the method further comprises: removing the perforated bottom surface of the tip from the first ROI; and placing the perforated bottom surface of the tip in contact with or adjacent to a second ROI on the skin.

[00100] Embodiment 30. A method of treating skin of a subject in need thereof, the method comprising: attaching a tip to a handpiece, wherein the tip comprises a perforated bottom surface and a needle array positioned above the perforated bottom surface when the needle array is in a retracted configuration and operable to pass through the perforated bottom surface when the needle array is in one or more extended configurations, and wherein the handpiece comprises an actuator operable to move the needle array between the retracted configuration and the one or more extended configurations; placing the perforated bottom surface of the tip in contact with or adjacent to a first region of interest (ROI) on the skin, when the needle array is in the retracted configuration; initiating the actuator of the handpiece to move the needle array from the retracted configuration to a first extended configuration; penetrating the skin with the needle array in the first ROI, at a first depth corresponding to the first extended configuration; applying an electric current between the needles of the needle array at the first depth; initiating the actuator of the handpiece to move the needle array from the first extended configuration to a second extended configuration, at a second depth in the first ROI corresponding to the second extended configuration; and applying an electric current between the needles of the needle array at the second depth, wherein the first depth and the second depth are different.

[00101J Embodiment 31. The method of Embodiment 30, wherein initiating the actuator comprises (1) manually triggering the actuator, (2) applying a downward force to the handpiece, or (3) manually triggering the actuator and applying a downward force to the handpiece at the same time.

[00102] Embodiment 32. The method of Embodiment 31, wherein manually triggering the actuator comprises pressing a button, switch, or pedal.

[00103] Embodiment 33. The method of Embodiment 32, wherein the button, switch, or pedal comprises a digital button, switch, or pedal.

[00104] Embodiment 34. The method of Embodiment 32 or Embodiment 33, wherein the button, switch, or pedal is pressed with a foot of a user.

[00105] Embodiment 35. The method of any of Embodiments 32-34, wherein applying downward force to the handpiece comprises pressing the perforated bottom surface of the tip against the skin of the subject.

[00106] Embodiment 36. The method of Embodiment 35, wherein: pressing the perforated bottom surface of the tip against the skin of the subject causes the perforated bottom surface to translocate; and translocation of the perforated bottom surface triggers the actuator.

[00107] Embodiment 37. The method of any of Embodiments 30-36, wherein the method further comprises cooling the first ROI (1) while placing the perforated bottom surface of the tip in contact with or adjacent to the first ROI, (2) while initiating the actuator of the handpiece to move the needle array from the retracted configuration to the extended configuration, and/or (3) while penetrating the skin with the needle array in the first ROI.

[00108] Embodiment 38. The method of any of Embodiments 30-37, wherein applying the electric current between the needles comprises applying electric current in one or more pulses, and wherein the one or more pulses have a power or average power of 25 W or less and a pulse width of 200 ms or longer.

[00109] Embodiment 39. The method of any of Embodiments 30-38, wherein applying the electric current between the needles comprises applying a voltage of no greater than 70 V between the needles.

[00110] Embodiment 40. The method of any of Embodiments 30-39, wherein initiating the actuator also initiates application of the electric current.

[00111] Embodiment 41. The method of any of Embodiments 30-40, wherein the method further comprises: ceasing to apply the electric current between the needles; and moving the needle array back to the retracted configuration from the second extended configuration.

[00112] Embodiment 42. The method of Embodiment 41, wherein the method further comprises: removing the perforated bottom surface of the tip from the first ROI; and placing the perforated bottom surface of the tip in contact with or adjacent to a second ROI on the skin.

[00113] Embodiment 43. The method of any of Embodiments 12-42, wherein the tip is disposable. [00114] Embodiment 44. The method of any of Embodiments 12-43, wherein penetrating the skin with the needle array comprises penetrating the dermis with the needle array.

[00115] Embodiment 45. The method of any of Embodiments 12-44, wherein applying the electric current between the needles of the needle array heats tissue adjacent to tips of the needles.

[00116] The skilled artisan would understand that various modifications can be made to the above described methods and systems without departing from the scope and objectives of the invention. For example, although specific configurations of systems are described above and depicted in the figures, other systems configured to treat skin can benefit from embodiments of the methods and systems described herein. Therefore, it is to be understood that the subject matter is not to be limited to the specific embodiments disclosed and that modifications and other embodiments are intended to be included within the scope of the appended claims. Although specific terms are employed herein, they are used in a generic and descriptive sense only and not for purposes of limitation.

[00117] Various implementations of systems and methods have been described, and exemplary embodiments are described above in fulfillment of various objectives of the present disclosure. It should be recognized that these implementations are merely illustrative of the principles of the present disclosure. Numerous modifications and adaptations thereof will be readily apparent to those skilled in the art without departing from the spirit and scope of the present disclosure. For example, individual steps of methods described herein can be carried out in any manner not inconsistent with the objectives of the present disclosure, and various configurations or adaptations of methods and systems described herein can be used.

