Subcutaneous peeling treatment for stretch marks

Abstract

Disclosed herein are devices and methods for subcutaneously ablating the inner surface of a subject's dermis. The subcutaneous ablating device may include a handle, an elongate shaft extending distally from the handle, and an ablating surface disposed on a distal end portion of the elongate shaft. The ablating surface may be configured to subcutaneously ablate the inner surface of a subject's dermis without substantially cutting or puncturing the subject's dermis.

Description

[Technical field]

[0001] Related Applications This application claims the benefit under 35 U.S.C. §119(e) to U.S. Provisional Application No. 63 / 257,881, filed October 20, 2021, and entitled “Subcutaneous Abrasion Treatment for Stretch Marks,” the entire contents of which are incorporated herein by reference.

[0002] Field The disclosed embodiments relate to devices and methods for subcutaneously ablating localized areas of a subject's skin, for example to treat stretch marks. [Background technology]

[0003] background Stretch marks (striae distensae) are common skin scars that affect nearly half of humanity, including about 40% of men and 70% of women. The appearance of scars can cause, among other things, cosmetic concerns, especially for patients who do not like the appearance of scars. Summary of the Invention

[0004] Quick Overview According to one aspect, a subcutaneous abrasion device includes a handle, an elongate shaft extending distally from the handle, and an abrasion surface disposed at a distal end portion of the elongate shaft, the abrasion surface configured to subcutaneously abrade an inner surface of a subject's dermis without substantially cutting or puncturing the subject's dermis.

[0005] According to another aspect, a method of treating a topical area of ​​skin of a subject includes inserting an abrasion device into an opening in the skin of the subject and subcutaneously abrading an inner surface of the dermis of the subject.

[0006] It should be understood that the foregoing concepts, and additional concepts discussed below, may be arranged in any suitable combination, as the disclosure is not limited in this respect. Moreover, other advantages and novel features of the present disclosure will become apparent from the following detailed description of various non-limiting embodiments when considered in conjunction with the accompanying figures. [Brief description of the drawings]

[0007] BRIEF DESCRIPTION OF THE DRAWINGS Non-limiting aspects of the present disclosure are described by way of example with reference to the accompanying figures, which are schematic and not intended to be drawn to scale. In the figures, each identical or nearly identical component shown in the figures is typically represented by a single numeral. For clarity, not every component is labeled in every figure, nor are every component of each aspect of the disclosure shown where explanation is not necessary for one skilled in the art to understand the disclosure. In the figures:

[0008] [Figure 1A] FIG. 1A is a side view of a subcutaneous ablation device according to one exemplary embodiment. [Figure 1B] FIG. 1B is a side view of a subcutaneous ablation device according to one exemplary embodiment. [Figure 1C] FIG. 1C is a side view of a subcutaneous ablation device configured to selectively transition between an undeployed configuration and a deployed configuration according to one example embodiment. [Figure 1D] FIG. 1D is a side view of a subcutaneous ablation device configured to selectively transition between an undeployed configuration and a deployed configuration according to one example embodiment.

[0009] [Figure 1E] FIG. 1E is a side view of a subcutaneous ablation device according to one exemplary embodiment. [Figure 1F] FIG. IF is a side view of a subcutaneous ablation device according to one exemplary embodiment. [Figure 1G] FIG. 1G is a side view of a subcutaneous ablation device according to one exemplary embodiment.

[0010] [Diagram 2] FIG. 2 is a side view of a subcutaneous ablation device in use on a subject, according to one exemplary embodiment; and [Diagram 3] FIG. 3 is a flow chart illustrating a method of using a subcutaneous ablation device according to one example embodiment. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0011] Detailed Description Generally speaking, when a subject's skin stretches, scars called stretch marks may appear on the skin. In particular, stretch marks may form when the collagen and / or elastin that supports the skin is damaged or ruptured. Stretch marks may form under appropriate circumstances, such as during a growth spurt, pregnancy, rapid weight loss or gain, rapid muscle growth, and / or other appropriate circumstances. Stretch marks may cause cosmetic concerns, especially for patients who do not like the appearance of stretch marks.

