0001140361-21-037603 | 10-Q | XBRL Viewer

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Document and Entity Information - shares	9 Months Ended
Document and Entity Information - shares	Sep. 30, 2021	Nov. 04, 2021
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2021
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2021
Document Fiscal Period Focus	Q3
Document Transition Report	false
Entity File Number	0-51481
Entity Registrant Name	STRATA SKIN SCIENCES, INC.
Entity Central Index Key	0001051514
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	13-3986004
Entity Address, Address Line One	5 Walnut Grove Drive
Entity Address, Address Line Two	Suite 140
Entity Address, City or Town	Horsham
Entity Address, State or Province	PA
Entity Address, Postal Zip Code	19044
City Area Code	215
Local Phone Number	619-3200
Title of 12(b) Security	Common Stock, $0.001 par value per share
Trading Symbol	SSKN
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		34,364,679

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Current assets:
Cash and cash equivalents	$ 13,047	$ 10,604
Restricted cash	0	7,508
Accounts receivable, net of allowance for doubtful accounts of $248 and $274, respectively	3,151	2,944
Inventories	3,225	3,444
Prepaid expenses and other current assets	623	331
Total current assets	20,046	24,831
Property and equipment, net	6,403	5,529
Operating lease right-of-use assets, net	727	988
Intangible assets, net	10,546	6,345
Goodwill	8,803	8,803
Other assets	233	282
Total assets	46,758	46,778
Current liabilities:
Note payable	0	7,275
Current portion of long-term debt	0	1,478
Accounts payable	2,480	2,764
Other accrued liabilities	5,548	4,690
Current portion of operating lease liabilities	359	369
Deferred revenues	3,767	2,262
Total current liabilities	12,154	18,838
Long-term liabilities:
Long-term debt, net	7,282	1,050
Deferred tax liability	266	254
Long-term operating lease liabilities, net	445	710
Other liabilities	428	34
Total liabilities	20,575	20,886
Commitments and contingencies (see Note 15)
Stockholders' equity:
Series C Convertible Preferred Stock, $0.10 par value, 10,000,000 shares authorized; 0 shares issued and outstanding at September 30, 2021 and, December 31, 2020	0	0
Common Stock, $0.001 par value, 150,000,000 shares authorized; 34,364,679, and 33,801,045 shares issued and outstanding at September 30, 2021 and December 31, 2020, respectively	34	34
Additional paid-in capital	246,979	244,831
Accumulated deficit	(220,830)	(218,973)
Total stockholders' equity	26,183	25,892
Total liabilities and stockholders' equity	$ 46,758	$ 46,778

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Current assets:
Allowance for doubtful accounts	$ 248	$ 274
Stockholders' equity:
Series C Convertible Preferred Stock, par value (in dollars per share)	$ 0.10	$ 0.10
Series C Convertible Preferred Stock, shares authorized (in shares)	10,000,000	10,000,000
Series C Convertible Preferred Stock, shares issued (in shares)	0	0
Series C Convertible Preferred Stock, shares outstanding (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	150,000,000	150,000,000
Common stock shares issued on exercise of options (in shares)	34,364,679	33,801,045
Common stock, shares outstanding (in shares)	34,364,679	33,801,045

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Revenues, net	$ 7,711	$ 5,613	$ 20,920	$ 16,373
Cost of revenues	2,335	2,383	7,070	6,780
Gross profit	5,376	3,230	13,850	9,593
Operating expenses:
Engineering and product development	371	411	1,158	950
Selling and marketing	3,295	2,051	9,387	6,446
General and administrative	2,175	1,929	7,085	5,921
Total operating expenses	5,841	4,391	17,630	13,317
Income (loss) from operations	(465)	(1,161)	(3,780)	(3,724)
Other income (expense), net:
Gain on forgiveness of debt			2,028	0
Interest expense, net	(52)	(21)	(93)	(38)
Other (expense) income, net			1,935	(38)
Income (loss) before income taxes	(517)	(1,182)	(1,845)	(3,762)
Income tax expense	(4)	(72)	(12)	(207)
Net loss	$ (521)	$ (1,254)	(1,857)	(3,969)
Common Shares [Member]
Other income (expense), net:
Net loss			$ (1,857)	$ (3,947)
Loss per share - basic (in dollars per share)	$ (0.02)	$ (0.04)	$ (0.05)	$ (0.12)
Loss per share - diluted (in dollars per share)	$ (0.02)	$ (0.04)	$ (0.05)	$ (0.12)
Weighted average shares outstanding - basic (in shares)	34,150,438	33,754,909	33,944,321	33,551,070
Weighted average shares outstanding - diluted (in shares)	34,150,438	33,754,909	33,944,321	33,551,070
Preferred Series C Shares [Member]
Other income (expense), net:
Net loss			$ 0	$ (22)
Loss per share - basic (in dollars per share)			$ 0	$ (43.73)
Loss per share - diluted (in dollars per share)			$ 0	$ (43.73)
Weighted average shares outstanding - basic (in shares)			0	491
Weighted average shares outstanding - diluted (in shares)			0	491

CONDENSED CONSOLIDATED STATEMENT OF CHANGES IN STOCKHOLDERS' EQUITY - USD ($) $ in Thousands	Preferred Stock [Member] Convertible Preferred Stock - Series C [Member]	Common Stock [Member]	Additional Paid-In Capital [Member]	Accumulated Deficit [Member]	Total	Convertible Preferred Stock - Series C [Member]
Beginning balance at Dec. 31, 2019	$ 1	$ 33	$ 243,180	$ (214,561)	$ 28,653
Beginning balance (in shares) at Dec. 31, 2019	2,103	32,932,273
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Stock-based compensation	$ 0	$ 0	430	0	430
Conversion of convertible preferred stock into common stock	$ (1)	$ 1	0	0	0
Conversion of convertible preferred stock into common stock (in shares)	(2,103)	782,089
Net loss	$ 0	$ 0	0	(1,035)	(1,035)
Ending balance at Mar. 31, 2020	$ 0	$ 34	243,610	(215,596)	28,048
Ending balance (in shares) at Mar. 31, 2020	0	33,714,362
Beginning balance at Dec. 31, 2019	$ 1	$ 33	243,180	(214,561)	28,653
Beginning balance (in shares) at Dec. 31, 2019	2,103	32,932,273
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net loss					(3,969)	$ (22)
Ending balance at Sep. 30, 2020	$ 0	$ 34	244,423	(218,530)	25,927
Ending balance (in shares) at Sep. 30, 2020	0	33,754,909
Beginning balance at Mar. 31, 2020	$ 0	$ 34	243,610	(215,596)	28,048
Beginning balance (in shares) at Mar. 31, 2020	0	33,714,362
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Stock-based compensation	$ 0	$ 0	410	0	410
Issuance of restricted stock	$ 0	$ 0	0	0	0
Issuance of restricted stock (in shares)	0	40,547
Net loss	$ 0	$ 0	0	(1,680)	(1,680)
Ending balance at Jun. 30, 2020	$ 0	$ 34	244,020	(217,276)	26,778
Ending balance (in shares) at Jun. 30, 2020	0	33,754,909
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Stock-based compensation	$ 0	$ 0	403	0	403
Net loss	0	0	0	(1,254)	(1,254)
Ending balance at Sep. 30, 2020	$ 0	$ 34	244,423	(218,530)	25,927
Ending balance (in shares) at Sep. 30, 2020	0	33,754,909
Beginning balance at Dec. 31, 2020		$ 34	244,831	(218,973)	25,892
Beginning balance (in shares) at Dec. 31, 2020		33,801,045
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Stock-based compensation		$ 0	662	0	662
Issuance of restricted stock		$ 0	0	0	0
Issuance of restricted stock (in shares)		16,260
Net loss		$ 0	0	(2,418)	(2,418)
Ending balance at Mar. 31, 2021		$ 34	245,493	(221,391)	24,136
Ending balance (in shares) at Mar. 31, 2021		33,817,305
Beginning balance at Dec. 31, 2020		$ 34	244,831	(218,973)	25,892
Beginning balance (in shares) at Dec. 31, 2020		33,801,045
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net loss					(1,857)	$ 0
Ending balance at Sep. 30, 2021		$ 34	246,979	(220,830)	26,183
Ending balance (in shares) at Sep. 30, 2021		34,364,679
Beginning balance at Mar. 31, 2021		$ 34	245,493	(221,391)	24,136
Beginning balance (in shares) at Mar. 31, 2021		33,817,305
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Stock-based compensation		$ 0	581		581
Issuance of restricted stock		$ 0	0		0
Issuance of restricted stock (in shares)		71,934
Net loss		$ 0	0	1,082	1,082
Ending balance at Jun. 30, 2021		$ 34	246,074	(220,309)	25,799
Ending balance (in shares) at Jun. 30, 2021		33,889,239
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Stock-based compensation		$ 0	320	0	320
Exercise of stock options		$ 0	0	0	0
Exercise of stock options (in shares)		329,076
Issuance of restricted stock		$ 0	0	0	0
Issuance of restricted stock (in shares)		146,364
Issuance of warrants		$ 0	585	0	585
Issuance of warrants (in shares)		0
Net loss				(521)	(521)
Ending balance at Sep. 30, 2021		$ 34	$ 246,979	$ (220,830)	$ 26,183
Ending balance (in shares) at Sep. 30, 2021		34,364,679

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Cash Flows From Operating Activities:
Net loss	$ (1,857)	$ (3,969)
Adjustments to reconcile net loss to net cash provided by operating activities:
Depreciation and amortization	2,689	2,793
Amortization of right-of-use asset	261	242
Provision (recoveries) for doubtful accounts	(26)	65
Stock-based compensation	1,563	1,243
Loss on disposal of property and equipment	73	23
Gain on forgiveness of debt	(2,028)	0
Deferred taxes	12	207
Changes in operating assets and liabilities:
Accounts receivable	(181)	1,811
Inventories	219	(475)
Prepaid expenses and other assets	(243)	98
Accounts payable	(284)	1,608
Other accrued liabilities	859	(576)
Other liabilities	(88)	(126)
Operating lease liabilities	(275)	(226)
Deferred revenues	145	(968)
Net cash provided by operating activities	839	1,750
Cash Flows From Investing Activities:
Purchase of property and equipment	(2,523)	(1,447)
Cash paid in connection with Ra Medical asset acquisition	(3,473)	0
Net cash used in investing activities	(5,996)	(1,447)
Cash Flows From Financing Activities
Proceeds from Senior Term Facility borrowings, net of fees	7,867	0
Repayment of note payable	(7,275)	0
Proceeds from (repayment of) long-term debt	(500)	2,528
Net cash provided by financing activities	92	2,528
Net (decrease) increase in cash and cash equivalents and restricted cash	(5,065)	2,831
Cash, cash equivalents and restricted cash, beginning of period	18,112	15,629
Cash, cash equivalents and restricted cash, end of period	13,047	18,460
Cash and cash equivalents	13,047	11,063
Restricted cash	0	7,397
Supplemental information of cash and non-cash transactions:
Cash paid for interest	109	157
Fair value of warrants issued in connection with debt	585	0
Assumed deferred revenue in connection with Ra Medical asset acquisition	$ 1,841	$ 0

The Company

9 Months Ended

Sep. 30, 2021

The Company [Abstract]

The Company

Note 1

The Company:

Background

STRATA Skin Sciences (the “Company”) is a medical technology company in dermatology dedicated to developing, commercializing and marketing innovative products for the treatment of dermatologic conditions. Its products include the XTRAC® and Pharos® excimer lasers and VTRAC® lamp systems utilized in the treatment of psoriasis, vitiligo and various other skin conditions.

The XTRAC is an ultraviolet light excimer laser system utilized to treat psoriasis, vitiligo and other skin diseases. The XTRAC excimer laser system received clearance from the United States Food and Drug Administration (the “FDA”) in 2000. As of September 30, 2021, there were 880 XTRAC systems placed in dermatologists' offices in the United States and 49 systems internationally under the Company's recurring revenue business model. The XTRAC systems deployed under the recurring revenue model generate revenue on a per procedure basis or include a fixed payment over an agreed upon period with a capped number of treatments, which if exceeded would incur additional fees. The per-procedure charge is inclusive of the use of the system and the services provided by the Company to the customer, which includes system maintenance and other services. The VTRAC Excimer Lamp system, offered in addition to the XTRAC system internationally, provides targeted therapeutic efficacy demonstrated by excimer technology with a lamp system.

In September 2020, the Company signed a direct distribution agreement with its Japanese distributor for a combination of direct capital sales and recurring revenue for the country of Japan.

In February 2021, the Company signed an agreement with its Chinese distributor for a combination of direct capital sales and recurring revenues for the country of China.