Claims

1. A system for treating skin of a subject in need thereof, the system comprising: a removable tip attached to a handpiece; wherein the tip comprises a perforated bottom surface and a needle array positioned above the perforated bottom surface when the needle array is in a retracted configuration and operable to pass through the perforated bottom surface when the needle array is in an extended configuration; and wherein the handpiece comprises an actuator operable to move the needle array between the retracted configuration and the extended configuration; a source of electric current; and a cooling system operable, wherein the cooling system is operable to cool a first region of interest (ROI) on the skin (1) while placing the perforated bottom surface of the tip in contact with or adjacent to the first ROI, (2) while initiating the actuator of the handpiece to move the needle array from the retracted configuration to the extended configuration, and/or (3) while penetrating the skin with the needle array in the first ROI.

2. The system of claim 1, wherein the system further comprises: a manual trigger operable to initiate actuation of the actuator of the handpiece to move the needle array from the retracted configuration to the extended configuration.

3. The system of claim 2, wherein the manual trigger comprises a button, switch, or pedal.

4. The system of claim 3, wherein the button, switch, or pedal comprises a digital button, switch, or pedal.

5. The system of claim 3, wherein the button, switch, or pedal is pressed with a foot of a user.

6. The system of claim 2, wherein: the perforated bottom surface of the tip translocates when the bottom surface is pressed against the skin of the subject; and translocation of the perforated bottom surface triggers the actuator.

7. The system of claim 1, wherein the tip is disposable.

8. A method of treating skin of a subject in need thereof, the method comprising: attaching a tip to a handpiece, wherein the tip comprises a perforated bottom surface and a needle array positioned above the perforated bottom surface when the needle array is in a retracted configuration and operable to pass through the perforated bottom surface when the needle array is in an extended configuration, and wherein the handpiece comprises an actuator operable to move the needle array between the retracted configuration and the extended configuration; placing the perforated bottom surface of the tip in contact with or adjacent to a first region of interest (ROI) on the skin, when the needle array is in the retracted configuration; initiating the actuator of the handpiece to move the needle array from the retracted configuration to the extended configuration; penetrating the skin with the needle array in the first ROI; applying an electric current between the needles of the needle array; and cooling the first ROI (1) while placing the perforated bottom surface of the tip in contact with or adjacent to the first ROI, (2) while initiating the actuator of the handpiece to move the needle array from the retracted configuration to the extended configuration, and/or (3) while penetrating the skin with the needle array in the first ROI.

9. The method of claim 8, wherein initiating the actuator comprises (1) manually triggering the actuator, (2) applying a downward force to the handpiece, or (3) manually triggering the actuator and applying a downward force to the handpiece at the same time.

10. The method of claim 9, wherein manually triggering the actuator comprises pressing a button, switch, or pedal.

11. The method of claim 10, wherein the button, switch, or pedal comprises a digital button, switch, or pedal.

12. The method of claim 10, wherein the button, switch, or pedal is pressed with a foot of a user.

13. The method of claim 9, wherein applying downward force to the handpiece comprises pressing the perforated bottom surface of the tip against the skin of the subject.

14. The method of claim 13, wherein: pressing the perforated bottom surface of the tip against the skin of the subject causes the perforated bottom surface to translocate; and translocation of the perforated bottom surface triggers the actuator.

15. The method of claim 8, wherein: applying the electric current between the needles comprises applying electric current in one or more pulses, and the one or more pulses have a power of 25 W or less and a pulse width of 200 ms or longer.

16. The method of claim 8, wherein applying the electric current between the needles comprises applying a voltage of no greater than 70 V between the needles.

17. The method of claim 8, wherein initiating the actuator also initiates application of the electric current.

18. The method of claim 8, wherein the method further comprises: ceasing to apply the electric current between the needles; and moving the needle array back to the retracted configuration from the extended configuration.

19. The method of claim 18, wherein the method further comprises: removing the perforated bottom surface of the tip from the first ROI; and placing the perforated bottom surface of the tip in contact with or adjacent to a second ROI on the skin.

20. The method of claim 8, wherein the tip is disposable.

21. The method of claim 8, wherein penetrating the skin with the needle array comprises penetrating the dermis with the needle array.

22. The method of claim 8, wherein applying the electric current between the needles of the needle array heats tissue adjacent to tips of the needles.

23. The method of claim 22, wherein the heating results in tissue coagulation.

24. A method of treating skin of a subject in need thereof, the method comprising: attaching a tip to a handpiece, wherein the tip comprises a perforated bottom surface and a needle array positioned above the perforated bottom surface when the needle array is in a retracted configuration and operable to pass through the perforated bottom surface when the needle array is in one or more extended configurations, and wherein the handpiece comprises an actuator operable to move the needle array between the retracted configuration and the one or more extended configurations; placing the perforated bottom surface of the tip in contact with or adjacent to a first region of interest (ROI) on the skin, when the needle array is in the retracted configuration; initiating the actuator of the handpiece to move the needle array from the retracted configuration to a first extended configuration; penetrating the skin with the needle array in the first ROI, at a first depth corresponding to the first extended configuration; applying an electric current between the needles of the needle array at the first depth; initiating the actuator of the handpiece to move the needle array from the first extended configuration to a second extended configuration, at a second depth in the first ROI corresponding to the second extended configuration; applying an electric current between the needles of the needle array at the second depth, wherein the first depth and the second depth are different; and cooling the first ROI (1) while placing the perforated bottom surface of the tip in contact with or adjacent to the first ROI, (2) while initiating the actuator of the handpiece to move the needle array from the retracted configuration to the one or more extended configurations, and/or (3) while penetrating the skin with the needle array in the first ROI.