[0012] Conventional therapies for treating stretch marks include applying treatments or other procedures to the upper (e.g., outer surface facing outward) surface of the skin. These treatments may include the following: topical medications (e.g., Mederma, retinoids, silicones), chemical peels, microdermabrasion, lasers (e.g., non-ablative lasers (e.g., pulsed dye, 1450 diode, 1550 erbium) and / or ablative lasers (e.g., CO2, erbium / yag)), radiofrequency, and / or microneedling. Such treatments and procedures may have different efficacy, morbidity, and / or the need for multiple treatments. Furthermore, such "top-down" approaches may attempt to reach the dermis through the epidermis and / or induce damage to a limited upper portion of the dermis (e.g., the papillary layer of the dermis or a small upper portion of the reticular layer of the dermis), which is repaired with the formation of new collagen in the dermis to treat the presence of stretch marks. However, such "top-down" approaches may have difficulty effectively penetrating through the skin to the lower dermis and inducing the desired regenerative effects (e.g., collagen growth), which may limit the effectiveness of such "top-down" approaches.

[0013] In view of the above, the inventors have recognized the advantages of a subcutaneous approach to promote dermal repair, for example, to treat stretch marks. In particular, according to some aspects of the present disclosure, a method of subcutaneously treating a subject's skin (e.g., a method of treating stretch marks) is disclosed. In some aspects, a clinician may insert an abrasion device into an opening in the subject's skin, so that the abrasion device reaches the inner surface of the subject's dermis. Thus, the clinician may then subcutaneously ablate the inner surface of the subject's dermis (e.g., the deepest reticular layer at its junction with the underlying fatty tissue) and induce the subject's skin to heal (e.g., by repairing the skin with new collagen as described herein). As described in more detail below, such a method is capable of directly affecting the lower portion of the dermis, compared to previous systems and methods that are limited to treating the epidermis or upper portion of the dermis (e.g., the papillary layer of the dermis or the small upper portion of the reticular layer of the dermis).

[0014] According to another aspect, a subcutaneous abrasion device is disclosed. The subcutaneous abrasion device may include a handle, an elongated shaft, and an abrasion surface. The elongated shaft may extend distally from the handle, and the abrasion surface may, in turn, be disposed on a distal end portion of the elongated shaft. In some embodiments, the abrasion surface may be configured to subcutaneously abrade the inner surface of the subject's dermis without substantially cutting or puncturing the subject's dermis.

[0015] Unlike conventional treatments that may be limited to treating the upper portion of a subject's dermis (e.g., a small upper portion of the papillary or reticular layers of the dermis), the embodiments disclosed herein may provide direct access to the lower portion of the dermis, including the reticular layer of the dermis. Thus, the embodiments disclosed herein may provide the clinician the ability to more easily and directly induce pressure at the underside of the dermis. Furthermore, the inventors have found that such treatment methods can induce extensive remodeling of the dermis to more effectively treat stretch marks, as compared to other "top-down" methods.

[0016] As will be appreciated by those skilled in the art, in addition to inducing pressure directly on the underside of the dermis, directly subcutaneously peeling the underside of the dermis may allow the clinician to affect a larger portion of the dermis in a shorter period of time. For example, chair time (e.g., the time it takes for the procedure to be performed) may be reduced compared to conventional procedures as described herein. In some cases, chair time may be reduced from about 45 minutes to about 10 minutes, although the disclosure is not so limited and appropriate treatment times may be used depending on the size and extent of the procedure.

[0017] As described herein, and without wishing to be bound by theory, subcutaneously exfoliating the dermis of a subject may promote increased collagen production in the subject in the exfoliated area. Increased collagen production in the exfoliated area may dramatically reduce the visibility of stretch marks, especially compared to conventional treatments.

[0018] In some embodiments, the subcutaneous peeling may be performed in a minimally invasive manner. For example, a clinician may create a small incision in the subject to create an opening in the subject's skin. The clinician may then insert an abrasive device into the opening and scrape and / or rub the abrasive surface of the abrasive device against the targeted inner surface of the subject's dermis to directly induce pressure to the underside of the dermis. The abrasive device may then be removed through the same opening. In some embodiments, the abrasive device may be deployable within the subject such that the abrasive surface is deployed from an undeployed configuration that is smaller than the opening to an undeployed configuration and a deployed configuration that is larger than the opening. In some cases, the opening may be created at or near the navel or other suitable portion of the subject's skin, and the incision may be made to match existing lines within the subject's body. Of course, it should be understood that while deployable abrasive surfaces are discussed above, fixed abrasive surfaces are also contemplated, as detailed below.

