Meet Shimon Eckhouse. The Inventors of Aesthetics Series No. 1

Dr. Grant Stevens

Hello and welcome back to the Technology of Beauty, where I have the opportunity to interview the movers and shakers of the beauty business. And today is no exception. In fact, today. I'm gonna be interviewing truly a living legend in the aesthetic industry. Shimon Eckhouse has invented so many technologies.

He's had run companies, invented companies, and you're going to hear about the many contributions that he has personally made and the people's lives he's influenced. I've followed him. More than 25 years. He is an a living legend. And today I want to thank him for joining us. He's in Haifa, Israel. Thank you very much Shimon for joining us on this program today.

Shimon Eckhouse

Thank you, Dr. Stevens. Real pleasure being with you.

Dr. Grant Stevens

Now, Shimon, let's get started. If you are Shimon, then I am Grant, because we'll start with the fact that Shimon is actually a doctor, also he's a PhD, and we'll get to that. So first of all, Shimon, tell us a little bit about yourself. Where did you grow up and where did you go to school?

Shimon Eckhouse

So actually I grew up in Israel. I, my parents brought me to Israel when I was four and a half years old. They were Holocaust survivors out of Europe. I grew up in a small place. In Israel and then went to school in teknon, which is one of the well regarded schools of technology in Israel. And this is where I grew up, and I live now in actually High Israel, which is in the north part of the country.

Dr. Grant Stevens

Beautiful part. I've been there. And then subsequently, I happen to know you got your PhD over here in the United States. In the shadow of my home where I grew up. So why don't you tell us about that?

Shimon Eckhouse

So I got my PhD at UC Irvine. I came to UC Irvine in 1975, so quite a while ago, as you may calculate.

The reason I decided to choose Irvine in those days can tell you it was about 5,000 students. It's a little bit smaller than the 25 or 30,000 that they count today, but my thesis advisor was a very famous researcher in the area of plasma physics. This reason I came here, I spent about three years doing my PhD and then returned to Israel.

And actually I came back to the US once more in 86 for four years work, working for a company in San Diego called Maxwell Technologies.

Dr. Grant Stevens

Okay, so you were three years at the University of California in Irvine, and then you went back to Israel and came back to San Diego, and I don't know about that company. Tell us a little bit about what you did there.

Shimon Eckhouse

Technologies, sorry for interrupting you. Maxwell Technologies. Actually specialized in the area of what doing what's called pulse power technology, which is how you take energy, condense it into a short time to make high power pulses. And I've done lots of work in this space during my years in Israel, of course at Maxwell as well.

And this is the reason I came there cause it was a highly regarded. Being an Israeli citizen, I had to really limit myself to what's called civilian projects. So I've done lots of things in areas such as well, logging food processing, things like that, using the high energies.

Dr. Grant Stevens

That's a long way from aesthetics. Now take us to the start of Lumenis.

Shimon Eckhouse

So actually in the early nineties or 1990 , I decided to go back to Israel with my family. And I also made another decision, which was to become an entrepreneur. And this is typically a relatively late age to the current entrepreneur. I was 45 years old at that point in.

And I read one day, I think it was Laser Focus World, about a company called Candela that is using lasers in the orange to treat port Wayne stains. I did lots of work on flash lamps before that and I said, wait a minute. I think I can do a better job with a broad broadband light source where I have lots of control over wavelength past duration, as well as a big advantage of being able to treat relatively large areas at a short period of time. This is the way I started Lumenis.

Dr. Grant Stevens

And so you mentioned broadband light. Tell me how you started developing intense pulse light and was it that time that you started developing the intense pulse light?

Shimon Eckhouse

Yes. I wrote my first patent in 1991. This is like the very first patent on IPL. Looks quite similar to what I think millions of IPL devices around the world. Look alike. It's a flash lamp with a cooling system around it with a reflector that points the light to the skin of the patient.

That was basically the idea. I talked there a lot about doing it for blood vessel. because, this was like where this whole industry started, as I'm sure you're very familiar with. And also about pigmented lesions. I wrote the patent, I looked for an investment for about one year, and I ended up getting half a million dollars in giving away 50% of the company.

Dr. Grant Stevens

You're kidding. And was that the beginning of Lumenis?

Shimon Eckhouse

That was the beginning of Lumenis.

Dr. Grant Stevens

For a value of 1 million, you gave away half?

Shimon Eckhouse

For a value of post money of 1 million.

Dr. Grant Stevens

Okay. And then did you develop CO2 lasers also at Lumenis?