In the first quarter of 2021, the Company introduced its Home by XTRAC™ business on a pilot test basis, by leveraging in-house resources including DTC advertising, in-house call center and its insurance reimbursement team to provide an at-home, insurance-reimbursed treatment option for patients with certain skin diseases that do not qualify for in-office treatments. The Company has discontinued the pilot program and is evaluating this potential business opportunity.

In late 2019, there was an outbreak of a new strain of coronavirus (“COVID-19”) which became a global pandemic. The COVID-19 pandemic has negatively impacted the global economy, disrupted global supply chains, constrained work force participation and created significant volatility and disruption of financial markets. In addition, the pandemic lead to the suspension of elective procedures in the U.S. and to the temporary closure of many physician practices which are our primary customers. The Company does not know the extent of the impact on its customers, including their potential for permanent closure. While many offices have reopened, the ongoing impact of the COVID-19 pandemic and its variants on the Company’s operational and financial performance, including its ability to execute its business strategies and initiatives in the expected time frames will depend on future developments, including the duration and ongoing spread of the COVID-19 outbreak and its variants, continued or renewed restrictions on business operations and transport, any governmental and societal responses thereto, including legislative or regulatory changes as well as the distribution and effectiveness of COVID-19 vaccines and the continued impact on worldwide economic and geopolitical conditions, all of which are uncertain and cannot be predicted.

Domestically, as the procedures for which the Company’s devices are used are elective in nature; and as social distancing, travel restrictions, quarantines and other restrictions became prevalent in the United States, this had a negative impact on the Company’s recurring revenue model and its financial position and cash flow. The virus has disrupted the supply chain from China and other countries which the Company depends upon to provide a steady source of components to manufacture and repair our devices. To mitigate the impact of COVID-19 the Company took a variety of measures to ensure the availability and functioning of its critical infrastructure by implementing business continuity plans. To promote the safety and security of its employees, while complying with various government mandates including work-from-home arrangements and social-distancing initiatives to reduce the transmission of COVID-19, the Company provided face masks for employees at facilities significantly impacted and required masks and on-site body temperature monitoring before entering facilities. In addition, the Company created and executed programs utilizing its direct to consumer advertising and call center to contact patients and partner clinics to restart the Company’s partners’ businesses. In October 2021, the Company implemented a policy whereby all Company employees are required to be vaccinated or complete weekly COVID-19 testing. To conserve its cash in order to mitigate the ongoing impact of the COVID-19 pandemic, in the second quarter of 2020 the Company furloughed employees, who returned to work after the Company received proceeds from the PPP Loan. The Company also reduced discretionary spending in 2020. See Note 2, Liquidity for discussion on Company liquidity.

Supply chain disruptions which began during the pandemic have continued and may continue for the foreseeable future. While the Company’s operations have not been materially impacted by the general trends in supply chain problems, the Company continues to monitor and assess potential risks.

Basis of Presentation:

Principles of Consolidation

The condensed consolidated financial statements include the accounts of the Company and its wholly-owned, inactive subsidiary in India. All significant intercompany balances and transactions have been eliminated in consolidation.

Unaudited Interim Condensed Consolidated Financial Statements

The accompanying unaudited interim condensed consolidated financial statements have been prepared pursuant to the rules and regulations of the United States Securities and Exchange Commission ("SEC") for interim financial reporting. These condensed consolidated statements are unaudited and, in the opinion of management, include all adjustments (consisting of normal recurring adjustments and accruals) necessary to fairly present the results of the interim periods. The condensed consolidated balance sheet at December 31, 2020, has been derived from the audited consolidated financial statements at that date. Operating results and cash flows for the nine months ended September 30, 2021 are not necessarily indicative of the results that may be expected for the fiscal year ending December 31, 2021 or any other future period. Certain information and footnote disclosures normally included in annual financial statements prepared in accordance with accounting principles generally accepted in the United States of America (U.S. GAAP) have been omitted in accordance with the rules and regulations for interim reporting of the SEC. These interim condensed consolidated financial statements should be read in conjunction with the consolidated financial statements and notes thereto included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2020 (the “2020 Form 10-K”), and other forms filed with the SEC from time to time. Dollar amounts included herein are in thousands, except share, per share data and number of lasers.

Reclassifications

Certain reclassifications from the prior year presentation have been made to conform to the current year presentation. These reclassifications did not have a material impact on the Company’s equity, results of operations, or cash flows.

Significant Accounting Policies

The significant accounting policies used in preparation of these condensed consolidated financial statements are disclosed in the Company’s Annual Report on Form 10-K for the year ended December 31, 2020, and there have been no changes to the Company’s significant accounting policies during the nine months ended September 30, 2021.

Use of Estimates

The preparation of the condensed consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect amounts reported of assets and liabilities at the date of the financial statements and the reported amount of revenues and expenses during the reporting periods. Actual results could differ from those estimates and be based on events different from those assumptions. As of September 30, 2021, the more significant estimates include (1) revenue recognition, in regards to deferred revenues and the contract term and valuation allowances of accounts receivable, (2) the inputs used in the impairment analysis of goodwill, (3) the estimated useful lives of intangible assets and property and equipment, (4) the inputs used in determining the fair value of equity-based awards, (5) the valuation allowance related to deferred tax assets, (6) the inventory reserves, (7) state sales and use tax accruals and (8) warranty claims.

Additionally, the full impact of the ongoing COVID-19 outbreak is unknown and cannot be reasonably estimated. However, management has made appropriate accounting estimates on certain accounting matters, which include the allowance for doubtful accounts, inventory valuation, carrying value of the goodwill and other long-lived assets, based on the facts and circumstances available as of the reporting date. The Company’s future assessment of the magnitude and duration of the ongoing COVID-19 outbreak, as well as other factors, could result in material impacts to the Company’s financial statements in future reporting periods.

Fair Value Measurements

The Company measures and discloses fair value in accordance with Financial Accounting Standards Board (“FASB”) Accounting Standards Codification 820, Fair Value Measurements and Disclosures (“ASC Topic 820”). ASC Topic 820 defines fair value, establishes a framework and gives guidance regarding the methods used for measuring fair value, and expands disclosures about fair value measurements. Fair value is an exit price, representing the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date. As such, fair value is a market-based measurement that should be determined based on assumptions that market participants would use in pricing an asset or liability. As a basis for considering such assumptions there exists a three-tier fair value hierarchy which prioritizes the inputs used in measuring fair value as follows:

	•	Level 1 – unadjusted quoted prices are available in active markets for identical assets or liabilities that the Company has the ability to access as of the measurement date.
	•	Level 2 – pricing inputs are other than quoted prices in active markets that are directly observable for the asset or liability or indirectly observable through corroboration with observable market data.
	•	Level 3 – pricing inputs are unobservable for the non-financial asset or liability and only used when there is little, if any, market activity for the non-financial asset or liability at the measurement date. The inputs into the determination of fair value require significant management judgment or estimation. Fair value is determined using comparable market transactions and other valuation methodologies, adjusted as appropriate for liquidity, credit, market and/or other risk factors.

This hierarchy requires the Company to use observable market data, when available, and to minimize the use of unobservable inputs when determining fair value.

The fair value of cash and cash equivalents and restricted cash are based on their respective demand value, which are equal to the carrying value. The carrying value of all short-term monetary assets and liabilities is estimated to be approximate to their fair value due to the short-term nature of these instruments. As of September 30, 2021 and December 31, 2020, the carrying value of the note payable and the Company’s long term debt are estimated to approximate fair value.

Earnings Per Share

The Company calculates earnings (loss) per common share and Preferred Series C share in accordance with ASC 260, Earnings per Share. Under ASC 260, basic loss per common share and Preferred Series C share is calculated by dividing the loss attributable to common shares and Preferred Series C shares by the weighted-average number of common shares and Preferred Series C shares outstanding during the reporting period and excludes dilution for potentially dilutive securities. Diluted loss per common share and Preferred Series C share gives effect to dilutive options, warrants and other potential common shares outstanding during the period.

No shares of the Company’s Series C Convertible Preferred Stock were outstanding as of September 30, 2021 and 2020. These shares were subordinate to all other securities at the same subordination level as common stock and they participated in all dividends and distributions declared or paid with respect to common stock of the Company, on an as-converted basis. Therefore, the Series C Convertible Preferred Shares met the definition of common stock under ASC 260. Earnings per share is presented for each class of security meeting the definition of common stock. The loss is allocated to each class of security meeting the definition of common stock based on their contractual terms.

The Company considered its Series C Convertible Preferred Stock to be participating securities in the presentation of earnings (loss) per share. For the three and nine months ended September 30, 2021 and the three and nine months ended September 30, 2020, diluted loss per common share and Series C Convertible Preferred Stock share is equal to the basic loss per common share and Series C Convertible Preferred Stock share, respectively, since all potentially dilutive securities were anti-dilutive.

The following table sets forth the potentially dilutive securities outstanding as of September 30, 2021 and 2020 that have been excluded from the loss per share calculation as their inclusion would have been anti-dilutive:

	September 30,
	2021		2020
Common stock purchase warrants		373,626		149,901
Restricted stock units		144,497		119,330
Common stock options		3,963,889		4,908,038
Total		4,482,012		5,177,269

Accounting Pronouncements Recently Adopted

In December 2019, the FASB issued ASU No. 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes. ASU 2019-12 eliminated certain exceptions and changed guidance on other matters. The exceptions relate to the allocation of income taxes in separate company financial statements, tax accounting for equity method investments and accounting for income taxes when the interim period year-to-date loss exceeds the anticipated full year loss. Changes relate to the accounting for franchise taxes that are income-based and non-income-based, determining if a step up in tax basis is part of a business combination or if it is a separate transaction, when enacted tax law changes should be included in the annual effective tax rate computation, and the allocation of taxes in separate company financial statements to a legal entity that is not subject to income tax. The new standard is effective for fiscal years, and interim periods within those fiscal years, beginning after December 15, 2020, with early adoption permitted. The adoption of ASU No. 2019-12 on January 1, 2021 did not have a material effect on the Company’s condensed consolidated financial statements.

Recent Accounting Pronouncements Not Yet Adopted

In March 2020, the FASB issued ASU 2020-04, Reference Rate Reform (Topic 848) Facilitation of the Effects of Reference Rate Reform on Financial Statements. This pronouncement provides temporary optional expedients and exceptions for applying U.S. GAAP principles to contract modifications and hedging relationships to ease the financial reporting burdens of the expected market transition from LIBOR and other interbank offered rates to alternative reference rates. The guidance is effective upon issuance in March 2020, and will apply through December 31, 2022. The Company continues to evaluate the temporary expedients and options available under this guidance and the effects of these pronouncements, and as the Company does not have any hedging activities does not believe this will have a material effect on its condensed consolidated financial statements.

In August 2020, the FASB issued ASU 2020-06, Debt with Conversion and Other Options (Subtopic 470-20) and Derivative and Hedging – Contracts in Entity’s Own Equity (Subtopic 815-40); Accounting for Convertible Instruments and Contracts in an Entity’s own Equity. The pronouncement simplifies the accounting for certain financial instruments with characteristics of liabilities and equity, including convertible instruments and contracts on an entity's own equity. Specifically, the ASU "simplifies accounting for convertible instruments by removing major separation models required under current U.S. GAAP." In addition, the ASU "removes certain settlement conditions that are required for equity contracts to qualify for it" and "simplifies the diluted earnings per share (EPS) calculations in certain areas.” The guidance is effective beginning after December 15, 2023 and early adoption is permitted. The Company does not currently engage in contracts covered by this guidance and does not believe it will have a material effect on the Company’s condensed consolidated financial statements, but could in the future.

In May 2021, the FASB issued ASU 2021-04, Earnings per Share (Topic 260), Debt – Modifications and Extinguishments (Subtopic 470-50), Compensation – Stock Compensation (Topic 718), and Derivatives and Hedging – Contracts in Entity’s Own Equity (Subtopic 815-40): Issuer’s Accounting for Certain Modifications or Exchanges or Freestanding Equity-Classified Written Call Options. The pronouncement outlines how an entity should account for modifications made to equity-classified written call options, including stock options and warrants to purchase the entity’s own common stock. The guidance in the ASU requires an entity to treat a modification of an equity-classified written call option that does not cause the option to become liability-classified as an exchange of the original option for a new option. This guidance applies whether the modification is structured as an amendment to the terms and conditions of the equity-classified written call option or as termination of the original option and issuance of a new option. The guidance is effective prospectively for fiscal years beginning after December 15, 2021 and early adoption is permitted. The Company does not believe this will have a material effect on its condensed consolidated financial statements.