[0019] As will be appreciated by those skilled in the art, while a clinician may seek to induce pressure and / or micro-tears in the dermis (e.g., as described herein), it may be desirable for the dermis to remain substantially intact (e.g., substantially free of punctures, cuts, tears, etc.) during the procedure. Thus, a subcutaneous abrasion device according to the present disclosure may include an abrasion surface of any suitable size and / or shape configured to abrade the inner surface of a subject's dermis while substantially avoiding punctures, cuts, tears, and other major damage to the subject's skin. In some embodiments, the abrasion portion may have any suitable shape, including, but not limited to, rectangular, circular, cylindrical, spherical, semicircular, and / or any other suitable shape. Alternatively or in addition, the abrasion portion may be wider than the elongated shaft of the subcutaneous abrasion device, although this need not necessarily be the case. However, embodiments in which the abrasion portion is narrower than or as wide as the elongated shaft with which it is associated are also contemplated, as the disclosure is not so limited.

[0020] Furthermore, the abrasive surface may include any suitable feature or features configured to abrade the inner surface of the dermis of a subject.For example, in some embodiments, the abrasive surface may include one or more of: a file; a hook; a protrusion; an angled surface; a fin; a structure that includes an edge that extends radially outward from the relevant portion of the elongated shaft, and / or other suitable structure that is configured to direct pressure onto the inner local area of ​​the dermis while avoiding puncturing or tearing the dermis during normal operation.

[0021] In some embodiments, the abrasion surface may extend at least partially distally relative to the elongated shaft of the device, but the abrasion surface may be angularly offset by an offset angle relative to the elongated shaft of the subcutaneous abrasion device. In some embodiments, the offset angle may be 30 degrees or more, 40 degrees or more, 50 degrees or more, and / or any other suitable dimension or more. In some embodiments, the offset angle may be 90 degrees or less, 80 degrees or less, 70 degrees or less, and / or any other suitable dimension or less. The aforementioned combinations are contemplated to include, for example, offset angles between or equal to 30 degrees and 90 degrees. Of course, the offset angle may be any suitable value depending on the application, as the disclosure is not limited in this respect.

[0022] In some embodiments, the offset angle may be adjustable, while in other embodiments, the offset angle may be fixed. In embodiments in which the offset angle is adjustable, the offset angle may be actively adjustable (e.g., affirmatively by a clinician) and / or passively adjustable (e.g., based on the contour of the inner surface of the subject's dermis).

[0023] In some embodiments, the subcutaneous abrasion device according to the present disclosure may include an abrasion surface that includes one or more automatic or movable structures. For example, in some embodiments, the abrasion surface may include a spinning member. The spinning member may be driven electrically (e.g., by an electric motor) or passively (e.g., based on the contour of the subject's skin). Of course, any movable structure of the abrasion surface may be arranged in any suitable manner, as structures other than spinning members are also contemplated. Such automated or movable members may help reduce the repetition of strokes during treatment (e.g., by a clinician) and / or increase the consistency of results between different subjects.

[0024] It is understood by those skilled in the art that in some embodiments, it may be desirable to shield the patient from the abrasion surface of the subcutaneous abrasion device until the abrasion surface is positioned close to the inner surface of the target of the subject's dermis.Therefore, the clinician may insert the subcutaneous abrasion device into the opening of the subject with the abrasion surface facing away from the inner surface of the dermis.Then, once the abrasion surface is properly positioned, the clinician may rotate the subcutaneous abrasion device so that the abrasion surface contacts the inner surface of the target of the subject's dermis.In such an embodiment, the device may have a reduced dimension in one direction to facilitate insertion in a first direction and a larger dimension in a second direction to facilitate treatment of the desired target area of ​​the subject's skin.

[0025] In some embodiments, the abrasion surface of the subcutaneous abrasion device may be expandable. For example, in an unexpanded configuration, the abrasion surface may have a first smaller lateral dimension (i.e., width or diameter). Thus, in such a state, the clinician can easily and minimally invasively insert the subcutaneous abrasion device into the subject (e.g., as described herein). When the subcutaneous abrasion device is inserted into the subject, the abrasion surface may then be expanded (e.g., actively or passively) into an expanded configuration, such that the abrasion surface has a larger lateral dimension compared to the unexpanded configuration. In some cases, the larger lateral dimension may be wider than the elongated shaft of the device.