Shimon Eckhouse

No. No. We, this is an interesting story because I started Lumenis on the IPL concept. We brought our first product to the market called PhotoDerm. In 1994, we started selling in Europe. In 95, we got our first FDA clearance started selling in the us. And that actually became very successful cause doctors realized that this broadband light source has many features that are quite unique, that are very different than what you do with lasers.

I'll just tell you a simple anecdote. As you, as I'm sure when you use pulsed lasers to treat port stains, get what's called purple. When we developed IPL at the beginning, by the way, I was worried cause we weren't getting purple, but we ended up getting blood vessels disappearing and then became quite successful, which really in 1996 enabled me to take the company public on Nasdaq.

Reached the valuation of about 1 billion. And in 97 I acquired laser industries or Sharplan as many people know it, and that then, CO2 lasers become, became a significant part of our business. But I started my career was what I called truly non-invasive energy-based devices.

Dr. Grant Stevens

Okay, so then you moved on from there to Sharplan. Is that right?

Shimon Eckhouse

Sharplan actually became part of Lumenis. We acquired them. We, of course, kept on selling this CO2 lasers and alexandrite lasers and some other thing they were doing during those days, and I stayed with the company until, or was the end of 1999 and then left.

Dr. Grant Stevens

Okay interesting enough, my first laser I ever used was in St. Louis at Barnes Hospital, Washington University. And it was a pulse dye laser for a port wine stain right here on a child. And what he was referring to the perra is the purple color like eggplant color that one sees. And it's interesting, you were concerned when you were doing your broadband light or IPL, that you didn't see that you were concerned about efficacy. Isn't that interesting?

Shimon Eckhouse

Exactly, because as I'm sure it takes a while until the blood vessels really disappear. When you don't see it right away. You ask yourself, if patients ask you What's going on, Dr.

Dr. Grant Stevens

And it's interesting to me. My first laser I purchased after I was done with my training was a sharpen laser, both the 40 watt as well as I bought the sh surio lace XJ one 50.

And from that I developed the laser bra. And I followed you and you went from Irbm and then Alexander Wright for hair and so forth. Now take us to the next company you've started.

Shimon Eckhouse

So actually in 2000. This was like a year after I left luminous. I started a company which we called Syneron in those days.

S y n e r o n and the basic idea there was that the combination of energy energies can be more effective than just a single one. And the product that we developed was really a combination of IPL together with conducted RF as we. We called the technology hilos, which stands for electro optic synergy.

And again, the company grew very fast. The fact that we used RF together was light, brought us more closely to the skin tightening space. If I'm sure what I mean. And again, this was quite successful. We took the company public on Nasdaq in 2004. A year later we reached evaluation.

Of about 1 billion, a little over that. And we kept on growing. In 2010 we acquired Candela.

Dr. Grant Stevens

And out of that came Syneron Candela. Yes, go ahead.

Shimon Eckhouse

Which was closing really a big circle. Cause as I just told you the first time I thought about aesthetic medicine was when I read about port wine stains and post-dialysis.

And then we ended up buying Candela, which was emotionally very interesting. I would call it exercise for myself.

Dr. Grant Stevens

Okay. Now how long did you stay with that combination? The Syneron combined with Candela that I remember, Syneron, Candela. And and then when did you exit Syneron Candela?

Shimon Eckhouse

So in 2017, apex partners, which is one of the well known private equity funds, came to us and proposed to take the company private and we sold the company, which was, a nice thing. I've been with it for all together over 15 years and I thought that's long enough.

Dr. Grant Stevens

Okay, so that brings us to, does that bring us to soft Wave or not?

Shimon Eckhouse

It does, actually. Soft Wave became as, as something that I started as part of an incubator that I own that has actually net about 15 companies that we started over the last six years.

And Soft Wave was one of the early ones that we started when a guy came to me with an idea of using a beam of ultra. To treat what is called hypertension or high blood pressure by doing what's called renal denervation. I will not go into all the details of how you do it, but it's a really interesting endovascular device, as it is called, in the area of cardiology.

And I said to him, listen, what you do is very interesting, but I think we can do something much, much better with it in the area of skin, this is the way we started software.

Dr. Grant Stevens

And so Soft Wave was born then out of your incubator, is that correct? Yes. And and you're using ultrasound energy, correct?

Shimon Eckhouse

Correct. But what we're using is actually a beam of ultrasound that propagates into the skin. This is done by using the special design of the transducer. And what we also do, which is really unique and we believe has lots of potential in it, is we could each of the transducers that is, is attached or that is coupled to the skin.

