Thulium 1927: The New Era of Skin Resurfacing

In this episode of Cowboy & The Queen, we explore the science and clinical applications of the 1927 nm Thulium laser—one of the most effective technologies for improving sun damage, pigmentation, fine lines, and overall skin quality. We discuss how Thulium works, who makes an ideal candidate, and what patients can realistically expect from treatment. We also compare two popular 1927 nm platforms, Moxi and NouvaDerm, highlighting their similarities, differences, and where each may fit into a comprehensive skin rejuvenation plan. Whether you’re considering treatment yourself or simply want to understand the latest advances in laser technology, this episode is packed with practical insights and expert advice. 

Transcript

SPEAKER_00 0:06

Hello, everyone. Welcome back to Cowboy and the Queen of Aesthetics. And today we are going to be talking about Thullium 1927 lasers, which is super exciting because we have a couple in our practice. But before we jump into this, Wyatt, let's talk a little bit about some controversy that we've had on some of our previous podcasts.

SPEAKER_01 0:25

Yeah, and so this is so great. I mean, like we're always talking about whether it's someone that has questions about if it's a if it's a positive or negative, that's okay. But it was in regards to peptides. Um, and we kind of chatted about this this weekend and so forth. So just, you know, I didn't know for sure if we want to just elaborate in on this, but this is always great to see or and always great to hear because this is what we want. We want these we want Absolutely.

SPEAKER_00 0:52

I think healthy conversations in regards to things that we disagree about or we disagree about are very healthy, especially in the aesthetics and wellness space. And so one of the concerns this weekend was they wanted to know where we got all the information from our podcast on peptides. So right now we know that in the functional medicine space that peptides are very controversial. And so we're waiting that to be, we're waiting for that to be kind of ironed out. But I still think, Wyatt, because of what we see in our practice every day, that when I come on this podcast, I'm going to show you and tell you about my real life experiences for hundreds of patients that are on these peptides and hundreds of patients that have changed their lives, literally. They're off more medicines than they've ever been before. They walk in looking like a different person because they feel better internally. We've helped them get off of numerous medications like cholesterol medicine, heart medication, blood pressure medications. And so I just speak from what I see in real practice. And so we can beat the street on, you know, well, peptides have not been, you know, formally FD approved for this, that, and the other. And that's fine. And if someone believes that that's true, they are totally entitled to their perception and their opinion on that. But it isn't going to change mine because I will stand on all the data and research that I know exist in this space. And I will also base what I say on this podcast on what I see in my practice every single day. And you would have to beat me down and make me think really hard to make me change my mind on the hundreds of patients that literally bounce into my office and they're like, I'm off of this medication and this medication, and I've lost 20 pounds, and I have my life back. And they look differently when they walk in my front door. So bring on the concerns, bring on the questions because we are ready to go toe-to-toe, because everyone is entitled to their opinion. And I'm happy to debate why we feel like this is ours. And that's the lovely thing about medicine is that we can agree, agree to disagree. But as long as we're practicing safe, ethical medicine and patients are getting better and there's no harm done to patients. I think this is the, you know, the forefront of medicine. I'm a little woo-woo. I'll say it, right? I think lights can heal people, the right kind of lights. I believe that peptides can heal people. And I am not for taking medicine. In my household, we try to stay far away from pharmaceuticals. And now you'll hear me say the pharmaceutical cartel, you know, more than once on this podcast. So we welcome those questions and concerns. But when someone chooses just to say, where did you get that information from? It depends on which question, because every single question that we answer on this podcast has many references. So I appreciate that. And let's let's just go, man. I mean, I'm ready to debate and have these conversations.

SPEAKER_01 3:40

Yep, yep. And then we do appreciate that as I appreciate that as well. But like and today, though, we're talking billion lasers and specifically the two everyone keeps talking about, um, Nuba Derm and Moxie, right?

SPEAKER_00 3:55

Yes, yes, because patients and honestly, providers keep asking the wrong questions, in my opinion, on these lasers.

SPEAKER_01 4:04

Well, yeah, because everyone wants to know which one is better, a lot more, you know. Right.

SPEAKER_00 4:10

It's true, it's true. But it's it's which one is better for who and for what goal, right?

SPEAKER_01 4:16

Right. So all right, let's level set this. Well, let's level set this first, right? Because both these visors are based on a 1927, um, you know, nanometer uh thium technology, correct?

SPEAKER_00 4:28

Right. And what that wavelength loves is to target water in the epidermis and if you should in superficial dermis.

SPEAKER_01 4:35

Yeah, so like translation for real humans, these lasers are great for pigment, texture, early collagen stimulation.

SPEAKER_00 4:44

Yes, why? That is true. So at a high level, yes, these do live in the same family because they behave clinically, because how they behave clinically is where things start to diverge.