[0026] In some embodiments, the length of the elongate shaft of the subdermal ablation device may be adjustable. For example, the elongate shaft may be configured to telescopically transition between different lengths (e.g., a first retracted length and a second fully extended length) depending on the application. Of course, this need not be the case, as embodiments with fixed elongate shafts are also contemplated.

[0027] Turning now to the figures, certain non-limiting aspects will be described in further detail. It will be understood that the various systems, components, features, and methods described in connection with these aspects can be used individually and / or in any desired combination, as the disclosure is not limited to only the specific aspects described herein.

[0028] 1A shows a subdermal abrasion device 100 according to an exemplary embodiment. The subdermal abrasion device 100 includes a handle 108, an elongate shaft 106, and an abrasive surface 102. The elongate shaft 106 extends distally away from the handle 108. The handle 108 includes the abrasive surface 102 disposed on a distal end of the elongate shaft 106. In the exemplary embodiment, the abrasive surface includes a plurality of rasps 104 configured to non-destructively ablate (e.g., as described herein) inner regions of the subject's dermis.

[0029] FIG. 1B illustrates a subcutaneous abrasion device 110 configured to reduce a subject's chair time during a procedure. As above, the abrasion surface 102 is disposed on a distal portion of an elongated shaft 106 attached to a handle 108. However, the abrasion surface is configured to be wider than the elongated shaft 106. Notably, the abrasion surface 102 has a width W2 that is greater than the width W1 of the elongated shaft 106. In the illustrated embodiment, the abrasion surface corresponds to an elongated paddle disposed on the distal portion of the elongated shaft and extending in a direction that is at least partially transverse to the longitudinal axis of the elongated shaft. A wider abrasion surface 102 may enable a clinician to ablate (e.g., via a handle as described herein) a larger area of ​​the inner surface of the subject's dermis for a given dexterous movement. Thus, the clinician may be able to ablate targeted locales of the inner surface of the subject's dermis more quickly, and the subject's chair time may be reduced.

[0030] In some embodiments, it may be desirable for a procedure involving a subcutaneous abrasion device to be administered in a minimally invasive manner. Thus, the subcutaneous abrasion device may be deployable, as shown in the embodiment of FIG. 1C-1D. In particular, it may be desirable for the subcutaneous abrasion device to be deployed from a narrow undeployed configuration to a wider deployed configuration (e.g., to reduce chair time as described herein). For example, as shown in FIG. 1C, in some embodiments, the abrasion surface 102 of the subcutaneous abrasion device may be deployable from a first folded configuration to an deployed configuration in which the abrasion surface extends at least partially outwardly from the elongate shaft. However, other deployable shapes may also be used, including deployable T-shapes or paddles disposed on a distal portion of the elongate shaft. In the illustrated embodiment, the subcutaneous abrasion device may be initially configured in an undeployed configuration 112. In the undeployed configuration 112, the abrasion surface 102 of the subcutaneous abrasion device has a first width L1. The subdermal delamination device may be inserted into a subject in an undeployed configuration, for example, to allow for creating a smaller incision in the subject (e.g., as compared to a deployed subdermal delamination device). Once inserted, the delamination surface 102 of the subdermal delamination device may be deployed into the deployed configuration 114. In the deployed configuration 114, the delamination surface 102 of the subdermal delamination device has a second width L2 that is greater than the first width L1.

[0031] Relatedly, as shown in the embodiment of FIG. 1D, in some embodiments, the abrasive surface 102 of the subcutaneous abrasion device may be deployable into an umbrella-like shape. As in the embodiment of FIG. 1C, in the depicted embodiment, the subcutaneous abrasion device may be initially set to an undeployed configuration 112. In the undeployed configuration 112, the abrasive surface 102 of the subcutaneous abrasion device has a first width D1. The subcutaneous abrasion device may be inserted into a subject in the undeployed configuration, for example, to enable a smaller incision to be made in the subject (compared to the deployed subcutaneous abrasion device, for example). Once inserted, the abrasive surface 102 of the subcutaneous abrasion device may be deployed into a deployed configuration 114. In the deployed configuration 114, the abrasive surface 102 of the subcutaneous abrasion device has a second width D2 that is greater than the first width D1.