Liquidity	9 Months Ended
Liquidity	Sep. 30, 2021
Liquidity [Abstract]
Liquidity	Note 2 Liquidity The Company has been negatively impacted by the ongoing COVID-19 pandemic, has historically experienced recurring losses, has been dependent on raising capital from the sale of securities in order to continue to operate and refinanced its debt at a lower interest rate. During the COVID-19 pandemic, the Company received cash proceeds from the PPP loan, which was forgiven, and the EIDL loan (each as defined in Note 10 below) that was repaid at the time the senior credit facility entered into with MidCap Financial Trust in September 2021 (see Note 10). Additionally, in October 2021, the Company entered into an equity distribution agreement with an investment bank under which the Company may sell up to $11,000 of its common stock in registered “at-the-market” offerings (see Note 16). Management believes that the Company’s cash and cash equivalents, combined with the anticipated revenues from the sale or use of the Company’s products, will be sufficient to satisfy our working capital needs, capital asset purchases, outstanding commitments and other liquidity requirements associated with its existing operations through the next 12 months following the date of the issuance of these unaudited interim condensed consolidated financial statements. However, the negative impact of the ongoing COVID-19 outbreak on the financial markets and supply chain disruptions could interfere with the Company’s ability to access financing and on favorable terms.

Revenue Recognition

9 Months Ended

Sep. 30, 2021

Revenue Recognition [Abstract]

Revenue Recognition

Note 3

Revenue Recognition

In the Dermatology Recurring Procedures Segment the Company has two types of arrangements for its phototherapy treatment equipment as follows: (i) the Company places its lasers in a physician’s office at no charge to the physician, and generally charges the physician a fee for an agreed upon number of treatments; or (ii) the Company places its lasers in a physician’s office and charges the physician a fixed fee for a specified period of time not to exceed an agreed upon number of treatments; if that number is exceeded additional fees will have to be paid.

For the purposes of U.S. GAAP only, these two types of arrangements are treated under the guidance of ASC 842, Leases. While these arrangements are not contractually operating leases, since the Company sells the physician access codes in order to operate the treatment equipment, these arrangements are similar to operating leases for accounting purposes since the Company provides the customers limited rights to use the treatment equipment and the treatment equipment resides in the physician’s office and the Company may exercise the right to remove the equipment upon notice, under certain circumstances, while the physician controls the utility and output of such equipment during the term of the arrangement as it pertains to the use of access codes to treat the patients. For the lasers placed-in service under these arrangements, the terms of the domestic arrangements are generally 36 months with automatic one-year renewals and include a termination clause that can be affected at any time by either party with 30 to 60 day notice. Amounts paid are generally non-refundable. For the first type of arrangement, sales of access codes are considered variable treatment code payments and are recognized as revenue over the estimated usage period of the agreed upon number of treatments. For the second type of arrangement, customers purchase access codes and revenue is recognized ratably on a straight-line basis as the lasers are being used over the term period specified in the agreement. Variable treatment code payments that will be paid only if the customer exceeds the agreed upon number of treatments are recognized only when such treatments are being exceeded and used. Internationally, through its Korean, Japanese and, in 2021, Chinese distributors, the Company generally sells access codes for a fixed amount on a monthly basis to end-user customers and the terms are generally 48 months, with termination in the event of the customers’ failure to remit payments timely, and include a potential buy-out at the end of the term of the contract. Currently, this is the only foreign recurring revenue. Pre-paid amounts are recorded in deferred revenue and recognized as revenue over the lease term in the patterns described above. Under both methods, pricing is fixed with the customer.

With respect to lease and non-lease components, the Company adopted the practical expedient to account for the arrangement as a single lease component.

In the Dermatology Procedures Equipment segment, the Company sells its products internationally through distributors and domestically directly to physicians. For the product sales, the Company recognizes revenues when control of the promised products is transferred to either the Company's distributors or end-user customers, in an amount that reflects the consideration the Company expects to be entitled to in exchange for those products (the transaction price). Control transfers to the customer at a point in time. To indicate the transfer of control, the Company must have a present right to payment and legal title must have passed to the customer. The Company ships most of its products FOB shipping point, and as such, the Company primarily transfers control and records revenue upon shipment. From time to time the Company will grant certain customers, for example governmental customers, FOB destination terms, and the transfer of control for revenue recognition occurs upon receipt. The Company has elected to recognize the cost of freight and shipping activities as fulfillment costs. Amounts billed to customers for shipping and handling are included as part of the transaction price and recognized as revenue when control of the underlying goods are transferred to the customer. The related shipping and freight charges incurred by the Company are included in cost of revenues.

Remaining performance obligations related to ASC 606 represent the aggregate transaction price allocated to performance obligations with an original contract term greater than one year, which are fully or partially unsatisfied at the end of the period. Remaining performance obligations include the potential obligation to perform under extended warranties but excludes any equipment accounted for as leases. As of September 30, 2021, the aggregate amount of the transaction price allocated to remaining performance obligations was $1,549, and the Company expects to recognize $1,148 of the remaining performance obligations within one year and the balance over one to three years. At September 30, 2021, $1,506 of the $1,549 remaining performance obligations are comprised of the deferred revenue acquired in connection with the RA Medical asset acquisition. Contract assets primarily relate to the Company’s rights to consideration for work completed in relation to its services performed but not billed at the reporting date. The contract assets are transferred to receivables when the rights become unconditional. Currently, the Company does not have any contract assets which have not transferred to a receivable. Contract liabilities primarily relate to extended warranties where the Company has received payments, but has not yet satisfied the related performance obligations.

The allocations of the transaction price are based on the price of stand-alone warranty contracts sold in the ordinary course of business. The advance consideration received from customers for the warranty services is a contract liability that is recognized ratably over the warranty period. As of September 30, 2021, the $1,148 of short-term contract liabilities is presented as deferred revenues and the $401 of long-term contract liabilities is presented within Other Liabilities on the condensed consolidated balance sheet. For the three and nine months ended September 30, 2021 and 2020, the Company recognized $19 and $73, and $52 and $162 respectively, as revenue from amounts classified as contract liabilities (i.e. deferred revenues) as of December 31, 2020, and 2019.

With respect to contract acquisition costs, the Company applied the practical expedient and expenses these costs immediately.

The Company records co-pay reimbursements made to patients receiving laser treatments as a reduction of revenue. For the three and nine months ended September 30, 2021, and 2020, the Company recorded such reimbursements in the amounts of $199 and $542, and $160 and $414, respectively.

The following tables present the Company’s revenue disaggregated by geographical region for the three and nine months ended September 30, 2021 and 2020, respectively. Domestic refers to revenue from customers based in the United States, and substantially all foreign revenue is derived from sales to our distributors, primarily in Asia.

	Three Months Ended September 30, 2021
	Dermatology Recurring Procedures		Dermatology Procedures Equipment		TOTAL
Domestic	$	5,370	$	519	$	5,889
Foreign		340		1,482		1,822
Total	$	5,710	$	2,001	$	7,711

	Nine Months Ended September 30, 2021
	Dermatology Recurring Procedures		Dermatology Procedures Equipment		TOTAL
Domestic	$	14,923	$	1,113	$	16,036
Foreign		918		3,966		4,884
Total	$	15,841	$	5,079	$	20,920


	Three Months Ended September 30, 2020
	Dermatology Recurring Procedures		Dermatology Procedures Equipment		TOTAL
Domestic	$	3,690	$	261	$	3,951
Foreign		145		1,517		1,662
Total	$	3,835	$	1,778	$	5,613

	Nine Months Ended September 30, 2020
	Dermatology Recurring Procedures		Dermatology Procedures Equipment		TOTAL
Domestic	$	11,957	$	701	$	12,658
Foreign		375		3,340		3,715
Total	$	12,332	$	4,041	$	16,373

The following table summarizes the Company’s expected future undiscounted fixed treatment code payments from international recurring revenue customers as of September 30, 2021:

Remaining 2021	$	390
2022		1,556
2023		1,479
2024		1,076
2025		362
Thereafter		-
Total	$	4,863

- Definition

The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-URI http://asc.fasb.org/topic&trid=49130388

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 10
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130551-203045

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 13
-Subparagraph (b)(2)
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130556-203045

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 12
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130554-203045

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 9
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130550-203045

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 12
-Subparagraph (e)
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130554-203045

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 12
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130554-203045

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 12
-Subparagraph (d)
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130554-203045

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 15
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130558-203045

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 12
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130554-203045

+ Details

Acquisition of Pharos Assets and Liabilities

9 Months Ended

Sep. 30, 2021

Acquisition of Pharos Assets and Liabilities [Abstract]

Acquisition of Pharos Assets and Liabilities

Note 4

Acquisition of Pharos Assets and Liabilities

In August 2021, the Company acquired certain assets and liabilities related to the U.S. dermatology Pharos business from Ra Medical Systems, Inc. (“Ra Medical”). Ra Medical’s Pharos excimer laser system holds FDA clearance to treat chronic skin diseases, including psoriasis, vitiligo, atopic dermatitis and leukoderma. The acquisition of these assets and liabilities allows the Company to market its full business solutions to Ra Medical’s existing customer base comprised of 400 dermatology practices offering opportunities to increase its recurring revenue base and a pathway to gain additional placements for the Company’s XTRAC excimer laser system.

The purchase price of $3,700 was paid in cash at the time of acquisition. In addition, the Company assumed certain extended warranty service contracts associated with acquired laser system products. Concurrent with the purchase of the net assets, the Company and Ra Medical entered into a services agreement whereby Ra Medical will provide certain transitional services for the Company as it integrates the acquired assets into the Company. The Company determined this transaction represented an asset acquisition as substantially all of the value was in the acquired customer list intangible asset as defined by ASC 805, Business Combinations (“ASC 805”). The purchase price was allocated, on a relative fair basis, to the acquired inventory, customer lists and deferred revenue as follows (in thousands):

Consideration:
Cash payment	$	3,700
Transaction costs		57
Total consideration	$	3,757

Assets acquired:
Inventory	$	284
Customer lists		5,314
Total assets acquired	$	5,598

Liabilities assumed:
Deferred revenues - service contracts	$	1,841
Total liabilities assumed	$	1,841

Net assets acquired	$	3,757

The customer lists intangible asset is being amortized on a straight-line basis over a period of twelve years. As the transaction was accounted for as an asset acquisition, the Company allocated consideration paid to the inventory acquired and the deferred revenue assumed with the remaining consideration paid allocated to the customer lists intangible asset which also equal its estimated fair value. The intangible asset was valued using an excess earnings model. Significant assumptions used in the excess earnings model include estimated customer sales growth, customer attrition, and weighted average cost of capital of 3%, 5% and 17%, respectively.

Inventories

9 Months Ended

Sep. 30, 2021

Inventories [Abstract]

Inventories

Note 5

Inventories:

Inventories consist of:

	September 30, 2021		December 31, 2020
Raw materials and work-in-process	$	3,024	$	2,949
Finished goods		201		495
Total inventories	$	3,225	$	3,444

Work-in-process is immaterial, given the Company’s typically short manufacturing cycle, and therefore is disclosed in conjunction with raw materials.

Property and Equipment, net

9 Months Ended

Sep. 30, 2021

Property and Equipment, net [Abstract]

Property and Equipment, net

Note 6

Property and Equipment, net:

Property and equipment consist of:

	September 30, 2021			December 31, 2020
Lasers placed-in-service	$	25,190		$	22,942
Equipment, computer hardware and software		224			146
Furniture and fixtures		236			243
Leasehold improvements		43			43
		25,693			23,374
Accumulated depreciation and amortization		(19,290	)		(17,845	)
Property and equipment, net	$	6,403		$	5,529

Depreciation and related amortization expense was $575 and $1,576, and $454 and $1,535 for the three and nine months ended September 30, 2021, and 2020, respectively. During the nine months ended September 30, 2021, the Company recognized a $73 loss on the disposal of property and equipment with an original cost of $204 and accumulated depreciation of $131 at the time of disposal.

Intangible Assets, net

9 Months Ended

Sep. 30, 2021

Intangible Assets, net [Abstract]

Intangible Assets, net

Note 7

Intangible Assets, net:

Set forth below is a detailed listing of definite-lived intangible assets as of September 30, 2021:

	Balance		Accumulated Amortization			Intangible assets, net
Core technology	$	5,700	$	(3,562	)	$	2,138
Product technology		2,000		(2,000	)		-
Customer relationships		6,900		(4,313	)		2,587
Tradenames		1,500		(938	)		562
Pharos customer list		5,314		(55	)		5,259
	$	21,414	$	(10,868	)	$	10,546

The following table is a detailed listing of definite-lived intangible assets as of December 31, 2020:

	Balance		Accumulated Amortization			Intangible assets, net
Core technology	$	5,700	$	(3,135	)	$	2,565
Product technology		2,000		(2,000	)		-
Customer relationships		6,900		(3,795	)		3,105
Tradenames		1,500		(825	)		675
	$	16,100	$	(9,755	)	$	6,345

In August 2021, the Company acquired customer lists in connection with the Ra Medical asset acquisition with an estimated fair value of $5,314 at the time of acquisition (see Note 3).

