LED Lip Perfector, model: ZC-05

K223642 · Light Tree Ventures Europe B.V. · ILY · Mar 9, 2023 · Physical Medicine

Device Facts

• Record ID: K223642
• Device Name: LED Lip Perfector, model: ZC-05
• Applicant: Light Tree Ventures Europe B.V.
• Product Code: ILY · Physical Medicine
• Decision Date: Mar 9, 2023
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 890.5500
• Device Class: Class 2
• Attributes: Therapeutic

Indications for Use

The LED Lip Perfector (Model: ZC-05) is an Over-the-Counter (OTC) device intended to treat fine lines and wrinkles and increase in circulation within the perioral region.

Device Story

Hand-held LED device; treats perioral fine lines/wrinkles; increases local circulation. Emits light at 605nm, 630nm, 660nm, and 850nm wavelengths via 56 LEDs. Powered by 3.7V lithium battery. User applies device directly to perioral skin for 3-minute treatment sessions. Single-button operation (on/off). Intended for OTC home use. Consistent light administration achieved through direct skin contact. Benefits include non-invasive cosmetic improvement of perioral skin appearance.

Clinical Evidence

Bench testing only. No clinical data provided. Safety and performance verified via compliance with IEC 60601-1, IEC 60601-1-11, IEC 60601-2-57, IEC 60601-1-2, IEC 60601-1-6, IEC 62133-2, ISO 10993-5, and ISO 10993-10.

Technological Characteristics

Hand-held LED device; 56 LEDs (605nm, 630nm, 660nm, 850nm); 3.7V lithium battery power source; 24 cm2 treatment area; 67.7 mW/cm2 energy level. Biocompatibility per ISO 10993-5 and ISO 10993-10. Electrical safety per IEC 60601 series. No software algorithm described.

Indications for Use

Indicated for OTC treatment of fine lines and wrinkles and increasing circulation in the perioral region.

Regulatory Classification

Identification

An infrared lamp is a device intended for medical purposes that emits energy at infrared frequencies (approximately 700 nanometers to 50,000 nanometers) to provide topical heating.

Special Controls

*Classification.* Class II (special controls). The device, when it is an infrared therapeutic heating lamp, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 890.9.

Predicate Devices

• reVive Perioral LED Light Therapy System (K172662)

Submission Summary (Full Text)

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March 9, 2023

Light Tree Ventures Europe B.V. Alain Dijkstra Manager Laan van Ypenburg 108, 2497 GC, The Hague, The Netherlands Hague, Netherlands

Re: K223642

Trade/Device Name: LED Lip Perfector, model: ZC-05 Regulation Number: 21 CFR 878.4810 Regulation Name: Laser Surgical Instrument For Use In General And Plastic Surgery And In Dermatology Regulatory Class: Class II Product Code: OHS. ILY Dated: February 15, 2023 Received: February 15, 2023

Dear Alain Dijkstra:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal

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statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email ([e-mail]) or phone [phone] or 301-796-7100).

Sincerely,

Image /page/1/Picture/5 description: The image shows the name "Jianting Wang -S" in a large, clear font. The text is horizontally oriented and appears to be a title or heading. The font is simple and sans-serif, making it easy to read. The background is plain, which helps the text stand out.

Jianting Wang Acting Assistant Director DHT4A: Division of General Surgery Devices OHT4: Office of Surgical and Infection Control Devices Office of Product Evaluation and Ouality Center for Devices and Radiological Health

Enclosure

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# Indications for Use

510(k) Number (if known) K223642

Device Name LED Lip Perfector (Model: ZC-05)

Indications for Use (Describe)

The LED Lip Perfector (Model: ZC-05) is an Over-the-Counter (OTC) device intended to treat fines and wrinkles and increase in circulation within the perioral region.

| Type of Use (Select one or both, as applicable) | |
|-------------------------------------------------|--|
|-------------------------------------------------|--|

Prescription Use (Part 21 CFR 801 Subpart D)

X Over-The-Counter Use (21 CFR 801 Subpart C)

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### 510(k) Summary of K223642

This summary of 510(k) safety and effectiveness information is being submitted in accordance with the requirement of 21 CFR 807.92.

