The development of a device that transformed laser surgery began in 1992 when Dr. J. Stuart Nelson, then medical director at the Beckman Laser Institute & Medical Clinic (BLIMC) at UC Irvine, was inspired while watching a baseball game. Nelson had been seeking ways to improve laser treatments for vascular birthmarks in children, but early attempts using ice, cold water, and chilled metal plates proved ineffective.
Nelson recounted the moment of inspiration: “We needed to get something very cold onto the skin surface in perfect thermal contact and then off the skin surface – all within a fraction of a second,” he said. “I remembered what I saw watching a baseball game.” He recalled seeing trainers use ethyl chloride spray to numb players’ injuries and suggested this approach might work with lasers if it evaporated quickly enough to cool only the outermost layer of skin.
Over dinner with colleagues Thomas Milner and Lars Svaasand, Nelson shared his idea. The team soon built the first prototype of what became known as the Dynamic Cooling Device (DCD), using readily available parts including a fuel injector valve and air conditioning coolant. They tested it on themselves to determine optimal performance.
“It was a fairly simple construction,” said Milner, now at Baylor College of Medicine. “That’s the beauty of the invention: It’s so simple and works so well.”
The DCD sprays a nonflammable cryogen onto the skin, cooling only its surface before each pulse of laser light is delivered milliseconds later. This allows higher doses of laser energy while reducing pain and minimizing injury to patients’ skin.
“Because the spurt durations are so short, the cooling remains confined to the skin’s most superficial layer and does not affect the deeper targeted blood vessels causing the vascular birthmark,” Nelson explained. “This allows much higher laser light dosages to be used, while at the same time minimizing injury to the skin and pain to the patient.”
Patented in 1998 and licensed commercially by Candela Laser Corp., DCD technology has become standard on more than 47,000 Candela lasers worldwide as well as devices from other manufacturers. The patent expired in 2020.
Between 2001 and 2010, DCD ranked among the top-earning inventions licensed by University of California system campuses; it generated nearly $60 million in royalties for UC Irvine during its commercial life.
Michael Berns, Arnold & Mabel Beckman Chair in Laser Biomedicine and institute co-founder, described its development: “The combination of basic research, engineering and clinical testing that went into the Dynamic Cooling Device is exactly what was envisioned over 30 years ago when the idea of BLIMC was first conceived.”
While used for various cosmetic procedures such as hair removal or scar treatment, Nelson emphasized its primary benefit for those born with port-wine stains—a type of vascular birthmark—especially infants treated at BLIMC’s Vascular Birthmarks & Malformations Diagnostic & Treatment Center.
“The technology has made possible the early, painless, safe and effective treatment of port-wine stains and other disfiguring vascular birthmarks in infants and young children in ways that Tom, Lars and I could never have imagined,” Nelson said. “That’s what I’m most proud of.”