So it protects the upper layer of the skin. So in a way, by controlling the frequency, the power, the design of the transducer and the cooling that the same transducer provides, we get a situation where we can cause a nicely controlled injury inside the. But you don't see anything on the outside part of the skin.

You don't do any damage to the epidermis.

Dr. Grant Stevens

Okay. It's somewhat analogous then to radiation therapy in the way we're delivering radiation therapy to the tumor and sparing the skin. And initially we weren't you skin. Absolutely right. So this, yes, this thermal cooling, if you will, of the external epidermis of the outside of the skin is a protectant to the ultrasound thermal energy that in the dermis.

Exactly. Exactly. Now for the guests that Aren. Versed in this idea of skin tightening with energy based. Why don't you walk us through the way you see the energy and where it's being delivered? We said the dermis. And how does that lead to skin tightening? How do we get from energy in the dermis to skin tightening?

Shimon Eckhouse

So actually and I will mention this because you have been involved in it, you have seen it over the years. We started, when I say we, I. Doctors that do it started doing skin tightening with CO2 lasers. And I don't think we even knew exactly what we were doing, but we knew that it was generating good results.

And as you are very familiar, and you mentioned it at the beginning, we did really full skin resurfacing where we ablated everything. We left the layer of the dermis heated to a high enough temperature. That it'll induce growth of new collagen and LS 10, which in those days was a little bit controversial, speculated, whatever you want to call it.

We discovered later, and this was actually something we discovered with IPL, and I can mention that one of the unique things that we didn't expect but discovered with I P N was that the heating effect creates some benefits of getting a better scale, not, if you do enough treatments, you start seeing the benefit again, the basic idea, and we didn't fully understand it.

As you heat up the dermis to 50 or 40 degrees centigrade, you get some kind of an effect of neurogenesis or neurogenesis, if you want to call it this one. And then, as I'm sure you're very well, very familiar with, fractional CO2 lasers. Actually in 2010 in addition to acquisition of the of Candela, we also acquired a very small company in the Bay Area called with a product that we call Profound that was using needles that go into the dermis.

And once they are in the dermis, you flow RF current. Through them, it heats up locally. And with this local damage you in use growth of new collagen and. And this, as I'm sure RF Micro League became a big thing. There are probably 20 companies doing it. And I was very familiar with it. I was familiar with the degree of effectiveness, but I was also familiar with the fact that not every patient.

Whether it's a woman or a man likes to be pricked in his face, a few thousand times there are some, there is significant downtime because you do create some injury on the upper layer of the skin. So when this guy came to me with the so ultrasound idea, I said, wait a minute.

We can do something very similar to what you do with other cooling technologies, where you can protect the epidermis and still create the right parameters inside the dermis. And what we actually do in soft wave is we create, we have an array of seven transducers that are coupled to the skin. The doctor just puts it on the skin when the coupling is right.

Radiate the ultrasound energy. It is absorbed in the skin. The epidermis itself is protected because we cool it with the same transducer that also radiates the energy. And by choosing the frequency, the power, the geometrical dimension, we create an injury inside the dermis, which is actually a terminal injury with temperatures of 60 to 70 degrees centigrade at a depth of about 1.5 minutes.

The beauty of it is we do and I can tell you some of the people that sell our products say we are better than rf micro leading. I. Let's say we are as good as RF micro, but if we're able to do it without injuring the upper layer of the epidermis, that's a good enough story and we have lots of data that really supports the fact that we can do a treatment with zero downtime to patients.

Dr. Grant Stevens

Okay. Full disclosure, I have had a sound wave treatment. of my forehead, my cheeks, and my neck. Just recently. In the last month I'm gonna jump back to Profound. You were involved with Profound when you had Sinon Candela. I was the, I had the good fortune. Felipe Shaan allowed me to have when he was running Syron, Candela the profound, and there's no question in my mind that it's very effective. It's needles, it's rf, and there's many needles in RSF as we know, and they are effective? And they can debate about which one's more effective and so forth, and what the depth of the needles and if it's insulated or not insulated, and on, and correct. In any event, I think we can agree that profound is effective in tightening skin.

Shimon Eckhouse

Oh, absolutely. I promoted it for many years.

Dr. Grant Stevens

One of the downsides of profound, the main downside for me and for my patients was pain. And how do you mitigate the pain? We knew it worked, but it was painful and I think that was the downfall. Frankly a lot of the RF devices now are less painful and they may well be less effective.