SPEAKER_01 4:55

Yeah, so I mean let you let's just start with um, let's start with Moxie because this one uh has become extremely popular um in the prejuvenation uh space as well. And you know, Moxie.

SPEAKER_00 5:08

Yeah, I know.

SPEAKER_01 5:08

I'm using all these fancy words you got teaching me because you're helping me. But like, you know, Moxie is really designed as a uh, you know, a gentle, non-ablative fractional treatment, you know, like the maintenance, fresh, and you know, like early um intervention.

SPEAKER_00 5:23

Yes. So I always tell patients this is your keep your skin honest laser.

SPEAKER_01 5:28

Exactly. And it shines for younger patients, early pigment, um, and people who who want minimal downtime.

SPEAKER_00 5:35

Right. So Moxie is great, and and let's be fair, it's very predictable. It helps healing. It the healing time is very smooth, it's tolerable, tolerability is high, and it stacks beautifully with BBL and other laser treatments. So it's a very easy treatment to do. It's simple, it's 30 minutes. And so whatever you can treat in 30 minutes, you can do with with Moxie. Moxie does time out, and so you have a set amount of time that you can use the tip, and then that tip is no longer good. And so you have to change the tip as a provider. So for me, sometimes I feel a little boxed in, right? Because I like to have the time availability to do multiple areas or maybe focus on one area. So Moxie's a very simple entry-level thulium type treatment, especially for a provider, because it's very much plug and play, and that's it.

SPEAKER_01 6:28

But not, and I think this is this is important. It's not a heavy lifter, right?

SPEAKER_00 6:34

No, you're you're exactly right, Wyatt. So if someone has significant texture, deeper photo damage, or more advanced aging, moxie may require multiple sessions, and that still may not be enough for the patient.

SPEAKER_01 6:47

Yeah, so it's a you know, it's a great maintenance tool. It's not gonna, it's not your full remodel, if you will.

SPEAKER_00 6:53

No, spray things get a little bit interesting with these two lasers for sure.

SPEAKER_01 6:57

Well, that's you know, this is all so now getting into you know to the Nubiderm, you know, as often described, you know, as the next generation fractional feeling system. Um and the key word here is customizable.

SPEAKER_00 7:09

Unlike strictly gentle devices, this platform can operate across multiple intensity levels. And so that's why it is really that next level when it comes to resurfacing.

SPEAKER_01 7:22

I and I do I love it. You know, it's an ablate, subablative, more aggressive settings, and you know, it's all depending on how the provider, of course, programs it.

SPEAKER_00 7:32

Absolutely. So the chefs can cook as much as they want in the kitchen and change the recipe however they choose fit or however they seem fit. And so what makes this incredibly versatile is the fact that you can change those settings, but it also makes it more operator dependent. So if you want to use those as a beginning laser tech, then you will just go with the set settings that come available on the system. But when you become a master chef and you want to really dial those in, the beauty of Nuvoderm is it allows you to change the jewels and the dwell time and even for hair restoration, how large of an area we're treating at one time. So we can really dial this in and do many different things with with Nuvoderm.

SPEAKER_01 8:14

Yeah. But and then that, like I said, where Nuvoderm stands out, you know, it I tend to reach for it because we're because there's mixed concerns, right?

SPEAKER_00 8:22

Right. So if a patient comes in and they have pigment and texture and laxity, then we can treat on a pigment setting with one pass. We can go in on a wrinkle setting with one pass, we could do a texture setting on one pass, or we can focus focus in a little different setting for laxity and tightening. So again, in one session, as long as we need that session to be, we can change those settings and really dial those in. So we can stack energies too. So I can go in and do, I could do a stamping setting where I'm treating pigment, and then I can stamp on top of that and treat the deeper wrinkles, and then I can treat scars, and then I can lightly go over and treat the entire area or the entire face, neck, chest, really any body part with just a lighter setting for texture and tightening.

SPEAKER_01 9:07

Yeah, and I love Nuvaderm too. It also fits beautifully into like your genetic protocols, you know, where you want scale scalable collagen stimulation.

SPEAKER_00 9:15

Absolutely. But what I like to say is with Nuvader, with bigger power comes and greater power comes greater responsibility. So settings and patient selection really matter a lot here. And so with this device, because it has more power, we just need to know and understand Fitzpatrick's and what we're trying to treat because it does not have a lot of pain involved and it's super sexy and sleek to use. But we need to remember that we do have to be very responsible when we are using these more customizable settings.

SPEAKER_01 9:47

All right, so if we zoom out, then you would say.

SPEAKER_00 9:51

So I guess I would say Moxie is more of a maintenance first type of treatment.

SPEAKER_01 9:55

Okay, so Nubiderm is more is flexible first, correct?