#### Date of the summary prepared: March 3, 2023 1.

#### Submitter's Information 2.

Sponsor Name: Light Tree Ventures Europe B.V. Establishment Registration Number: 3017422691 Address: Laan van Ypenburg 108, 2497 GC, The Hague, The Netherlands Contact Person (including title): Alain Dijkstra (Manager) Tel: [phone] Fax: [phone] E-mail: [e-mail]

### Distributor:

Company: CurrentBody.com Ltd Add: Unit D6, Stanley Green Business Park, Commercial Avenue, Cheadle Hulme,Cheshire, SK8 6QH

### Application Correspondent:

Contact Person: Alain Dijkstra Company: Light Tree Ventures Europe B.V. Address: Laan van Ypenburg 108, 2497 GC, The Hague, The Netherlands Tel: [phone] Fax: [phone] Email: [e-mail]

#### 3. Subject Device Information

Trade Name: LED Lip Perfector, model: ZC-05 Trademark: CurrentBody Skin™ Classification Name: Light Based Over-The-Counter Wrinkle Reduction Review Panel: General & Plastic Surgery Product Code: OHS, ILY Regulation Number: 21 CFR 878.4810 Regulation Class: II

#### 4. Predicate Device Information

Sponsor: LED Technologies, Inc. Trade Name: reVive Perioral LED Light Therapy System Classification Name: Light Based Over-The-Counter Wrinkle Reduction device 510(K) Number: K172662 Review Panel: General & Plastic Surgery Product Code: OHS, ILY Regulation Number: 21 CFR 878.4810 Regulation Class: II

#### 5. Device Description

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The LED Lip Perfector (Model: ZC-05) is an over-the-counter light-emitting diode (LED) device that emits energy for dermatology to treat fine lines and increase circulation within the perioral region. The device contains four types of LEDs: 605nm, 630nm, and 850nm The LED Lip Perfector components include the main device, charging base, power cord, alternative mouthpiece, user manual, and storage bag. There is only one button on the top edge of the main unit. Short press the power button to turn on the device, and long press the power button to turn off the device.

This device only has one treatment mode. The LED Lip Perfector is applied to the skin to ensure consistent light administration during each treatment. The device is sold Over the Counter (OTC).

#### Intended Use / Indications for Use 6.

The LED Lip Perfector (Model: ZC-05) is an Over-the-Counter (OTC) device intended to treat fine lines and wrinkles and increase in circulation within the perioral region.

#### Comparison to predicate device 7.

Compare with predicate device, the subject device is very similar in design principle, intended use, indications for use, functions, material and the applicable standards. The differences between subject device and predicate device do not raise and new questions of safety or effectiveness.

| Elements of<br>Comparison | Subject Device | Predicate Device | Remark |
|---------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------|
| Company | Light Tree Ventures Europe<br>B.V. | LED Technologies, Inc. | -- |
| Trade Name | LED Lip Perfector | reVive Perioral LED Light<br>Therapy System | -- |
| Model | ZC-05 | / | -- |
| Classification Name | Light Based Over-The-<br>Counter Wrinkle Reduction | Light Based Over-The-<br>Counter Wrinkle Reduction<br>device | -- |
| 510(k) Number | Applying | K172662 | -- |
| Product Code | OHS, ILY | OHS, ILY | Same |
| Intended Use /<br>Indications for Use | The LED Lip Perfector<br>(Model: ZC-05) is an Over-<br>the-Counter (OTC) device<br>intended to treat fine lines<br>and wrinkles and increase in<br>circulation within the perioral<br>region. | The reVive® Perioral LED<br>Light Therapy system is an<br>Over-the-Counter (OTC)<br>device intended for the<br>treatment fine lines and<br>wrinkles, and increase in<br>circulation within the perioral<br>region. | Same |
| Design | Hand-held device | Hand-held device | Same |
| Type of use | Over-The-Counter Use | Over-The-Counter Use | Same |
| Treatment Distance | Applied directly to the skin | Applied directly to the skin | Same |
| Treatment Sites | Perioral region | Perioral region | Same |

