Accolade QS Alexandrite 755 nm Benign Pigmented Lesions and Tattoo Removal

1. Accolade QS Alexandrite 755 nm Benign Pigmented Lesions and Tattoo Removal

2. Market Size and Incidence • Epidermal Lesions- Superficial • 30% of population has solar lentigines • 10% of population has café-aulait • 60% have freckles • Dermal Lesions • Nevus of Ota and Ito (Acquired Dermal Melanocytosis) • 0.014%-0.034% of Asian population • 0.4-0.8% of people of Japanese and Korean descent • Cosmetic, Medical, Body Art Tattoo • Permanent makeup tattoos • Reconstructive medical tattoos after mastectomy and surgery • Cosmetic tattoos to cover up scars and other skin imperfections • Body Art Tattoos

3. Treatment Market Size • Benign Pigmented Lesion Removal • Global treatment size $2.50 Billion to $6.48 Billion • 2008 expected US market size $38 M at CAGR 12%* • Tattoo Removal • 2008 expected US market size $120 M at CAGR 17%* • International market estimated $45 M *Source: Millennium Research Group

4. Nanosecond Pulse Width Equal amounts of energy Power Microsecond Pulse Width Nano vs microsecondPulse Width • Effectively destroys melanosomes and tattoo pigments • Ultra-short pulse widths required to shatter melanosome/ pigments by photoacoustic effect Courtesy of: Dr. Wang Hongwei Peking Union Medical College Hospital Time

5. Benign Pigmented Lesions • Discoloration caused by high concentration of melanocytes in a particular area • Treatments include cover up with makeup, or painful removal by dermabrasion or cryosurgery • Mostly for pediatric treatments or as an adjunct procedure in skin rejuvenation for adults • Lasers remove pigmented lesions through photoaccoustic effects • Melanin absorbs laser energy more intensely than the surrounding tissue which leads to fracturing of the pigment and melanocyte cell death • Fractured melanin/melanocyte is removed by the immune system

6. Nevus of Ota • First described in 1861 • Bluish hyperpigmentation along the first or second branches of trigeminal nerve • Most patients have no family history • Age of onset- perinatal period or puberty • Significant predominance among women • Male to female ratio 1:4.8 • Female hormones suggested as potent stimuli • Other stimuli include infection, trauma, or ultraviolet light exposure Source: Chan and Kono et al Nevus of Ota: Clinical Aspects & Management, SKINmed, 2003

7. Nevus of Ito, Mongolian spots & Other conditions Nevus of Ito • Variant of Nevus of Ota. • Skin pigmentation occurs is more diffuse and less mottled in the acromioclavicular region Mongolian spot • Sacrococcygeal region • Usually regresses and disappears during childhood. • The spot is found in almost all newborn Chinese, Japanese and Mongolian children, as well as some white and black children. Becker Nevus and Henry Nevus

8. Treatment of Pigmented Lesions

9. Treatment of Pigmented Lesions

10. Incidence – Tattoos • Sixth fastest-growing retail business in the United States in recent years • 80% of tattoo customers are upper middle-class white suburban females • 15-20% of US teens and young adults have tattoos (40M Americans) • 23% of college students have tattoos • 50% of everyone receiving a tattoo, wants it removed (ASDS) “In the 90’s I did five laser treatments a month… now I do that in one day” Elizabeth McBurney, MD Source: The Pulse, Hofstra University and ASDS- American Society of Dermatologic Surgery

11. Treatment of Tattoos

12. Treatment of Tattoos

13. The Accolade • Q-Switched Alexandrite Laser • The Speed of Alex • The Spot Size of Ruby • Removes Pigmented Lesions • Removes Black, Blue, Brown and Green Tattoos

14. Correct Wavelength for Specific Treatment Alexandrite 755 nm

15. 1320nm Nd:YAG Effective Wavelengths Accolade • 755nm • Absorbed by most pigments • Greater depth of penetration for treating deeper structures • 50-70 ns pulse width • Disrupts melansomes and tattoo pigments

16. Accolade Specs

17. Accolade Improved Design • Faster than other competing systems • 2x spot size of other Alex • More than 10x the speed of Ruby • Faster Treatments and Faster Clearance • Larger Spot and Higher Repetition rate give the fastest treatment possible • Larger Spot means deeper penetration for faster clearance

18. Accolade Treatments Characteristics • Accolade treatments are gentler • Less painful especially for the face • Greater specificity towards target chromophore • Reduces damage to peripheral tissue • Minimum pinpoint bleeding • Decreases incidence of scarring

19. AccoladeFeatures and Benefits

20. Weakness of Other Lasers

21. Comparison of Different Lasers

22. Clinical Results: Nevus of Ota BEFORE AFTER

23. Nevus of Ota Before & After BEFORE AFTER 4 treatments Courtesy of: Dr. Wang Hongwei Peking Union Medical College Hospital

24. Nevus of Ota Before & After BEFORE AFTER Courtesy of: Dr. Wang Hongwei Peking Union Medical College Hospital 7 treatments

25. Pigmented Lesion Before & After BEFORE AFTER 3 treatments Courtesy of: Dr. Wang Hongwei Peking Union Medical College Hospital

26. Freckles Before & After BEFORE AFTER 1 treatment Courtesy of: Dr. Wang Hongwei Peking Union Medical College Hospital

27. Tattoo Treatment Before & After Eyebrow Tattoo BEFORE AFTER After 2 treatments (5.8-8.6 J/cm2) Courtesy of: Dr. Lu Zhong Huashan Hospital Caution: Spot test first. Tattoo pigments with iron may turn jet black with laser; continue treatment for black

28. Tattoo Treatment Before & After BEFORE AFTER After 3 treatments (5.8-8.6 J/cm2) Courtesy of: Dr. Lu Zhong Huashan Hospital