[0032] In some embodiments, it may be desirable for the length of the elongated shaft of the subcutaneous abrasion device to be adjustable. For example, as depicted in FIG. 1E, in some embodiments, the subcutaneous abrasion device 116 includes an elongated shaft having multiple telescopic shaft sections 118, 120, 122. As will be appreciated, the first telescopic shaft section 118 may be configured to fit within the second telescopic shaft section 120. In turn, the second telescopic shaft section 120 and / or the first telescopic shaft section 118 may be configured to fit within the third telescopic shaft section 122 in a collapsed configuration, although other telescopic configurations may also be used. Thus, a clinician may adjust the length of the subcutaneous abrasion device 116, for example, to adapt the device for different applications.

[0033] In some embodiments, it may be desirable for a subcutaneous abrasion device to include an angled abrasion surface, for example, to facilitate dexterity in manipulating the subcutaneous abrasion device in otherwise difficult-to-reach locations within a subject. One such embodiment is depicted in FIG. IF. FIG. IF shows a subcutaneous abrasion device 124 having an abrasion surface 102 that is angularly offset from an elongated shaft 106 by an offset angle θ. The offset angle θ may be adjustable (either actively or passively as described herein). In some embodiments, the offset angle may be adjusted based on input from a clinician on the handle 108.

[0034] FIG. 1G depicts yet another embodiment of a subdermal abrasion device 126 having an abrasion surface 102 disposed on a distal portion of an elongate shaft 106 and a handle 108 from which the elongate shaft extends distally. In the depicted embodiment, the abrasion surface corresponds to one or more, and possibly multiple, structures extending radially outward from an associated portion of the elongate shaft, which may have a closed outer surface at least in this portion of the device. The structures may include one or more edges configured to ablate the inner surface of the subject's dermis. In the particular embodiment depicted in the figure, the structures correspond to a curved strip extending between a first proximal location and a second distal location along the length of the elongate shaft. Between these locations, the strip is disposed radially outward from the elongate shaft such that one or more edges of the strip can engage adjacent tissue to ablate the tissue as the device is moved. Of course, while a curved shape is shown, other shapes are contemplated, including polygonal shapes, and the disclosure is not limited to the depicted shapes of structures that extend radially outward from the elongate shaft. Additionally, the strips are depicted in the figures illustrating the shaft with gaps disposed between portions of the strips, but embodiments having rigid protrusions with edges at positions located radially outward from the surface of the elongate shaft are also contemplated.

[0035] FIG. 2 shows a subdermal abrasion device 200 being used to treat a subject 202. To treat the subject 202, a clinician may create an opening 206 (e.g., an incision) in the subject 202. The clinician may then insert the subdermal abrasion device 200 into the subject 202 through the opening 206 and guide the abrasive surface of the subdermal abrasion device 200 toward a target locale on the inner surface of the dermis of the subject 202. In the depicted embodiment, one or more target locales correspond to stretch marks 204, which may be treated by abrading the inner surface of the dermis with the depicted subdermal abrasion device. Once the target locale has been treated, the clinician may remove the subdermal abrasion device 200 from the subject 202 through the opening 206 and seal the opening 206 (e.g., using sutures, adhesive, bandages, etc.).

[0036] FIG. 3 is a flow chart illustrating a method of ablating the inner surface of a subject's dermis. In particular, at step 300, a clinician may first form an opening in the subject's skin at 302 prior to inserting a subcutaneous abrasion device (e.g., according to an embodiment described herein) into the patient's opening. Then, at step 304, the clinician may place an abrasive surface of the subcutaneous abrasion device adjacent to the inner surface of the subject's dermis corresponding to one or more portions of the subject's skin to be treated. In some embodiments, this may optionally include deploying the abrasive surface from a first undeployed configuration to a deployed configuration. In either case, at 306, the clinician may use the abrasive surface to ablate the inner surface of the subject's dermis prior to removing the subcutaneous abrasion device from the subject's opening at 308. In some embodiments, the method may further include removing the subcutaneous abrasion device from the subject, sealing the opening, and / or rotating the subcutaneous abrasion device as described herein.