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| Change in energy (the<br>addition of battery) | Yes | Yes | Same |
|-----------------------------------------------|-------------------------------------------------------------------|-------------------------------------------------------------------|--------------------|
| Power Supply | 3.7V lithium battery | 3.7V lithium battery | Same |
| Treatment Range | 3 minutes per treatment | 3 minutes per treatment | Same |
| Wavelengths | 605nm, 630nm, 660nm,<br>850nm | 605nm, 630nm, 660nm,<br>880nm | Different,<br>Note |
| Location for USE | OTC | OTC | Same |
| Number of LEDs | Total 56 LEDs<br>605nm: 14<br>660nm: 14<br>630nm: 14<br>880nm: 14 | Total 56 LEDs<br>605nm: 14<br>660nm: 14<br>630nm: 14<br>880nm: 14 | Same |
| Energy Level | 67.7±10% mW/cm $2$ | 67.7 mW/cm $2$ | Same |
| Treatment Area | 24 cm $2$ | 24 cm $2$ | Different |
| Irradiance source | LED | LED | Same |
| Visible light LEDs | Yes | Yes | Same |
| EMC | IEC 60601-1-2 | IEC 60601-1-2 | Same |
| Biocompatibility | ISO 10993-5<br>ISO 10993-10 | ISO 10993-5<br>ISO 10993-10 | Same |

# Note:

Although the "Wavelengths" of subject device is a little different from the predicate device, they are both have a same intended use and the "Energy Level" is the same. So, the differences between the subject device and predicate device will not raise any safety or effectiveness issue.

#### 8. Test Summary

The LED Lip Perfector (Model: ZC-05) has been evaluated the safety and performance by lab bench testing as following:

| Standards<br>No. | Standard Title | Version | Date | Recognition<br>Number | Location |
|--------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------|------------|-----------------------|-----------------|
| IEC 60601-1 | Medical electrical<br>equipment - Part 1:<br>General requirements for<br>basic safety and essential<br>performance | 2005/AMD1:2012,<br>IEC 60601-<br>1:2005/AMD2:2020 | / | / | Attachment<br>9 |
| IEC 60601-<br>1-11 | Medical electrical<br>equipment - Part 1-11:<br>General requirements for<br>basic safety and essential<br>performance - Collateral<br>Standard: Requirements for<br>medical electrical<br>equipment and medical<br>electrical systems used in<br>the home healthcare<br>environment | Edition 2.1 2020-<br>07 | 12/21/2020 | 19-38 | Attachment<br>9 |
| IEC 60601-<br>2-57 | Medical Electrical<br>Equipment - Part 2-57:<br>Particular requirements for<br>the basic safety and<br>essential performance of<br>non-laser light source<br>equipment intended for<br>therapeutic, diagnostic,<br>monitoring and<br>cosmetic/aesthetic use | Edition 1.0 2011-<br>01 | 03/16/2012 | 12-242 | Attachment<br>9 |
| IEC 60601-<br>1-2 | Medical Electrical<br>Equipment - Part 1-2:<br>General Requirements For<br>Basic Safety And Essential<br>Performance - Collateral<br>Standard: Electromagnetic<br>Disturbances --<br>Requirements And Tests | 60601-1-2 Edition<br>4.1 2020-09 | 12/21/2020 | 19-36 | Attachment<br>9 |
| IEC 60601-<br>1-6 | Medical electrical<br>equipment - Part 1-6:<br>General requirements for<br>basic safety and essential<br>performance - Collateral<br>standard: Usability | Edition 3.2 2020-<br>07 | 12/21/2020 | 5-132 | Attachment<br>9 |
| IEC 62133-2 | Secondary cells and<br>batteries containing<br>alkaline or other non-acid<br>electrolytes - Safety<br>requirements for portable<br>sealed secondary cells,<br>and for batteries made from<br>them, for use in portable<br>applications - Part 2:<br>Lithium systems | Edition 1.0 2017-<br>02 | 12/23/2019 | 19-33 | Attachment<br>9 |
| ISO 10993-<br>5 | Biological evaluation of<br>medical devices - Part 5:<br>Tests for in vitro cytotoxicity | Third edition | 2009-06-01 | 2-245 | / |
| ISO 10993-<br>10 | Biological evaluation of<br>medical devices - Part 10:<br>Tests for irritation and skin<br>sensitization | Third Edition | 2010-08-01 | 2-174 | / |

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# 9. Final Conclusion

The subject device is as safe, as effective, and performs as well as the legally marketed predicated devices K172662.