Amortization expense was $408 and $1,113, and $353 and $1,258 for the three and nine months ended September 30, 2021, and 2020, respectively.

Definite-lived intangible assets are tested for impairment when events or changes in circumstances indicate that the carrying value of the asset group may not be recoverable. The Company recognizes an impairment loss when and to the extent that the recoverable amount of an asset group is less than its carrying value. There were no impairment charges for the nine months ended September 30, 2021.

Estimated amortization expense for the above amortizable intangible assets for future periods is as follows:

Remaining 2021	$	463
2022		1,853
2023		1,853
2024		1,853
2025		1,148
Thereafter		3,376
Total	$	10,546

Other Accrued Liabilities

9 Months Ended

Sep. 30, 2021

Other Accrued Liabilities [Abstract]

Other Accrued Liabilities

Note 8

Other Accrued Liabilities:

Other accrued liabilities consist of:

	September 30, 2021		December 31, 2020

Accrued warranty, current	$	54	$	87
Accrued compensation, including commissions and vacation		1,578		891
Accrued state sales, use and other taxes		3,152		3,105
Accrued professional fees and other accrued liabilities		764		607
Total other accrued liabilities	$	5,548	$	4,690

Accrued State Sales and Use Tax

In the ordinary course of business, the Company is, from time to time, subject to audits performed by state taxing authorities. These actions and proceedings are generally based on the position that the arrangements entered into by the Company are subject to sales and use tax rather than exempt from tax under applicable law. The Company uses estimates when accruing its sales and use tax liability. All of the Company’s tax positions are subject to audit. One state has assessed the Company, in two assessments, an aggregate amount of $1,484 for the period from March 2014 through February 2020, including penalties and interest. The Company has declined an informal offer to settle at a substantially lower amount, and the Company appealed in that jurisdiction’s administrative process of appeal.

In January 2021, the Company received notification that the administrative judge from the respective state had issued an opinion finding in favor of the Company that the sale of XTRAC treatment codes were not taxable as sales tax with respect to the first assessment. The jurisdiction has filed an appeal of the administrative law judge’s finding, and the appeal is in process.

A second jurisdiction has made an assessment of $720 from June 2015 through March 2018 plus interest of $171 through April 2020. The Company is also in that jurisdiction’s administrative process of appeal and the timing of the process has been impacted by the COVID-19 pandemic. If there is a determination that the true object of the Company’s recurring revenue model is not exempt from sales taxes and is not a prescription medicine or the Company does not have other defenses where the Company does not prevail, the Company may be subject to sales taxes in those particular states for previous years and in the future, plus potential interest and penalties.

The Company believes its state sales and use tax accruals have properly recognized such that if the Company’s arrangements with customers are deemed more likely than not that the Company would not be exempt from sales tax in a particular state are the basis for measurement of the state sales and use tax is calculated in accordance with ASC 405, Liabilities as a transaction tax. If and when the Company is successful in defending itself or in settling the sales tax obligation for a lesser amount, the reversal of this liability is to be recorded in the period the settlement is reached. However, the precise scope, timing and time period at issue, as well as the final outcome of any audit and actual settlement remains uncertain.

The Company records state sales tax collected and remitted for its customers on equipment sales on a net basis, excluded from revenue. The Company’s sales tax expense that is not presently being collected and remitted for the recurring revenue business is recorded in general and administrative expenses on the condensed consolidated statements of operations.

Accrued Warranty Costs

The Company offers a standard warranty on product sales generally for a one to two-year period, however, the Company has offered longer warranty periods, ranging from three to four years, in order to meet competition or meet customer demands. The Company provides for the estimated cost of the future warranty claims on the date the product is sold. Total accrued warranty is included in other accrued liabilities and other liabilities on the condensed consolidated balance sheets. The activity in the warranty accrual during the three and nine months ended September 30, 2021, and 2020, is summarized as follows:

	Three Months Ended, September 30,						Nine Months Ended, September 30,
	2021			2020			2021			2020
Accrual at beginning of period	$	98		$	139		$	113		$	232
Additions charged to warranty expense		11			37			52			46
Expiring warranties/claimed satisfied		(28	)		(41	)		(84	)		(143	)
Total		81			135			81			135
Less: current portion		(54	)		(107	)		(54	)		(107	)
Total long-term accrued warranty costs	$	27		$	28		$	27		$	28

Note Payable	9 Months Ended
Note Payable	Sep. 30, 2021
Note Payable [Abstract]
Note Payable	Note 9 Note Payable On December 30, 2020, the Company had renewed its $7,275 loan with a commercial bank pursuant to a one-year Fixed Rate – Term Promissory Note (the “Note”). The Company's obligations under the Note were secured by an Assignment and Pledge of Time Deposit, under which the Company had pledged to the commercial bank the proceeds of a time deposit account in the amount of the loan and recorded the time deposit and accrued interest as restricted cash on the balance sheet. The principal was due on December 30, 2021 with no penalties for prepayments. The interest rate is fixed at 1.40%. The secured time deposit had a fixed interest rate of 0.40%. On September 30, 2021, the Company repaid the Note with the proceeds from the Time Deposit.

Long-term Debt

9 Months Ended

Sep. 30, 2021

Long-term Debt [Abstract]

Long-term Debt

Note 10

Long-term Debt:

Senior Term Facility

On September 30 2021, the Company entered into a credit and security agreement with MidCap Financial Trust, also acting as the administrative agent, and the lenders identified therein (“Senior Term Facility”). The Senior Term Facility provides for an $8.0 million senior term loan that was drawn upon by the Company upon executing the agreement. On September 30, 2021, the Company also repaid the outstanding principal and interest for its Note Payable (Note 9) and the Economic Injury Disaster Loan. Borrowings under the Senior Term Facility bear interest at LIBOR (with a LIBOR floor rate of 0.50%) plus 7.50% and matures on September 1, 2026, unless terminated earlier. The Company is obligated to make monthly interest-only payments through September 30, 2024. From October 1, 2024 to the date of maturity, the Company will make 24 equal monthly principal payments plus interest and all borrowings are secured by substantially all of the Company’s assets.

The Company may voluntarily prepay the outstanding term loan, with such prepayment at least $5.0 million, at any time upon 30 days’ written notice. Upon prepayment, the Company will be required to pay a prepayment fee equal to (i) 4.00% of the outstanding principal prepaid or required to be prepaid (whichever is greater), if the prepayment is made within twelve months of September 30, 2021, (ii) 3.00% of the outstanding principal prepaid or required to be prepaid (whichever is greater), if the prepayment is made between twelve months and twenty-four months after September 30, 2021, (iii) 2.00% of the outstanding principal prepaid or required to be prepaid (whichever is greater), if the prepayment is made between twenty-four months and thirty-six months after September 30, 2021, or (iv) 1.00% of the outstanding principal prepaid or required to be prepaid (whichever is greater), if the prepayment is made after thirty-six months after September 30, 2021 and prior to the maturity date.

The Senior Term Facility contains certain customary representations and warranties, affirmative covenants and conditions. The Senior Term Facility also contains a number of negative covenants that subject the Company to certain exceptions and waivers and restrictions, as defined in the agreement. In addition, the Senior Term Facility contains a quarterly financial covenant that requires the Company to not have less than $24.0 million of net revenue for the trailing 12-month period as of September 30, 2021, with compliance measured on the last day of each fiscal quarter beginning on September 30, 2021. The minimum net revenue threshold will increase to $30.0 million by December 31, 2023. At September 30, 2021, the Company was in compliance with all financial and nonfinancial covenants within the Senior Term Facility. At December 31, 2021, the minimum net revenue threshold will be $25.0 million.

The Senior Term Facility contains customary indemnification obligations and customary events of default, including, among other things, (i) nonpayment, (ii) breach of warranty, (iii) nonperformance of covenants and obligations, (iv) default on other indebtedness, (v) judgments, (iv) change of control, (vii) bankruptcy and insolvency, (viii) impairment of security, (xi) regulatory matters, (xii) failure to remain a publicly traded company and (xiii) material adverse event. Where an event of default arises from certain bankruptcy events, the commitments shall automatically and immediately terminate and the principal of, and interest then outstanding on, all of the loans shall become immediately due and payable. Subject to certain notice requirements and other conditions, upon the occurrence of other events of default, including the occurrence of a condition having or reasonably likely to have a material adverse effect, commitments may be terminated and the principal of, and interest then outstanding on, all of the loans may become immediately due and payable. On September 30, 2021, no event of default had occurred and the Company believed that events or conditions having a material adverse effect, giving rise to an acceleration of any amounts outstanding under the Credit Agreement, had not occurred and was remote.

In connection with entering into the Senior Term Facility, the Company issued an affiliate of the lender a warrant to purchase 373,626 shares of the Company's common stock at an initial exercise price of $1.82 per share. The warrants are equity classified and are exercisable at any time on or prior to the tenth anniversary of their issue date. The estimated fair value of the warrants was $0.6 million and determined using the Black-Scholes option pricing model. The key assumptions used in the Black-Scholes option pricing model were (i) an expected term of ten years, (ii) expected volatility of 88.6%, (iii) a risk-free rate of 1.5% and (iv) no estimated dividend yield. In addition, the Company incurred third party costs and lender fees of $0.1 million. The proceeds were allocated on a basis that approximates the relative fair value method. The fair value of the warrants and fees incurred were recorded as a debt discount and are being recognized as interest expense over the life of the Senior Term Facility using the effective-interest method. No interest or amortization of debt discount was recognized during the three and nine months ended September 30, 2021 in connection with the Senior Term Facility.

Future minimum principal payments at September 30, 2021 are as follows (in thousands):

2024	$	1,000
2025		4,000
2026		3,000
Total	$	8,000

Paycheck Protection Program Loan

On April 22, 2020, the Company closed a loan of $2,028 (the “PPP loan”) from a commercial bank, pursuant to the Paycheck Protection Program (“PPP”) administered by the Small Business Administration (the “SBA”) pursuant to the CARES Act. The PPP loan would have matured on May 1, 2022 and bore an interest rate of 1% per annum. Payments of principal and interest of any unforgiven balance was scheduled to commence December 1, 2020, but was deferred until the SBA approved of the forgiveness amount. In the second quarter of 2021, the Company received notification that the PPP loan had been forgiven. In the second quarter, the Company recorded a gain on the forgiveness of debt in the amount of the loan of $2,028.

Economic Injury Disaster Loan

On May 22, 2020, the Company executed the standard loan documents required for securing a loan (the “EIDL Loan”) from the SBA under its Economic Injury Disaster Loan (“EIDL”) assistance program in light of the impact of the COVID-19 pandemic on the Company’s business. The principal amount of the EIDL Loan is up to $500, with proceeds to be used for working capital purposes and is collateralized by all the Company’s assets. On June 12, 2020, the Company received these funds from the SBA. Interest accrued at the rate of 3.75% per annum. Installment payments, including principal and interest, were originally due monthly beginning March 26, 2021 (twelve months from the date of the promissory note) in the amount of $2. In March 2021, the SBA deferred payments on the EIDL loans by an additional 12 months. The balance of principal and interest was payable over the next thirty years from the date of the promissory note. There are no penalties for prepayment. Based upon guidance issued by the SBA on June 19, 2020, the EIDL Loan was not required to be refinanced by the PPP loan. On September 30, 2021, the Company repaid this loan.

Stock-based Compensation

9 Months Ended

Sep. 30, 2021

Stock-based Compensation [Abstract]

Stock-based Compensation

Note 11

Stock-based Compensation:

On October 27, 2016, the Company’s stockholders approved the Company’s adoption of the new 2016 Omnibus Incentive Stock Plan (“2016 Plan”) having 2,058,880 shares available for issuance in respect of awards made thereunder. The Company terminated the 2013 Stock Incentive Plan in October 2016. On May 29, 2018, the Company’s stockholders approved the Company’s amendment to the 2016 Plan to increase the number of the Company’s common stock available for grants under the plan by 3,134,365. On July 7, 2021, the shareholders approved an amendment to the 2016 Omnibus Incentive Plan to increase the number of shares of common stock for issuance by 2,700,000. As of September 30, 2021, there were 3,853,038 shares of common stock remaining available for issuance for awards under the 2016 Plan.

The Company measures share‑based awards at their grant‑date fair value and records compensation expense on a straight‑line basis over the vesting period of the awards. The Company recorded share‑based compensation expense of $320 and $1,563, $403 and $1,243 for the three and nine months ended September 30, 2021, and 2020, respectively and within general and administrative expenses in the accompanying unaudited condensed consolidated statements of operations.

