Treatment systems and methods for affecting glands and other targeted structures

Abstract

Treatment systems, methods, and apparatuses for treating acne, hyperhidrosis, and other skin conditions are described. Aspects of the technology can include cooling a surface of a patient's skin and detecting changes in the tissue. The tissue can be cooled a sufficient length of time and to a temperature low enough to affect glands or other targeted structures in the skin.

What is claimed is: 
     
         1 . A method for treating a subject's exocrine glands, comprising:
 cooling a surface of a subject's skin with a cooling device to produce a freeze event in a portion of the skin with exocrine glands, the surface of the skin being cooled to a temperature higher than about −40 degrees C.;   detecting the freeze event in the patient's skin; and   controlling the cooling device and other treatment parameters to continue to cool the subject's skin after detecting the freeze event and to maintain at least a partially frozen state of the portion of the skin for a period of time long enough to alter a level of production by the exocrine glands, the partially frozen state of the portion of the skin is maintained without injuring the epidermis underlying the cooling device, and the period of time being longer than about 10 seconds.   
     
     
         2 . The method of  claim 1 , wherein the exocrine glands are sebaceous glands and/or sweat glands, wherein the cooling device and treatment parameters are controlled so as to not cause either or both hypopigmentation or hyperpigmentation more than a day following the treatment. 
     
     
         3 . The method of  claim 1 , wherein the period of time is shorter than about 1 minute, 2 minutes, 3 minutes, 4 minutes, 5 minutes, or 10 minutes. 
     
     
         4 . The method of  claim 1 , wherein the period of time and temperature are selected so that lipid rich cells in a subcutaneous layer are not substantially affected by the skin cooling. 
     
     
         5 . The method of  claim 1 , wherein the period of time and temperature are selected so that lipid rich cells in a subcutaneous layer are substantially affected by the skin cooling. 
     
     
         6 . The method of  claim 1 , further comprising thawing the subject's frozen skin after the period of time has transpired to control freeze damage caused by the skin cooling. 
     
     
         7 . The method of  claim 1 , further comprising controlling the cooling device so that the freeze event causes more apoptotic damage to the subject's tissue than necrotic damage. 
     
     
         8 . The method of  claim 1 , further comprising controlling the cooling device and treatment parameters so that the freeze event causes apoptotic damage to the subject's glands and does not cause necrotic damage to epidermal and/or subcutaneous tissue. 
     
     
         9 . The method of  claim 1 , further comprising controlling the cooling device and treatment parameters so that the freeze event is short enough to prevent equilibrium temperature gradients from being established in the cooled skin. 
     
     
         10 . The method of  claim 1 , further comprising controlling the cooling device so that the freeze event begins within a second predetermined period of time after the cooling device begins cooling the surface of the skin, the second predetermined period of time being shorter than about 30 seconds, or about 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10 minutes. 
     
     
         11 . The method of  claim 1 , wherein the cooling device is controlled to supercool the skin, and further comprising heating a surface of the skin to warm an epidermis to a temperature above freezing, then delivering a substance, energy, or pressure to the skin to aid in formation of nucleation sites in the supercooled skin to initiate the freeze event. 
     
     
         12 . The method of  claim 1 , further comprising delivering a cryoprotectant to the surface of the subject's skin for a period of time which is short enough to prevent the cryoprotectant from significantly inhibiting initiation of the freeze event in dermal tissue but is long enough to allow the cryoprotectant to provide substantial freeze protection to epidermal tissue so as to prevent either hypopigmentation or hyperpigmentation more than a day following the treatment. 
     
     
         13 . The method of  claim 1 , wherein the subject is affected by acne in the portion of the skin with exocrine glands, and wherein the method alters a level of secretion by sebaceous glands in the portion of the skin, whereby an appearance of the acne is improved in the portion of the skin. 
     
     
         14 . The method of  claim 1 , wherein the subject is affected by hyperhidrosis in the portion of the skin with exocrine glands, and wherein the method alters a level of sweat secretion by sweat glands in the portion of the skin, whereby hyperhidrosis is treated in the portion of the skin. 
     
     
         15 . A method for treating glands of a subject, comprising:
 cooling a surface of a subject's skin to produce a cooling event at a target region with the glands, the surface of the skin being cooled to a temperature higher than −40 degrees C.; and   controlling a cooling device and other treatment parameters to cool the surface of the skin for a period of time and to a temperature sufficiently low to injure the subject's dermis and the glands therein but without injuring the subject's epidermis and without injuring the subject's subcutaneous adipose tissue, the period of time being less than about 30 minutes.   
     
     
         16 . The method of  claim 15 , wherein the cooling device and other treatment parameters are controlled to sufficiently protect an epidermis so as to not cause either or both hypopigmentation or hyperpigmentation more than a day following the treatment. 
     
     
         17 . The method of  claim 15 , wherein the treatment is for treating acne by injuring sebaceous glands. 
     
     
         18 . The method of  claim 15 , wherein the treatment is for treating hyperhidrosis by injuring sweat glands. 
     
     
         19 . The method of  claim 15 , further comprising delivering a cryoprotectant to the skin to protect the subject's epidermal tissue. 
     
     
         20 . The method of  claim 15 , further comprising delivering thermal energy to the surface of the skin before, during, and/or after skin cooling to protect an uppermost region of the skin from freeze damage, and optionally delivering thermal energy to the subject's subcutaneous tissue transcutaneously through the skin to protect the subject's subcutaneous layer. 
     
     
         21 . The method of  claim 20 , further comprising cooling the skin to a supercooled temperature, then warming an epidermis to a non-freezing temperature, and then nucleating the skin to initiate the freeze event in the supercooled skin. 
     
     
         22 . The method of  claim 15 , further comprising cooling the skin sufficiently to a cause a freeze event, detecting the freeze event, and controlling the cooling device so that the freeze event lasts a second period of time which is longer than 10 seconds and shorter than 10 minutes. 
     
     
         23 . The method of  claim 15 , wherein the cooling device is controlled so that a most significant tissue injury cooling zone is centered at a depth between about 0.5 mm to about 2.0 mm. 
     
     
         24 . The method of  claim 15 , wherein the freeze event damages mostly dermal tissue. 
     
     
         25 . The method of  claim 15 , wherein the skin is facial skin or located on either a palm of a hand, a sole of a foot, brow, scalp, or axilla region.