A Laser That Sees Skin Cancer Before Your Doctor Can—Without a Biopsy

Researchers at UC Irvine have created a groundbreaking device that uses infrared laser technology to detect melanoma at the cellular level without requiring a skin biopsy. The innovation, called the fast, large-area, multiphoton exoscope (FLAME), scans beneath the skin surface in 10 to 15 minutes and can help doctors monitor how well immunotherapy treatments are working for patients with advanced melanoma. This represents a significant shift in how dermatologists might approach skin cancer detection and treatment monitoring in the coming years.

How Does This Laser Technology Actually Work?

The FLAME device uses a low-power infrared laser to excite molecules beneath the skin, creating detailed images of cells and fibers without cutting into the skin. A small metal ring is taped to the patient's skin to keep it stable during the scan. The laser essentially allows doctors to see what's happening under the skin surface in real time, revealing the microscopic changes that signal melanoma or other skin conditions. The team at UC Irvine, led by associate professor Mihaela Balu, is working to reduce scan time from the current 10 to 15 minutes down to just 5 minutes.

What makes this approach particularly valuable is that it eliminates the need for a traditional biopsy—a procedure where doctors remove a small piece of skin tissue for laboratory analysis. For patients, this means less invasive testing and faster results.

Why This Matters for Melanoma Treatment and Monitoring?

Beyond early detection, the FLAME device offers something equally important: the ability to track how well immunotherapy treatments are working at the cellular level. Immunotherapy drugs work by helping the immune system recognize and attack cancer cells, but doctors currently have limited ways to see whether treatment is actually working until weeks or months have passed. With this laser technology, physicians can monitor treatment response in real time and adjust therapy plans accordingly.

"We're tracking the response at a cellular level to see when treatment is working or not," explains Mihaela Balu, the physicist and engineer leading the research. "That allows us to give feedback so therapies can be tailored to each individual." This personalized approach could mean patients make fewer trips to the doctor while receiving more targeted, effective care.

What's Behind This Innovation?

The development of the FLAME device didn't happen in isolation. Balu's team represents a rare combination of expertise that brings the technology to life:

• Interdisciplinary Team: The research group includes two physicists, a biologist, a chemist, and a biomedical engineer, bringing diverse perspectives to problem-solving.
• Federal Funding Support: The project has received multiple grants from the National Institutes of Health (NIH) and the Department of Defense, which recognizes the importance of protecting soldiers exposed to sun in the field.
• Clinical Integration: Unlike many research labs, this team operates directly within a clinical setting, allowing them to test devices on patients and immediately identify improvements needed.

Balu emphasizes that federal funding has been essential to attracting and retaining top talent. "Those grants give us the ability to attract the best talent, and it's important to have talented, passionate, dedicated people driving the research," she notes. Private industry can often offer higher salaries, making it challenging for academic research to compete without stable, long-term funding.

What Happens Next?

The FLAME device is currently in clinical trials, representing a critical phase where researchers test whether the technology works as intended in real-world patient care. This year, Balu's team is moving into new dedicated research space on the recently completed UC Irvine Health—Irvine campus, with two full research rooms designed specifically for this work. This expansion reflects the growing importance of the project and the institution's commitment to advancing melanoma detection and treatment monitoring.

For patients with melanoma, particularly those receiving immunotherapy for advanced disease, this technology could eventually mean earlier detection of treatment success or failure, leading to faster adjustments in care. For the broader field of dermatology, it represents a shift toward non-invasive, real-time monitoring that could transform how skin cancers are diagnosed and managed.