Stock Options

The following table summarizes stock option activity for the nine months ended September 30, 2021:

	Number of shares			Weighted average exercise price per share		Weighted average remaining contractual term (years)
Outstanding at January 1, 2021		5,292,888		$	1.87
Granted		2,043,714		$	1.67
Exercised		(1,557,628	)	$	1.12
Forfeited/expired		(1,815,085	)	$	1.84
Outstanding at September 30, 2021		3,963,889		$	2.05		8.2
Exercisable at September 30, 2021		1,236,841		$	2.77		5.6

The weighted‑average grant date fair value of options granted was $1.24 per share during the nine months ended September 30, 2021. There were no options granted during the nine months ended September 30, 2020. As of September 30, 2021, the total unrecognized compensation expense related to unvested stock option awards was $2,720, which the Company expects to recognize over a weighted‑average period of approximately 2.4 years. The aggregate intrinsic value of options outstanding and options exercisable at September 30, 2021 was $558 and $53, respectively.

For the nine months ended September 30, 2021, the fair value of each option was estimated on the date of grant using the weighted average assumptions in the table below:

Expected volatility		90.4	%
Risk‑free interest rate		1.0	%
Expected life (in years)		5.9
Expected dividend yield		0	%
Fair value of common stock	$	1.68

During the nine months ended September 30, 2021, there were 1,557,628 options that were exercised on a cashless basis at $1.12 per share resulting in the net issuance of 329,076 shares of common stock.

On February 28, 2021, in connection with the separation of the Company’s Chief Executive Officer, the Company accelerated the vesting of all unvested options to purchase shares of common stock and extended the period to exercise to August 22, 2021. This acceleration and the extension of the period to vest met the modification criteria for accounting purposes. For these modifications, the Company calculated and recorded the additional compensation expense of $173.

Restricted Stock Units

Restricted stock unit unvested are summarized in the following table:

	Number of shares			Weighted average grant date fair value
Unvested at January 1, 2021		-		$	-
Granted		290,861		$	1.44
Vested		(146,364	)	$	1.42
Unvested at September 30, 2021		144,497		$	1.45

As of September 30, 2021, the total unrecognized compensation expense related to unvested stock option awards was $167, which the Company expects to recognize over a weighted‑average period of approximately 0.8 years.

Income Taxes	9 Months Ended
Income Taxes	Sep. 30, 2021
Income Taxes [Abstract]
Income Taxes	Note 12 Income Taxes: The Company accounts for income taxes using the asset and liability method. The provision for income taxes includes federal, state and local income taxes currently payable and deferred taxes resulting from temporary differences between the financial statement and tax bases of assets and liabilities. Valuation allowances are recorded to reduce deferred tax assets when it is more likely than not that a tax benefit will not be realized. Income tax expense of $4 and of $12, and $72 and $207 for the three and nine months ended September 30, 2021, and 2020, respectively, was comprised primarily of changes in deferred tax liability related to goodwill. Goodwill is an amortizing asset according to tax regulations. The United States enacted the Coronavirus Aid, Relief, and Economic Security Act (CARES Act). The CARES Act is an approximately $2 trillion emergency economic stimulus package in response to the COVID-19 outbreak, which among other things contains numerous income tax provisions. Some of these tax provisions are expected to be effective retroactively for years ending before the date of enactment. The Company analyzed the impact of the CARES Act and does not foresee a significant impact on its condensed consolidated financial position, results of operations, effective tax rate and cash flows. The Company has experienced certain ownership changes, which under the provisions of Section 382 of the Internal Revenue Code of 1986, as amended, result in annual limitations on the Company's ability to utilize its net operating losses in the future. The February 2014, July 2014, June 2015 and May 2018 equity raises by the Company will limit the annual use of these net operating loss carryforwards. Although the Company has not performed a Section 382 study, any limitation of its pre-change net operating loss carryforwards that would result in a reduction of its deferred tax asset would also have an equal and offsetting adjustment to the valuation allowance.

- Definition

The entire disclosure for income taxes. Disclosures may include net deferred tax liability or asset recognized in an enterprise's statement of financial position, net change during the year in the total valuation allowance, approximate tax effect of each type of temporary difference and carryforward that gives rise to a significant portion of deferred tax liabilities and deferred tax assets, utilization of a tax carryback, and tax uncertainties information.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
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-URI http://asc.fasb.org/extlink&oid=121826272&loc=d3e32857-109319

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
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-Subparagraph (SX 210.4-08(h)(2))
-URI http://asc.fasb.org/extlink&oid=120395691&loc=d3e23780-122690

+ Details

Business Segments

9 Months Ended

Sep. 30, 2021

Business Segments [Abstract]

Business Segments

Note 13

Business Segments:

The Company has organized its business into two operating segments to present its organization based upon the Company’s management structure, products and services offered, markets served and types of customers, as follows: The Dermatology Recurring Procedures segment derives its revenues from the usage of its equipment by dermatologists to perform XTRAC procedures. The Dermatology Procedures Equipment segment generates revenues from the sale of equipment, such as lasers and lamp products. Management reviews financial information presented on an operating segment basis for the purposes of making certain operating decisions and assessing financial performance.

Unallocated operating expenses include costs that are not specific to a particular segment but are general to the group; included are expenses incurred for administrative and accounting staff, general liability and other insurance, professional fees and other similar corporate expenses. Interest expense and other income (expense), net, are also not allocated to the operating segments.

The following tables reflect results of operations from the Company’s business segments for the periods indicated below:

Three Months Ended September 30, 2021

	Dermatology Recurring Procedures			Dermatology Procedures Equipment			TOTAL
Revenues	$	5,710		$	2,001		$	7,711
Costs of revenues		1,512			823			2,335
Gross profit		4,198			1,178			5,376
Gross profit %		73.5	%		58.9	%		69.7	%

Allocated operating expenses:
Engineering and product development		333			38			371
Selling and marketing		3,094			201			3,295
Unallocated operating expenses		-			-			2,175
		3,427			239			5,841
Income (loss) from operations		771			939			(465	)
Interest expense, net		-			-			(52	)
Income (loss) before income taxes	$	771		$	939		$	(517	)

Nine Months Ended September 30, 2021

	Dermatology Recurring Procedures			Dermatology Procedures Equipment			TOTAL
Revenues	$	15,841		$	5,079		$	20,920
Costs of revenues		4,648			2,422			7,070
Gross profit		11,193			2,657			13,850
Gross profit %		70.7	%		52.3	%		66.2	%

Allocated operating expenses:
Engineering and product development		1,013			145			1,158
Selling and marketing		8,805			582			9,387
Unallocated operating expenses		-			-			7,085
		9,818			727			17,630
Income (loss) from operations		1,375			1,930			(3,780	)
Gain on forgiveness of debt		-			-			2,028
Interest expense, net		-			-			(93	)
Income (loss) before income taxes	$	1,375		$	1,930		$	(1,845	)

Three Months Ended September 30, 2020

	Dermatology Recurring Procedures			Dermatology Procedures Equipment			TOTAL
Revenues	$	3,835		$	1,778		$	5,613
Costs of revenues		1,368			1,015			2,383
Gross profit		2,467			763			3,230
Gross profit %		64.3	%		42.9	%		57.5	%

Allocated operating expenses:
Engineering and product development		329			82			411
Selling and marketing		1,883			168			2,051
Unallocated operating expenses		-			-			1,929
		2,212			250			4,391
Income (loss) from operations		255			513			(1,161	)
Interest expense, net		-			-			(21	)
Income (loss) before income taxes	$	255		$	513		$	(1,182	)

Nine Months Ended September 30, 2020

	Dermatology Recurring Procedures			Dermatology Procedures Equipment			TOTAL
Revenues	$	12,332		$	4,041		$	16,373
Costs of revenues		4,534			2,246			6,780
Gross profit		7,798			1,795			9,593
Gross profit %		63.2	%		44.4	%		58.6	%

Allocated operating expenses:
Engineering and product development		828			122			950
Selling and marketing		6,021			425			6,446
Unallocated operating expenses		-			-			5,921
		6,849			547			13,317
Income (loss) from operations		949			1,248			(3,724	)
Interest expense, net		-			-			(38	)
Income (loss) before income taxes	$	949		$	1,248		$	(3,762	)

- Definition

The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 31
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8924-108599

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Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
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Reference 13: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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-URI http://asc.fasb.org/topic&trid=2134510

+ Details

Significant Customer Concentration	9 Months Ended
Significant Customer Concentration	Sep. 30, 2021
Significant Customer Concentration [Abstract]
Significant Customer Concentration	Note 14 Significant Customer Concentration: For the three months ended September 30, 2021, there were no customers representing more than 10% of revenues. For the nine months ended September 30, 2021, there was one customer whose sales were $2,220, or 10.6% of total revenues for such period. There was one other customer that represented 10.5% of accounts receivable as of September 30, 2021. For the three and nine months ended September 30, 2020, revenues from the sales to the Company’s international master distributor were $846 and $2,149, or 15.1% and 13.1%, respectively, of total revenues for such periods. For the three months ended September 30, 2020 revenues from another distributor were $632 or 11.3% of total revenue for the period. No other distributor or customer represented more than 10% of total Company revenues for the three and nine months ended September 30, 2020.

Commitments

9 Months Ended

Sep. 30, 2021

Commitments [Abstract]

Commitments

Note 15

Commitments:

Leases

The Company recognizes right-of-use assets (“ROU assets”) and operating lease liabilities when it obtains the right to control an asset under a leasing arrangement with an initial term greater than twelve months. The Company adopted the short-term accounting election for leases with a duration of less than one year. The Company leases its facilities and certain IT and office equipment under non-cancellable operating leases. All of the Company's leasing arrangements are classified as operating leases with remaining lease terms ranging from 1 to 4 years, and one facility lease has a renewal option for two years. Renewal options have been excluded from the determination of the lease term as they are not reasonably certain of exercise. On May 1, 2019, the Company entered into an addendum with FR National Life, LLC for the Carlsbad, California facility for five years which began on October 1, 2019. Included in cash flows provided by operations for the nine months ended September 30, 2021, and 2020, there was amortization of right-of-use assets of $261 and $242, respectively.

Operating lease costs were $108 and $331, and $112 and $336 for the three and nine months ended September 30, 2021, and 2020, respectively. Cash paid for amounts included in the measurement of operating lease liabilities was $113 and $344 for the three and nine months ended September 30, 2021, and 2020, respectively. As of September 30, 2021, the incremental borrowing rate was 9.76% and the weighted average remaining lease term was 2.4 years. The following table summarizes the Company’s operating lease maturities as of September 30, 2021:

For the year ending December 31,	Amount
Remaining 2021	$	122
2022		371
2023		242
2024		186
Total remaining lease payments		921
Less: imputed interest		(117	)
Total lease liabilities	$	804

Contingencies:

In the ordinary course of business, the Company is routinely defendants in or parties to pending and threatened legal actions and proceedings, including actions brought on behalf of various classes of claimants. These actions and proceedings are generally based on alleged violations of employment, contract and other laws. In some of these actions and proceedings, claims for substantial monetary damages are asserted against the Company. In the ordinary course of business, the Company is also subject to regulatory and governmental examinations, information gathering requests, inquiries, investigations, and threatened legal actions and proceedings. In connection with formal and informal inquiries by federal, state, local and foreign agencies, the Company receives numerous requests, subpoenas and orders for documents, testimony and information in connection with various aspects of its activities.

Subsequent Events	9 Months Ended
Subsequent Events	Sep. 30, 2021
Subsequent Events [Abstract]
Subsequent Events	Note 16 Subsequent Events: In October 2021, the Company entered into an equity distribution agreement under which the Company may sell up to $11.0 million of its shares of common stock in registered “at-the-market” offerings. If the Company chooses, the shares will be offered at prevailing market prices, and the Company will pay commissions of up to 3.0% of the gross proceeds from the sale of shares sold through the Company’s agent, which may act as an agent and/or principal. The Company has no obligation to sell any shares under this agreement and may, at any time, suspend solicitations under this agreement.

The Company (Policies)

9 Months Ended

Sep. 30, 2021

The Company [Abstract]

Principles of Consolidation

Unaudited Interim Condensed Consolidated Financial Statements

Reclassifications

Significant Accounting Policies

Use of Estimates

Fair Value Measurements

	•	Level 1 – unadjusted quoted prices are available in active markets for identical assets or liabilities that the Company has the ability to access as of the measurement date.
	•	Level 2 – pricing inputs are other than quoted prices in active markets that are directly observable for the asset or liability or indirectly observable through corroboration with observable market data.
	•	Level 3 – pricing inputs are unobservable for the non-financial asset or liability and only used when there is little, if any, market activity for the non-financial asset or liability at the measurement date. The inputs into the determination of fair value require significant management judgment or estimation. Fair value is determined using comparable market transactions and other valuation methodologies, adjusted as appropriate for liquidity, credit, market and/or other risk factors.

This hierarchy requires the Company to use observable market data, when available, and to minimize the use of unobservable inputs when determining fair value.