We're not gonna debate that on this program, but I'd like you, since you uniquely are involved in soft wave, which is a transcutaneous, not percutaneous, if you will. It's a transcutaneous delivery of energy, protecting the epidermis versus profound, which is an RF different energy source. Also RF versus ultrasound that's delivered through these needles.

Could you con com compare and contrast them a little more for our listeners?

Shimon Eckhouse

Absolutely. Thank you. Absolutely. Thank you very much. The experience we had was. Taught us where we need to be in. Of the temperature that we reach, how long the heating is lasting, and where you need to do it to get the best results.

That's three basic parameters. When profound was started, by the way, in the very early days, they tried to use 72, 73 degrees, which was too high. Cause it ended up causing permanent damage and really desiccating collagen, which we don't really don't want to do. And what you actually.

Tried when Philippe did it on you or tried it on you or let you try it on someone else, was exactly these parameters. It is to create temperatures of about between 60 to 70 degrees for about four seconds at a depth of 1.5 millimeters in the derms. That's the basic. These are the basic parameters of profound.

I am not shy to tell you that when we started soft, I told the engineer that I worked with, this is what we need to reach a temperature in the range of 60 to 70. To be able to do it at the depth of about 1.5 millimeter, but to millimeters, but to do it without damaging anything on the upper layer of the skin.

And I can tell you because as I said a few minutes ago, I promoted profound cause I thought it's a great product. It's a great product. When I compare the. We have at least the same quality of results as you can get with profound. One of the reasons, by the way, is that what we do, which is unique the way we do our transducers, create one damage pattern, which is parallel to the surface of the skin rather than being perpendicular.

And more than that, we are able in a procedure of about 30 minutes to do, I would say, Four to five times more heating of collagen to these temperatures than what you can do is profound. We do probably 10 to 20 times more than what you can do with our other RF micro device. So there I feel on a very solid ground.

Cause everything that we are doing is based on what we have seen there on the basic scientific level. The beauty of it is that we do it without downtime to the patient without damage to the epidermis.

Dr. Grant Stevens

I see. And that's a very big difference. There's no question. Are there any other companies in this space vis-a-vis that are heating to 60 to 70 degrees, transcutaneous without needles?

Shimon Eckhouse

The closest one to what we do is Merz, which acquired Ulthera. I'm sure. You are familiar with Ulthera. I don't know if you experienced it, I'm sure you know about it. [I have it. I own it.] Actually what we do, in a way is similar from the point of view of the form of energy, but very different from the point of view of how we make sure the energy is doing it at the right place without damaging the upper layer of the epidermis.

Now the challenge with high, which is what what Ulthera is using or Merz now is using is that it is, HIFU is very nice if you try to get deep into tissue, and then you can do like a cone that has a small angle of convergence if you try to do the same thing when you are very close to the surface of the skin, you need to be very, have a very flat angle of convergence, and that makes it a little bit more difficult.

The end result of this is yes, you can get the right parameter. You cannot do the same volumes that we do. We do much more volume in terms of how much of the dermis itself we heat up. There is more pain associated because there is still lots of ultrasound power that the upper layer of the skin feels.

And if you use Ulthera, I'm sure you're, I don't know how long you followed them, they started out with more aggressive parameters. They went down cause it was too aggressive from the point of view of pain. But this is, this one is closest. Is closest to ours. And I think it is a very good technology.

And I'll be. More explicit on that. I give them lots of credit for coming up with the idea that ultrasound can be a very good technology of creating heat inside the skin. The big difference is the way we do it is different than what they do.

Dr. Grant Stevens

And yours is delivered at one and a half millimeters, correct? [That's correct. Correct.] And that, so that's where your focal point is or that's where your delivery is?

Shimon Eckhouse

Exactly. But yes, this is where the energy is.

Dr. Grant Stevens

Yes, that's what I meant. I know it's not actually focused. No, I know you did. Interesting. So there's is HIFU and yours is, it's not high energy focused.

Shimon Eckhouse

It's actually a beam of ultrasound. I see what we create, I hope we'll bring you one day to Israel and we'll show you. It's a very nice parallel beam uhhuh that doesn't diverge. And really it goes all the way to the depth we want. The frequency has chosen so it doesn't go too deep. Cause we don't want to heat nerve to hit nerve.

We don't want to eat blood, hit blood vessels. We don't want to hit bones, which you can do if you are too deep. And then by the cooling we make sure there's nothing happening on the upper layer of epidemics.