SPEAKER_00 9:59

Absolutely. So neither is really better. They just live at different points on the aesthetic roadmap. So Moxie is going to be your very basic intro-level thulium, 1927. And Nubiderm is going to allow us to treat a little bit more of those deeper skin conditions and we can be a little bit more aggressive with those. And also body areas, because it has the ability to treat larger body areas with not as much time involved in the procedure. We can treat a back in 15, 10 to 15 minutes. We can treat arms in five to 10 minutes. So the versatility size of the head also differs between Nuvoderm and Moxie. Moxie has one size treatment head and Nuvoderm has different size treatment heads. I think there's three different ones. So, and also it has a hair setting. I also like Nuvoderm when you're trying to really customize and treat maybe around the eye area because there are different shapes, which allows us to pick, you know, what shape we want and what size we want that shape to be. When we're trying to treat those stubborn areas that are hard to reach, like under the eyes where patients absolutely hate their texture. Or their upper eyelids where they hate their laxity.

SPEAKER_01 11:09

Yep, exactly. And then, like I said, let's let's let's let's make it real for the listeners here.

SPEAKER_00 11:14

Okay. So I think I would say if in your 20s and these and you have mild pigment and you want that glow with basically no downtime.

SPEAKER_01 11:22

So I mean m I mean moxie is obviously uh, you know, a beauti beautiful entry point, you know.

SPEAKER_00 11:26

That is exactly what I would say. Moxie would be what I would say for those patients. But if you're in your in your late 30s and 40s or beyond, and you're seeing more texture, tone, and those earlier structural changes in your in your skin, then you might want to Yeah.

SPEAKER_01 11:43

You would need something with more range and and it's more customized, customized. There's that word again, see, you know.

SPEAKER_00 11:49

Customizable.

SPEAKER_01 11:51

Yeah, exactly.

SPEAKER_00 11:53

And and this is exactly absolutely, this is exactly where your cookie cutter laser recommendations can get you into trouble because it's not one size fits all. And even though these are the same technologies, they're very, very different when it comes down to the customization of how we treat patients. And that really, when we can customize something, that's where outcomes become different. And that's where patient expectations and and patient experiences really vary as well.

SPEAKER_01 12:21

Right. And I and I and I agree. And you know, how we like to go into our next segment is of course super important, is the biggest mistake, the biggest mistake patients make.

SPEAKER_00 12:32

Well, as you know, Wyatt, the biggest mistake that patients make is shopping devices instead of shopping strategy and treatment plans for those specific patients.

SPEAKER_01 12:42

Yeah, say that louder for the people in the back, back, back.

SPEAKER_00 12:46

Right. So because the right answer is never which laser is best.

SPEAKER_01 12:52

It's it's what does my skin actually need right now?

SPEAKER_00 12:56

Right now. Absolutely right. So here is the takeaway.

SPEAKER_01 13:00

Mike said, Bremoxia is an excellent refresh and it is a maintenance tool, right?

SPEAKER_00 13:06

It is. And Nuvaderm is your more customizable platform for patients who need to see more of a range of change.

SPEAKER_01 13:12

Yeah. So the magic, you know, is in matching the technology to the biology.

SPEAKER_00 13:18

I love it. I love that. Matching the technology to the biology, and that's how you age intentionally and not accidentally.

SPEAKER_01 13:26

Is there um, I always like to ask you this question before we close, is there anything else that you would just kind of like to end with or just kind of to our viewers, uh, so that way um we can, you know, maybe get some questions here and uh how we could help?

SPEAKER_00 13:40

No, I think both lasers are, you know, obviously very good in your practice. I have them both in my practice. I just think that you have to know the limitations to whichever device that you choose on your skin and know that all devices are not created equally. And so there are going to be those little nuances in different devices. And I think the biggest one is if it's a beginning, it's a person that's just getting into the laser industry. I think Moxie is kind of dummy-proof, if you will. It's plug and play, you set it and forget it, and you just go, go, go until you time out. NufoDerm has that same capability, but in addition to that capability, it allows us as advanced laser practitioners to then go, okay, here's the canvas. What area of the canvas has the most damage and needs the most work? Pigment, okay, I'm gonna use this setting. Fine lines and wrinkles, this setting. Deeper lines and wrinkles, this setting. Redness and pore size, this setting. And overall skin tightening, this setting. And so I think if we can, you know, if we're really those more advanced aesthetic practitioners are looking for a tool that they can really dial in and customize. And I think with customization comes higher patient satisfaction.

SPEAKER_01 14:49

Right. And then of course the hair restoration side, because as I said, it's a that's a huge market. But like so, that's for that is for an another time. But no, so y'all it is, but quiet, it works so well. I know, I know. It's it's it's uh no consumable. So I mean, it is a huge, huge area. Um, so yeah, I've just always a pleasure, always such great information. Y'all, we appreciate y'all. Um thank you. And we will see y'all next time.

SPEAKER_00 15:19

Thanks for joining us in the Cowboys and the Queen of Aesthetics, and we'll see you next time on the next episode. Thanks for watching.