Earnings Per Share

	September 30,
	2021		2020
Common stock purchase warrants		373,626		149,901
Restricted stock units		144,497		119,330
Common stock options		3,963,889		4,908,038
Total		4,482,012		5,177,269

Accounting Pronouncements Recently Adopted and Not Yet Adopted

Accounting Pronouncements Recently Adopted

Recent Accounting Pronouncements Not Yet Adopted

The Company (Tables)

9 Months Ended

Sep. 30, 2021

The Company [Abstract]

Antidilutive Securities Excluded from Computation of Earnings (Loss) Per Share

	September 30,
	2021		2020
Common stock purchase warrants		373,626		149,901
Restricted stock units		144,497		119,330
Common stock options		3,963,889		4,908,038
Total		4,482,012		5,177,269

Revenue Recognition (Tables)

9 Months Ended

Sep. 30, 2021

Revenue Recognition [Abstract]

Disaggregation of Revenue

	Three Months Ended September 30, 2021
	Dermatology Recurring Procedures		Dermatology Procedures Equipment		TOTAL
Domestic	$	5,370	$	519	$	5,889
Foreign		340		1,482		1,822
Total	$	5,710	$	2,001	$	7,711

	Nine Months Ended September 30, 2021
	Dermatology Recurring Procedures		Dermatology Procedures Equipment		TOTAL
Domestic	$	14,923	$	1,113	$	16,036
Foreign		918		3,966		4,884
Total	$	15,841	$	5,079	$	20,920


	Three Months Ended September 30, 2020
	Dermatology Recurring Procedures		Dermatology Procedures Equipment		TOTAL
Domestic	$	3,690	$	261	$	3,951
Foreign		145		1,517		1,662
Total	$	3,835	$	1,778	$	5,613

	Nine Months Ended September 30, 2020
	Dermatology Recurring Procedures		Dermatology Procedures Equipment		TOTAL
Domestic	$	11,957	$	701	$	12,658
Foreign		375		3,340		3,715
Total	$	12,332	$	4,041	$	16,373

Future Undiscounted Fixed Treatment Code Payments from International Recurring Revenue Customers

The following table summarizes the Company’s expected future undiscounted fixed treatment code payments from international recurring revenue customers as of September 30, 2021:

Remaining 2021	$	390
2022		1,556
2023		1,479
2024		1,076
2025		362
Thereafter		-
Total	$	4,863

Acquisition of Pharos Assets and Liabilities (Tables)

9 Months Ended

Sep. 30, 2021

Acquisition of Pharos Assets and Liabilities [Abstract]

Purchase Price Allocation

Consideration:
Cash payment	$	3,700
Transaction costs		57
Total consideration	$	3,757

Assets acquired:
Inventory	$	284
Customer lists		5,314
Total assets acquired	$	5,598

Liabilities assumed:
Deferred revenues - service contracts	$	1,841
Total liabilities assumed	$	1,841

Net assets acquired	$	3,757

Inventories (Tables)

9 Months Ended

Sep. 30, 2021

Inventories [Abstract]

Inventories

Inventories consist of:

	September 30, 2021		December 31, 2020
Raw materials and work-in-process	$	3,024	$	2,949
Finished goods		201		495
Total inventories	$	3,225	$	3,444

Property and Equipment, net (Tables)

9 Months Ended

Sep. 30, 2021

Property and Equipment, net [Abstract]

Property and Equipment, Net

Property and equipment consist of:

	September 30, 2021			December 31, 2020
Lasers placed-in-service	$	25,190		$	22,942
Equipment, computer hardware and software		224			146
Furniture and fixtures		236			243
Leasehold improvements		43			43
		25,693			23,374
Accumulated depreciation and amortization		(19,290	)		(17,845	)
Property and equipment, net	$	6,403		$	5,529

Intangible Assets, net (Tables)

9 Months Ended

Sep. 30, 2021

Intangible Assets, net [Abstract]

Definite-lived Intangible Assets

Set forth below is a detailed listing of definite-lived intangible assets as of September 30, 2021:

	Balance		Accumulated Amortization			Intangible assets, net
Core technology	$	5,700	$	(3,562	)	$	2,138
Product technology		2,000		(2,000	)		-
Customer relationships		6,900		(4,313	)		2,587
Tradenames		1,500		(938	)		562
Pharos customer list		5,314		(55	)		5,259
	$	21,414	$	(10,868	)	$	10,546

The following table is a detailed listing of definite-lived intangible assets as of December 31, 2020:

	Balance		Accumulated Amortization			Intangible assets, net
Core technology	$	5,700	$	(3,135	)	$	2,565
Product technology		2,000		(2,000	)		-
Customer relationships		6,900		(3,795	)		3,105
Tradenames		1,500		(825	)		675
	$	16,100	$	(9,755	)	$	6,345

Finite-lived Intangible Assets Amortization Expense

Estimated amortization expense for the above amortizable intangible assets for future periods is as follows:

Remaining 2021	$	463
2022		1,853
2023		1,853
2024		1,853
2025		1,148
Thereafter		3,376
Total	$	10,546

Other Accrued Liabilities (Tables)

9 Months Ended

Sep. 30, 2021

Other Accrued Liabilities [Abstract]

Other Accrued Liabilities

Other accrued liabilities consist of:

	September 30, 2021		December 31, 2020

Accrued warranty, current	$	54	$	87
Accrued compensation, including commissions and vacation		1,578		891
Accrued state sales, use and other taxes		3,152		3,105
Accrued professional fees and other accrued liabilities		764		607
Total other accrued liabilities	$	5,548	$	4,690

Accrued Warranty Costs Activity

The activity in the warranty accrual during the three and nine months ended September 30, 2021, and 2020, is summarized as follows:

	Three Months Ended, September 30,						Nine Months Ended, September 30,
	2021			2020			2021			2020
Accrual at beginning of period	$	98		$	139		$	113		$	232
Additions charged to warranty expense		11			37			52			46
Expiring warranties/claimed satisfied		(28	)		(41	)		(84	)		(143	)
Total		81			135			81			135
Less: current portion		(54	)		(107	)		(54	)		(107	)
Total long-term accrued warranty costs	$	27		$	28		$	27		$	28

Long-term Debt (Tables)

9 Months Ended

Sep. 30, 2021

Long-term Debt [Abstract]

Future Minimum Principal Payments

Future minimum principal payments at September 30, 2021 are as follows (in thousands):

2024	$	1,000
2025		4,000
2026		3,000
Total	$	8,000

Stock-based Compensation (Tables)

9 Months Ended

Sep. 30, 2021

Stock-based Compensation [Abstract]

Stock Option Activity

The following table summarizes stock option activity for the nine months ended September 30, 2021:

	Number of shares			Weighted average exercise price per share		Weighted average remaining contractual term (years)
Outstanding at January 1, 2021		5,292,888		$	1.87
Granted		2,043,714		$	1.67
Exercised		(1,557,628	)	$	1.12
Forfeited/expired		(1,815,085	)	$	1.84
Outstanding at September 30, 2021		3,963,889		$	2.05		8.2
Exercisable at September 30, 2021		1,236,841		$	2.77		5.6

Estimated Fair Value Weighted Average Assumption

For the nine months ended September 30, 2021, the fair value of each option was estimated on the date of grant using the weighted average assumptions in the table below:

Expected volatility		90.4	%
Risk‑free interest rate		1.0	%
Expected life (in years)		5.9
Expected dividend yield		0	%
Fair value of common stock	$	1.68

Restricted Stock Unit

Restricted stock unit unvested are summarized in the following table:

	Number of shares			Weighted average grant date fair value
Unvested at January 1, 2021		-		$	-
Granted		290,861		$	1.44
Vested		(146,364	)	$	1.42
Unvested at September 30, 2021		144,497		$	1.45

Business Segments (Tables)

9 Months Ended

Sep. 30, 2021

Business Segments [Abstract]

Segment Reporting Information by Segment

The following tables reflect results of operations from the Company’s business segments for the periods indicated below:

Three Months Ended September 30, 2021

	Dermatology Recurring Procedures			Dermatology Procedures Equipment			TOTAL
Revenues	$	5,710		$	2,001		$	7,711
Costs of revenues		1,512			823			2,335
Gross profit		4,198			1,178			5,376
Gross profit %		73.5	%		58.9	%		69.7	%

Allocated operating expenses:
Engineering and product development		333			38			371
Selling and marketing		3,094			201			3,295
Unallocated operating expenses		-			-			2,175
		3,427			239			5,841
Income (loss) from operations		771			939			(465	)
Interest expense, net		-			-			(52	)
Income (loss) before income taxes	$	771		$	939		$	(517	)

Nine Months Ended September 30, 2021

	Dermatology Recurring Procedures			Dermatology Procedures Equipment			TOTAL
Revenues	$	15,841		$	5,079		$	20,920
Costs of revenues		4,648			2,422			7,070
Gross profit		11,193			2,657			13,850
Gross profit %		70.7	%		52.3	%		66.2	%

Allocated operating expenses:
Engineering and product development		1,013			145			1,158
Selling and marketing		8,805			582			9,387
Unallocated operating expenses		-			-			7,085
		9,818			727			17,630
Income (loss) from operations		1,375			1,930			(3,780	)
Gain on forgiveness of debt		-			-			2,028
Interest expense, net		-			-			(93	)
Income (loss) before income taxes	$	1,375		$	1,930		$	(1,845	)

Three Months Ended September 30, 2020

	Dermatology Recurring Procedures			Dermatology Procedures Equipment			TOTAL
Revenues	$	3,835		$	1,778		$	5,613
Costs of revenues		1,368			1,015			2,383
Gross profit		2,467			763			3,230
Gross profit %		64.3	%		42.9	%		57.5	%

Allocated operating expenses:
Engineering and product development		329			82			411
Selling and marketing		1,883			168			2,051
Unallocated operating expenses		-			-			1,929
		2,212			250			4,391
Income (loss) from operations		255			513			(1,161	)
Interest expense, net		-			-			(21	)
Income (loss) before income taxes	$	255		$	513		$	(1,182	)

Nine Months Ended September 30, 2020

	Dermatology Recurring Procedures			Dermatology Procedures Equipment			TOTAL
Revenues	$	12,332		$	4,041		$	16,373
Costs of revenues		4,534			2,246			6,780
Gross profit		7,798			1,795			9,593
Gross profit %		63.2	%		44.4	%		58.6	%

Allocated operating expenses:
Engineering and product development		828			122			950
Selling and marketing		6,021			425			6,446
Unallocated operating expenses		-			-			5,921
		6,849			547			13,317
Income (loss) from operations		949			1,248			(3,724	)
Interest expense, net		-			-			(38	)
Income (loss) before income taxes	$	949		$	1,248		$	(3,762	)

Commitments (Tables)

9 Months Ended

Sep. 30, 2021

Commitments [Abstract]

Operating Lease Maturities

The following table summarizes the Company’s operating lease maturities as of September 30, 2021:

For the year ending December 31,	Amount
Remaining 2021	$	122
2022		371
2023		242
2024		186
Total remaining lease payments		921
Less: imputed interest		(117	)
Total lease liabilities	$	804

The Company, Background (Details) - XTRAC [Member]	9 Months Ended
The Company, Background (Details) - XTRAC [Member]	Sep. 30, 2021 Systems
United States [Member]
Finite-Lived Intangible Assets, Net [Abstract]
Number of systems placed in dermatologists offices	880
International [Member]
Finite-Lived Intangible Assets, Net [Abstract]
Number of systems placed in dermatologists offices	49

The Company, Earnings Per Share (Details) - shares	9 Months Ended
The Company, Earnings Per Share (Details) - shares	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020
Loss Per Share [Abstract]
Series C Convertible Preferred Stock, shares outstanding (in shares)	0		0
Earnings Per Share, Basic and Diluted, Other Disclosures [Abstract]
Potential common stock equivalents (in shares)	4,482,012	5,177,269
Series C Convertible Preferred Stock [Member]
Loss Per Share [Abstract]
Series C Convertible Preferred Stock, shares outstanding (in shares)	0	0
Common Stock Purchase Warrants [Member]
Earnings Per Share, Basic and Diluted, Other Disclosures [Abstract]
Potential common stock equivalents (in shares)	373,626	149,901
Restricted Stock Units [Member]
Earnings Per Share, Basic and Diluted, Other Disclosures [Abstract]
Potential common stock equivalents (in shares)	144,497	119,330
Common Stock Options [Member]
Earnings Per Share, Basic and Diluted, Other Disclosures [Abstract]
Potential common stock equivalents (in shares)	3,963,889	4,908,038

Liquidity (Details) $ in Thousands	1 Months Ended
Liquidity (Details) $ in Thousands	Oct. 31, 2021 USD ($)
At-the-Market Equity Offering [Member] \| Subsequent Event [Member] \| Maximum [Member]
Equity Distribution Agreement [Abstract]
Amount of common stock the Company may sell under equity distribution agreement	$ 11,000