Dr. Grant Stevens

That's very interesting. So it's a much broader application of the energy, isn't it?

Shimon Eckhouse

Correct. We do a full face and neck, full face in 30 minutes. Full face and neck in about 45 minutes.

Dr. Grant Stevens

Yes, I can attest to that, but I think I heard in that last answer, I'll have to go back and watch this, but I think I heard an invitation to Israel.

Shimon Eckhouse

You absolutely heard it. And it'll be more than. Delighted to have you.

Dr. Grant Stevens

I'm gonna hold you to that.

Shimon Eckhouse

Not on business, just on pleasure.

Dr. Grant Stevens

Fantastic. We will go through the countryside. I love Israel. It's one of the most beautiful places I've ever been. We've been through a lot. We've talked about skin tightening.

We've talked about the beginning of intense pulse light, the Syneron story, the Syneron Candela story, the acquisition of Sharplan, you've been to the states and educated once with your PhD and then back to San Diego. You've seen a lot, sir. You have seen so many energy-based technologies and there you're sitting there.

I'd like to ask you something cuz I can see behind you. I think I see your crystal ball. Could you please look into your crystal ball and tell me what we are going to be seeing, or at least what Shae over the next few years. Eh, we've even as far out as a decade, but can, let me look. Let all of us hear what in your crystal ball, please.

Shimon Eckhouse

So actually, and of course I'll try and focus on aesthetic medicine. I'm doing thank you to other things as well. But in area of aesthetic medicine, I think the combination of the demand from patients, which I'm sure are much more aware of than I am, we are all aware of. We'll keep on growing.

There's no doubt about that. Cause I don't want to talk about zoom boom and many other things that everybody's talking about. But in addition to that, and this is a big revolution in the third years that I've been in this industry, when we started and did you know, skin rejuvenation was photofacial, as we used to call it in those days.

Yes. On a face of a patient. She wouldn't share it with anyone in the world. Maybe with her husband, maybe not these days, they do it and they put it on Facebook or TikTok or Instagram or whatever the case may be in this social, media craziness if you want to call it, or wonderful thing, if you want to call it this way.

is really driving the market to whole new direct. Combined with that, I believe the sophistication of patients as well as our sophistication keeps on moving forward, like doing what we do in software. The ability to do this damage and the patient walks back home and nobody knows that he or she were treated, I believe is a great thing.

The, I believe that we will keep on improving this significant. because we keep on get, getting much better understanding of the biology of the skin. PCR is a word that you'll ask any citizen in the Western world if he knows what PCR is, that it will say, of course, COVID. But you know that there is something called pcr.

But what we do today in sequencing didn't exist 30 or 20 or even 10 years ago. And when you combine that with the way you move technology forward, I believe we can end up with much better ways of predicting the results of treatments that we are doing in aesthetic medicine. And, I look we do lots of work on treating patients, taking biopsies and understanding what's going on internal.

And it's amazing and, these were speculations 20 years ago now they're really scientific facts. So that's very.

Dr. Grant Stevens

Thank you very much. I would entirely agree with you and we've been on parallel tracks for those 25 to 30 years and it's been so exciting and I, it's just such an honor for me to be able to interview you and meet you.

I wish you were here in our studio, but I'll take this Zoom and I'll meet you in Haifa and we'll go on. I'd love to see the, his histology. I want to see the neogenesis. I've never heard the word neogenesis, but it works for me. I do understand. And when you upset those fibroblasts, they pump out that collagen elastin, as we saw when we were doing CO2 lasers and back to the Beckman Institute and all the various things that we all live through.

And here we are using RF and ultrasound and various energy sources to heat the fibroblasts irritate. And have it pump out this new collagen in Elastin. And I'm very excited to get to know more about Soft Wave. I think it's a very exciting area and I look forward to learning more and seeing how it works on my face.

As I mentioned, I've been treated of course.

Shimon Eckhouse

We'll make sure. Absolutely. You look great, but we'll still do something .

Dr. Grant Stevens

Thank you very much. You're very welcome, Shimon, and I look forward to seeing you. And I'd like to thank all of you for joining us again on this exciting episode of The Technology of Beauty, where we've had the opportunity to get to know Shimon Eckhouse, clearly a pioneer in the field of energy-based improvement in aesthetics. Still going strong. I can't wait to see what his next invention is, thank you all very much for joining us and thank you once again Shimon. Be good.

Shimon Eckhouse

Thank you. All the best. Have a good day.

Dr. Grant Stevens

Thank you, sir. You too.