[0037] Example: Subcutaneous dermabrasion during a liposuction procedure During a liposuction procedure performed for reconstructive purposes related to a subject's condition, the inventors used a liposuction cannula that encompassed aggressive surface features in a manner not typically done during liposuction procedures. Thus, the inventors recognized that the cannula ablated the inner surface of the subject's dermis. Following the surgical procedure, it was recognized that areas of the subject's skin that received this unintended treatment (e.g., abrasion of the inner surface of the dermis) exhibited a dramatic reduction in stretch marks compared to untreated skin sections that retained stretch marks. Since this initial observation, the reduction in the presence of stretch marks upon abrasion of the inner surface of the dermis of the subject has been experimentally observed in (1) different subjects, (2) different diagnoses (e.g., lipedema and gynecomastia), (3) different genders (e.g., biologically female and male subjects), (4) different anatomical locations (e.g., legs and chest), and (5) multiple regions within the same subject (e.g., left and right legs and left and right sides of the chest). The observed results were initially unexpected, as typical treatments for stretch marks are performed in a top-down fashion through the top layers of skin, avoiding damage to the innermost layer of the dermis. The fact that these benefits have now been seen in multiple subjects, locations, and genders supports the belief that the presently disclosed method for subcutaneously abrading the inner surface of the dermis may provide an effective treatment for stretch marks in subjects.

[0038] Various aspects of the disclosure may be used alone, in combination, or in various arrangements not specifically discussed in the previously described embodiments, and therefore are not limited in their detailed application and to the details and arrangements of components set forth in the foregoing description or illustrated in the drawings. For example, aspects described in one embodiment may be combined in any manner with aspects described in other embodiments.

[0039] The aspects described herein may be embodied as a method, an example of which is provided. The acts performed as part of the method may be ordered in any suitable manner. Thus, aspects may be constructed in which acts are performed in an order different from that shown, which may include performing some acts simultaneously despite being shown as sequential acts in the illustrated aspects.

[0040] Additionally, some actions are described as being performed by a "user." It should be understood that a "user" need not be a single individual, and that in some embodiments, actions attributed to a "user" may be performed by a team of individuals and / or an individual in combination with computer-assisted tools or other mechanisms.

[0041] The use of ordinal terms such as "first," "second," "third," etc. in the claims to modify claim elements does not, by itself, imply a priority, precedence, or order of one claim element relative to another claim element, or the temporal order in which acts of a method are performed, but is used solely to distinguish claim elements as a label to distinguish a particular named claim element from another element having the same name (but because of the use of ordinal terms).

[0042] Also, the phraseology and terminology used herein is for the purpose of description and should not be regarded as limiting. The use of "including," "comprising," "having," "containing," "involving," and variations thereof herein means the inclusion of the items listed thereafter and equivalents thereof, as well as additional items.

[0043] While the present teachings have been described in conjunction with various aspects and embodiments, it is not intended that the present teachings be limited to such aspects or embodiments. On the contrary, the present teachings encompass various alternatives, modifications, and equivalents, as will be apparent to those skilled in the art. Accordingly, the foregoing description and drawings are by way of example only.

Claims

1. 1. A subcutaneous abrasion device comprising: handle; an elongate shaft extending distally from the handle; and an abrasion surface disposed on a distal end portion of the elongate shaft; wherein the abrasive surface is configured to subcutaneously ablate an inner surface of the dermis of the subject without substantially cutting or puncturing the dermis of the subject. The subcutaneous abrasion device.

2. The subcutaneous abrasion device of claim 1 , wherein the inner surface of the dermis comprises a portion of the reticular layer of the subject's dermis.

3. The subcutaneous abrasion device of claim 1 , wherein the abrasion surface comprises one or more rasps.

4. The subcutaneous abrasion device of claim 1 , wherein the abrasion surface includes a head portion that is wider than the elongated shaft.

5. The subcutaneous ablation device of claim 1 , wherein the ablation surface includes a deployable head that deploys from a first, undeployed configuration to a second, deployed configuration.

6. The subcutaneous ablation device of claim 5 , wherein the deployable head is selectively deployable within the subject.

7. The subcutaneous ablation device of claim 1 , wherein the elongate shaft is configured to have an adjustable length.

8. The subcutaneous ablation device of claim 1 , wherein the elongate shaft is a telescopic elongate shaft.

9. The subcutaneous abrasion device of claim 1 , wherein at least the abrasion portion is configured to be inserted into an orifice of a subject.

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