Revenue Recognition, Remaining Performance Obligation (Details) $ in Thousands	Sep. 30, 2021 USD ($)
Remaining Performance Obligation [Abstract]
Remaining performance obligations	$ 1,549
RA Medical Systems, Inc. [Member]
Remaining Performance Obligation [Abstract]
Deferred revenue acquired in remaining performance obligations	1,506
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2021-10-01
Remaining Performance Obligation [Abstract]
Remaining performance obligations	$ 1,148
Expected timing of satisfaction period	1 year
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2022-10-01 \| Minimum [Member]
Remaining Performance Obligation [Abstract]
Expected timing of satisfaction period	1 year
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2022-10-01 \| Maximum [Member]
Remaining Performance Obligation [Abstract]
Expected timing of satisfaction period	3 years

Revenue Recognition, Contract Liabilities (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Treatment Equipment [Abstract]
Lease term	36 months		36 months
Contract with Customer, Liability [Abstract]
Short-term contract liabilities	$ 1,148		$ 1,148
Long-term contract liabilities	401		401
Change in Contract with Customer, Liability [Abstract]
Contract liabilities recognized as revenue	19	$ 52	73	$ 162
Co-pay reimbursements recorded as reduction of revenue	$ (199)	$ (160)	$ (542)	$ (414)
Minimum [Member]
Treatment Equipment [Abstract]
Notice period to cancel contract agreement			30 days
Maximum [Member]
Treatment Equipment [Abstract]
Notice period to cancel contract agreement			60 days
South Korea [Member]
Treatment Equipment [Abstract]
Lease term	48 months		48 months

Revenue Recognition, Disaggregation of Revenue (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Disaggregation of Revenue [Abstract]
Revenues, net	$ 7,711	$ 5,613	$ 20,920	$ 16,373
Dermatology Recurring Procedures [Member]
Disaggregation of Revenue [Abstract]
Revenues, net	5,710	3,835	15,841	12,332
Dermatology Procedures Equipment [Member]
Disaggregation of Revenue [Abstract]
Revenues, net	2,001	1,778	5,079	4,041
Domestic [Member]
Disaggregation of Revenue [Abstract]
Revenues, net	5,889	3,951	16,036	12,658
Domestic [Member] \| Dermatology Recurring Procedures [Member]
Disaggregation of Revenue [Abstract]
Revenues, net	5,370	3,690	14,923	11,957
Domestic [Member] \| Dermatology Procedures Equipment [Member]
Disaggregation of Revenue [Abstract]
Revenues, net	519	261	1,113	701
Foreign [Member]
Disaggregation of Revenue [Abstract]
Revenues, net	1,822	1,662	4,884	3,715
Foreign [Member] \| Dermatology Recurring Procedures [Member]
Disaggregation of Revenue [Abstract]
Revenues, net	340	145	918	375
Foreign [Member] \| Dermatology Procedures Equipment [Member]
Disaggregation of Revenue [Abstract]
Revenues, net	$ 1,482	$ 1,517	$ 3,966	$ 3,340

- Definition

Amount, excluding tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value added and excise.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 30
-Subparagraph (a)
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Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 40
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e9031-108599

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
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-Paragraph 41
-Subparagraph (a)
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8933-108599

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8933-108599

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 4
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130543-203045

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 22
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8736-108599

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 42
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e9054-108599

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 5
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130545-203045

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 924
-SubTopic 10
-Section S99
-Paragraph 1
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-URI http://asc.fasb.org/extlink&oid=6472922&loc=d3e499488-122856

+ Details

Revenue Recognition, Future Undiscounted Fixed Payments from International Recurring Revenue Customers (Details) $ in Thousands	Sep. 30, 2021 USD ($)
Remaining Performance Obligation [Abstract]
Future undiscounted fixed payments from international recurring revenue customers	$ 1,549
International [Member]
Remaining Performance Obligation [Abstract]
Future undiscounted fixed payments from international recurring revenue customers	4,863
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2021-10-01
Remaining Performance Obligation [Abstract]
Future undiscounted fixed payments from international recurring revenue customers	$ 1,148
Expected timing of satisfaction period	1 year
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2021-10-01 \| International [Member]
Remaining Performance Obligation [Abstract]
Future undiscounted fixed payments from international recurring revenue customers	$ 390
Expected timing of satisfaction period	3 months
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2022-01-01 \| International [Member]
Remaining Performance Obligation [Abstract]
Future undiscounted fixed payments from international recurring revenue customers	$ 1,556
Expected timing of satisfaction period	1 year
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2023-01-01 \| International [Member]
Remaining Performance Obligation [Abstract]
Future undiscounted fixed payments from international recurring revenue customers	$ 1,479
Expected timing of satisfaction period	1 year
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2024-01-01 \| International [Member]
Remaining Performance Obligation [Abstract]
Future undiscounted fixed payments from international recurring revenue customers	$ 1,076
Expected timing of satisfaction period	1 year
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2025-01-01 \| International [Member]
Remaining Performance Obligation [Abstract]
Future undiscounted fixed payments from international recurring revenue customers	$ 362
Expected timing of satisfaction period	1 year
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2026-01-01 \| International [Member]
Remaining Performance Obligation [Abstract]
Future undiscounted fixed payments from international recurring revenue customers	$ 0
Expected timing of satisfaction period

Acquisition of Pharos Assets and Liabilities (Details) - RA Medical Systems, Inc. [Member] $ in Thousands	1 Months Ended	9 Months Ended
	Aug. 31, 2021 USD ($) Practice	Sep. 30, 2021
Acquisition of Assets and Liabilities [Abstract]
Number of dermatology practices \| Practice	400
Consideration [Abstract]
Cash payment	$ 3,700
Transaction costs	57
Total consideration	3,757
Assets acquired [Abstract]
Inventory	284
Total assets acquired	5,598
Liabilities assumed [Abstract]
Deferred revenues - service contracts	1,841
Total liabilities assumed	1,841
Net assets acquired	$ 3,757
Estimated customer sales growth	3.00%
Customer attrition	5.00%
Weighted average cost of capital	17.00%
Customer Lists [Member]
Assets acquired [Abstract]
Intangible assets	$ 5,314
Liabilities assumed [Abstract]
Amortization period of intangible assets		12 years

Inventories (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Schedule of inventory [Abstract]
Raw materials and work in process	$ 3,024	$ 2,949
Finished goods	201	495
Total inventories	$ 3,225	$ 3,444

Property and Equipment, net (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020
Property, Plant and Equipment, Net [Abstract]
Property and equipment, gross	$ 25,693		$ 25,693		$ 23,374
Accumulated depreciation and amortization	(19,290)		(19,290)		(17,845)
Property and equipment, net	6,403		6,403		5,529
Depreciation and related amortization expense	575	$ 454	1,576	$ 1,535
Gain on disposal of property and equipment			(73)	$ (23)
Property plant and equipment disposal, original cost	204		204
Property plant and equipment disposal, accumulated depreciation	131		131
Lasers Placed-In-Service [Member]
Property, Plant and Equipment, Net [Abstract]
Property and equipment, gross	25,190		25,190		22,942
Equipment, Computer Hardware and Software [Member]
Property, Plant and Equipment, Net [Abstract]
Property and equipment, gross	224		224		146
Furniture and Fixtures [Member]
Property, Plant and Equipment, Net [Abstract]
Property and equipment, gross	236		236		243
Leasehold Improvements [Member]
Property, Plant and Equipment, Net [Abstract]
Property and equipment, gross	$ 43		$ 43		$ 43

Intangible Assets, net (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
Intangible Assets, net (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020	Aug. 31, 2021	Dec. 31, 2020
Finite-Lived Intangible Assets, Net [Abstract]
Balance	$ 21,414		$ 21,414			$ 16,100
Accumulated amortization	(10,868)		(10,868)			(9,755)
Intangible assets, net	10,546		10,546			6,345
Amortization expense of intangible assets	408	$ 353	1,113	$ 1,258
Impairment of intangible assets			0
Estimated amortization expense [Abstract]
Remaining 2021	463		463
2022	1,853		1,853
2023	1,853		1,853
2024	1,853		1,853
2025	1,148		1,148
Thereafter	3,376		3,376
Intangible assets, net	10,546		10,546			6,345
Core Technology [Member]
Finite-Lived Intangible Assets, Net [Abstract]
Balance	5,700		5,700			5,700
Accumulated amortization	(3,562)		(3,562)			(3,135)
Intangible assets, net	2,138		2,138			2,565
Estimated amortization expense [Abstract]
Intangible assets, net	2,138		2,138			2,565
Product Technology [Member]
Finite-Lived Intangible Assets, Net [Abstract]
Balance	2,000		2,000			2,000
Accumulated amortization	(2,000)		(2,000)			(2,000)
Intangible assets, net	0		0			0
Estimated amortization expense [Abstract]
Intangible assets, net	0		0			0
Customer Relationships [Member]
Finite-Lived Intangible Assets, Net [Abstract]
Balance	6,900		6,900			6,900
Accumulated amortization	(4,313)		(4,313)			(3,795)
Intangible assets, net	2,587		2,587			3,105
Estimated amortization expense [Abstract]
Intangible assets, net	2,587		2,587			3,105
Tradenames [Member]
Finite-Lived Intangible Assets, Net [Abstract]
Balance	1,500		1,500			1,500
Accumulated amortization	(938)		(938)			(825)
Intangible assets, net	562		562			675
Estimated amortization expense [Abstract]
Intangible assets, net	562		562			$ 675
Pharos Customer List [Member]
Finite-Lived Intangible Assets, Net [Abstract]
Balance	5,314		5,314
Accumulated amortization	(55)		(55)
Intangible assets, net	5,259		5,259
Estimated fair value					$ 5,314
Estimated amortization expense [Abstract]
Intangible assets, net	$ 5,259		$ 5,259

Other Accrued Liabilities, Components of Other Accrued Liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020	Sep. 30, 2020
Other Accrued Liabilities [Abstract]
Accrued warranty, current	$ 54	$ 87	$ 107
Accrued compensation, including commissions and vacation	1,578	891
Accrued state sales, use and other taxes	3,152	3,105
Accrued professional fees and other accrued liabilities	764	607
Total other accrued liabilities	$ 5,548	$ 4,690

Other Accrued Liabilities, Accrued State Sales and Use Tax (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2021 USD ($) Assessment
Accrued State Sales and Use Tax [Abstract]
Interest amount	$ 171
Tax Period from March 2014 through February 2020 [Member]
Accrued State Sales and Use Tax [Abstract]
Number of assessments \| Assessment	2
Estimated tax positions subject to audit	$ 1,484
Tax Period from June 2015 through March 2018 [Member]
Accrued State Sales and Use Tax [Abstract]
Assessment amount	$ 720

Other Accrued Liabilities, Accrued Warranty Costs (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020
Product Warranty Accrual [Roll Forward]
Accrual at beginning of period	$ 98	$ 139	$ 113	$ 232
Additions charged to warranty expense	11	37	52	46
Expiring warranties/claims satisfied	(28)	(41)	(84)	(143)
Total	81	135	81	135
Less: current portion	(54)	(107)	(54)	(107)	$ (87)
Total long-term accrued warranty costs	$ 27	$ 28	$ 27	$ 28
Minimum [Member]
Accrued Warranty Costs [Abstract]
Standard warranty period			1 year
Offered warranty period			3 years
Maximum [Member]
Accrued Warranty Costs [Abstract]
Standard warranty period			2 years
Offered warranty period			4 years

Note Payable (Details) - USD ($) $ in Thousands	9 Months Ended
Note Payable (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Sep. 30, 2020	Dec. 30, 2020
Debt Instruments [Abstract]
Repayments of notes payable	$ 7,275	$ 0
Note [Member]
Debt Instruments [Abstract]
Face amount of debt			$ 7,275
Debt instrument term	1 year
Maturity date	Dec. 30, 2021
Fixed interest rate			1.40%
Repayments of notes payable	$ 7,275
Time Deposit [Member]
Debt Instruments [Abstract]
Fixed interest rate			0.40%

Long-term Debt, Senior Term Facility (Details) $ / shares in Units, $ in Millions	3 Months Ended	9 Months Ended	12 Months Ended
	Sep. 30, 2021 USD ($) $ / shares shares	Sep. 30, 2021 USD ($) Payment $ / shares shares	Dec. 31, 2021 USD ($)
Common Stock [Member]
Long-term Debt [Abstract]
Warrants issued (in shares) \| shares	0
MidCap Financial Trust [Member] \| Senior Term Facility [Member]
Long-term Debt [Abstract]
Face amount of debt	$ 8.0	$ 8.0
Maturity date		Sep. 01, 2026
Number of monthly principal payments plus interest \| Payment		24
Frequency of payment		monthly
Notice period		30 days
Prepayment fee if prepayment is made within twelve months		4.00%
Prepayment fee if prepayment is made between twelve months and twenty-four months		3.00%
Prepayment fee if prepayment is made between twenty-four months and thirty-six months		2.00%
Prepayment fee if prepayment is made after thirty-six months		1.00%
Minimum net revenue threshold		$ 24.0
Minimum net revenue threshold by December 31, 2023		30.0
Estimated fair value of warrants	0.6	0.6
Third party costs and lender fees		0.1
Interest	0.0	0.0
Amortization of debt discount	$ 0.0	0.0
MidCap Financial Trust [Member] \| Senior Term Facility [Member] \| Forecast [Member]
Long-term Debt [Abstract]
Minimum net revenue threshold			$ 25.0
MidCap Financial Trust [Member] \| Senior Term Facility [Member] \| Minimum [Member]
Long-term Debt [Abstract]
Prepayment of debt		$ 5.0
MidCap Financial Trust [Member] \| Senior Term Facility [Member] \| Common Stock [Member]
Long-term Debt [Abstract]
Warrants issued (in shares) \| shares		373,626
Warrants, exercise price (in dollars per share) \| $ / shares	$ 1.82	$ 1.82
MidCap Financial Trust [Member] \| Senior Term Facility [Member] \| LIBOR [Member]
Long-term Debt [Abstract]
Interest rate floor		0.50%
Basis spread on variable rate		7.50%
MidCap Financial Trust [Member] \| Senior Term Facility [Member] \| Expected Term [Member]
Long-term Debt [Abstract]
Warrants, expected term	10 years	10 years
MidCap Financial Trust [Member] \| Senior Term Facility [Member] \| Expected Volatility [Member]
Long-term Debt [Abstract]
Warrants, measurement input	0.886	0.886
MidCap Financial Trust [Member] \| Senior Term Facility [Member] \| Risk-Free Rate [Member]
Long-term Debt [Abstract]
Warrants, measurement input	0.015	0.015
MidCap Financial Trust [Member] \| Senior Term Facility [Member] \| Estimated Dividend Yield [Member]
Long-term Debt [Abstract]
Warrants, measurement input	0	0

Long-term Debt, Future Minimum Principal Payments (Details) $ in Thousands	Sep. 30, 2021 USD ($)
Future Payments for Long-Term Debt [Abstract]
2024	$ 1,000
2025	4,000
2026	3,000
Total	$ 8,000

- Definition

Amount, after unamortized (discount) premium and debt issuance costs, of long-term debt. Includes, but not limited to, notes payable, bonds payable, debentures, mortgage loans and commercial paper. Excludes capital lease obligations.

+ References + Details

Long-term Debt, PPP Loan and EIDL Loan (Details) - USD ($) $ in Thousands		3 Months Ended	9 Months Ended
	May 22, 2020	Jun. 30, 2021	Sep. 30, 2021	Sep. 30, 2020	Apr. 22, 2020
Long-term Debt [Abstract]
Gain on forgiveness of debt			$ 2,028	$ 0
PPP Loans [Member]
Long-term Debt [Abstract]
Face amount of debt					$ 2,028
Maturity date			May 01, 2022
Interest rate percentage					1.00%
Gain on forgiveness of debt		$ 2,028
EIDL [Member]
Long-term Debt [Abstract]
Face amount of debt	$ 500
Interest rate percentage	3.75%
Installment monthly payment amount	$ 2
Debt instrument term			30 years

Stock-based Compensation, Summary (Details) - USD ($) $ in Thousands			3 Months Ended		9 Months Ended
	Jul. 07, 2021	May 29, 2018	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020	Oct. 27, 2016
Stock-based Compensation [Abstract]
Stock-based compensation expense			$ 320	$ 403	$ 1,563	$ 1,243
2016 Omnibus Incentive Plan [Member]
Stock-based Compensation [Abstract]
Number of shares authorized for issuance (in shares)							2,058,880
Increase in number of shares authorized (in shares)	2,700,000	3,134,365
Number of shares available for issuance (in shares)			3,853,038		3,853,038

Stock-based Compensation, Stock Options (Details) $ / shares in Units, $ in Thousands	9 Months Ended
	Sep. 30, 2021 USD ($) $ / shares shares	Sep. 30, 2020 shares
Weighted average remaining contractual term [Abstract]
Exercisable	9 months 18 days
Unrecognized compensation expense \| $	$ 167
Stock Options [Member]
Number of shares [Abstract]
Outstanding at beginning period (in shares) \| shares	5,292,888
Granted (in shares) \| shares	2,043,714	0
Exercised (in shares) \| shares	(1,557,628)
Forfeited/expired (in shares) \| shares	(1,815,085)
Outstanding at end of period (in shares) \| shares	3,963,889
Exercisable at end of period (in shares) \| shares	1,236,841
Weighted average exercise price per share [Abstract]
Outstanding at beginning of period (in dollars per share)	$ 1.87
Granted (in dollars per share)	1.67
Exercised (in dollars per share)	1.12
Forfeited/expired (in dollars per share)	1.84
Outstanding at end of period (in dollars per share)	2.05
Exercisable at end of period (in dollars per share)	$ 2.77
Weighted average remaining contractual term [Abstract]
Outstanding	8 years 2 months 12 days
Exercisable	5 years 7 months 6 days
Weighted-average grant date fair value (in dollars per share)	$ 1.24
Unrecognized compensation expense \| $	$ 2,720
Unrecognized compensation expense, weighted average period	2 years 4 months 24 days
Aggregate intrinsic value of options outstanding \| $	$ 558
Aggregate intrinsic value of options exercisable \| $	$ 53

Stock-based Compensation, Fair Value Assumptions (Details) - USD ($) $ / shares in Units, $ in Thousands		9 Months Ended
	Feb. 28, 2021	Sep. 30, 2021
Fair Value Assumptions [Abstract]
Expected volatility		90.40%
Risk-free interest rate		1.00%
Expected life (in years)		5 years 10 months 24 days
Expected dividend yield		0.00%
Fair value of common stock (in dollars per share)		$ 1.68
Accelerated compensation expense	$ 173
Stock Options [Member]
Fair Value Assumptions [Abstract]
Option exercised (in shares)		(1,557,628)
Weighted average exercise price (in dollars per share)		$ 1.12
Stock option exercise, stock issued (in shares)		329,076

Stock-based Compensation, Restricted Stock Units (Details) $ / shares in Units, $ in Thousands	9 Months Ended
	Sep. 30, 2021 USD ($) $ / shares shares
Weighted average grant date fair value [Abstract]
Unrecognized compensation expense \| $	$ 167
Weighted average period of recognition	9 months 18 days
Restricted Stock Units [Member]
Number of shares [Abstract]
Unvested at beginning of period (in shares) \| shares	0
Granted (in shares) \| shares	290,861
Vested (in shares) \| shares	(146,364)
Unvested at end of period (in shares) \| shares	144,497
Weighted average grant date fair value [Abstract]
Unvested at beginning of period (in dollars per share) \| $ / shares	$ 0
Granted (in dollars per share) \| $ / shares	1.44
Vested (in dollars per share) \| $ / shares	1.42
Unvested at end of period (in dollars per share) \| $ / shares	$ 1.45

Income Taxes (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
Income Taxes (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Income Taxes [Abstract]
Income tax expense	$ 4	$ 72	$ 12	$ 207

- Definition

Amount of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations.

+ References + Details

Business Segments (Details) $ in Thousands	3 Months Ended		9 Months Ended
Business Segments (Details) $ in Thousands	Sep. 30, 2021 USD ($)	Sep. 30, 2020 USD ($)	Sep. 30, 2021 USD ($) Segment	Sep. 30, 2020 USD ($)
Business Segments [Abstract]
Number of operating segments \| Segment			2
Results of Operations from Business Segments [Abstract]
Revenues	$ 7,711	$ 5,613	$ 20,920	$ 16,373
Cost of revenues	2,335	2,383	7,070	6,780
Gross profit	$ 5,376	$ 3,230	$ 13,850	$ 9,593
Gross profit %	69.70%	57.50%	66.20%	58.60%
Allocated operating expenses [Abstract]
Engineering and product development	$ 371	$ 411	$ 1,158	$ 950
Selling and marketing	3,295	2,051	9,387	6,446
Unallocated operating expenses	2,175	1,929	7,085	5,921
Total operating expenses	5,841	4,391	17,630	13,317
Income (loss) from operations	(465)	(1,161)	(3,780)	(3,724)
Gain on forgiveness of debt			2,028	0
Interest expense, net	(52)	(21)	(93)	(38)
Income (loss) before income taxes	(517)	(1,182)	(1,845)	(3,762)
Dermatology Recurring Procedures [Member]
Results of Operations from Business Segments [Abstract]
Revenues	5,710	3,835	15,841	12,332
Dermatology Procedures Equipment [Member]
Results of Operations from Business Segments [Abstract]
Revenues	2,001	1,778	5,079	4,041
Operating Segments [Member] \| Dermatology Recurring Procedures [Member]
Results of Operations from Business Segments [Abstract]
Revenues	5,710	3,835	15,841	12,332
Cost of revenues	1,512	1,368	4,648	4,534
Gross profit	$ 4,198	$ 2,467	$ 11,193	$ 7,798
Gross profit %	73.50%	64.30%	70.70%	63.20%
Allocated operating expenses [Abstract]
Engineering and product development	$ 333	$ 329	$ 1,013	$ 828
Selling and marketing	3,094	1,883	8,805	6,021
Unallocated operating expenses	0	0	0	0
Total operating expenses	3,427	2,212	9,818	6,849
Income (loss) from operations	771	255	1,375	949
Gain on forgiveness of debt			0
Interest expense, net	0	0	0	0
Income (loss) before income taxes	771	255	1,375	949
Operating Segments [Member] \| Dermatology Procedures Equipment [Member]
Results of Operations from Business Segments [Abstract]
Revenues	2,001	1,778	5,079	4,041
Cost of revenues	823	1,015	2,422	2,246
Gross profit	$ 1,178	$ 763	$ 2,657	$ 1,795
Gross profit %	58.90%	42.90%	52.30%	44.40%
Allocated operating expenses [Abstract]
Engineering and product development	$ 38	$ 82	$ 145	$ 122
Selling and marketing	201	168	582	425
Unallocated operating expenses	0	0	0	0
Total operating expenses	239	250	727	547
Income (loss) from operations	939	513	1,930	1,248
Gain on forgiveness of debt			0
Interest expense, net	0	0	0	0
Income (loss) before income taxes	$ 939	$ 513	$ 1,930	$ 1,248

Significant Customer Concentration (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Concentration Risk [Abstract]
Revenues, net	$ 7,711	$ 5,613	$ 20,920	$ 16,373
Revenue [Member] \| Customer Concentration Risk [Member] \| Distributor One [Member]
Concentration Risk [Abstract]
Revenues, net		$ 846	$ 2,220	$ 2,149
Concentration risk percentage		15.10%	10.60%	13.10%
Revenue [Member] \| Customer Concentration Risk [Member] \| Distributor Two [Member]
Concentration Risk [Abstract]
Revenues, net		$ 632
Concentration risk percentage		11.30%
Accounts Receivable [Member] \| Customer Concentration Risk [Member] \| Distributor One [Member]
Concentration Risk [Abstract]
Concentration risk percentage			10.50%

- Definition

+ References

+ Details

Commitments (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
Commitments (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Lessee, Operating Lease, Description [Abstract]
Amortization of right-of-use assets			$ 261	$ 242
Operating lease costs	$ 108	$ 112	331	336
Cash paid for amounts included in measurement of operating lease liabilities	$ 113	$ 113	$ 344	$ 344
Incremental borrowing rate			9.76%
Weighted average remaining lease term	2 years 4 months 24 days		2 years 4 months 24 days
Operating Lease Maturities [Abstract]
Remaining 2021	$ 122		$ 122
2022	371		371
2023	242		242
2024	186		186
Total remaining lease payments	921		921
Less: imputed interest	(117)		(117)
Total lease liabilities	$ 804		$ 804
Minimum [Member]
Lessee, Operating Lease, Description [Abstract]
Remaining lease term			1 year
Maximum [Member]
Lessee, Operating Lease, Description [Abstract]
Remaining lease term			4 years
Facility One [Member]
Lessee, Operating Lease, Description [Abstract]
Renewal option term	2 years		2 years
Carlsbad Facility [Member]
Lessee, Operating Lease, Description [Abstract]
Renewal option term	5 years		5 years

Subsequent Events (Details) - Subsequent Event [Member] - At-the-Market Equity Offering [Member] - Maximum [Member] $ in Thousands	1 Months Ended
	Oct. 31, 2021 USD ($)
Subsequent Events [Abstract]
Amount of common stock the Company may sell under equity distribution agreement	$ 11,000
Commission as percentage of gross proceeds from sale of shares sold	3.00%