Intense pulsed light (IPL) is a procedure that utilizes a source of pulsed light energy, which, unlike lasers, is non-coherent, non-collimated, and covers a broad spectrum of wavelengths. Due to these attributes, even though it isn't precisely a laser, it finds extensive use in fields ranging from cutaneous vascular lesions to pigment disorders, even in the treatment of hirsutism and hypertrichosis.
The technology upon which it is founded allows the operator to select the appropriate wavelength and parameters tailored to the pigmented lesion being treated. This choice takes into account its depth and location, whether the lesion is composed of melanin or hemoglobin. The light energy is absorbed solely by the target being aimed at, raising its temperature to the point of causing fragmentation and subsequently eliminating the lesion.
By addressing the effects of cutaneous photoaging on the face, neck, décolletage, and back of hands, IPL technology enables rapid, effective, non-invasive photorejuvenation with minimal side effects. Pulsed light penetrates deeply into the structure of the skin's collagen, and thanks to its wide spectrum of wavelengths, it concurrently acts upon a broad range of conditions. This includes pigmented lesions, photoaging, rosacea, and flushing—a flexibility that is unmatched by conventional monochromatic lasers.
Main indications of pulsed light
- Non-ablative cutaneous photorejuvenation to treat photoaging damage, promoting neocollagen deposition, enhancing texture, and reducing dilated follicular ostia.
- Pigmentation disorders: hyperpigmentation, sunspots, etc.
- Vascular lesions: rosacea, flushing, couperose, ruby angiomas, etc.
- Progressively permanent hair removal.
Preparation for the Treatment
Assessment of the individual's phototype, lesion type, and its predominant component (vascular or pigmented), aided by a cutaneous check-up.
In the 4 weeks prior to the treatment and the 3 following weeks, it is imperative to avoid exposure to sunlight and/or UVA lamps. Additionally, for at least two months prior to the treatment, medications or substances that heighten skin sensitivity to light should not be taken.
The Treatment:
Light energy is emitted through a specialized handpiece in a series of electronically controlled pulses, tailored to the patient's skin characteristics and the type of lesion or condition being treated. This approach enables the light to selectively target the desired area, leaving the healthy or normally pigmented skin unchanged and undamaged.
During the initial visit, the doctor performs a test to identify the most suitable wavelength for the specific case. The duration of the treatment varies based on the dimensions of the targeted area and the type of intervention, generally spanning from 30 to 60 minutes. The number of sessions also varies according to the aesthetic concern being addressed—typically 4 to 6 sessions for photorejuvenation, and at least 5 sessions for significant hair density reduction.
The therapy isn't notably painful and therefore doesn't require anesthesia; the application of a cold gel alleviates the sensation of slight tingling, followed by warmth, which is felt briefly and recedes swiftly.
IPL therapy is contraindicated in the following cases: pregnancy, suspicious skin lesions in the regions to be treated, impaired wound healing, the use of vitamin A or isotretinoin, and epilepsy.
Post-Treatment Period and Contraindications:
- Treated hyperchromia may darken in the initial days post-session, lasting approximately 10-15 days.
- Small crusts appear where vessels were treated (8-10 days).
- Minor edema is present (lasting 24 hours) as well as moderate erythema (1-3 days).
- Following the treatment, soothing creams will be applied. Sunscreen is essential before exposing the treated area to sunlight to prevent hyperpigmentation.
Intense Pulsed Light therapy is not advised in the following cases: pregnancy, suspicious skin lesions in the regions to be treated, impaired healing, consumption of vitamin A or isotretinoin, epilepsy.
IPL for Hair Removal
Pulsed light technology can be employed for hair removal. The light emitted from the device is selectively absorbed by the hair shaft, causing carbonization of the hair and its root. Epilation refers to a procedure that isn't permanent but yields long-lasting results; however, maintenance sessions are still required.
The outcome is deemed satisfactory if a hair thinning of 70-80% is achieved; the remaining 20-30% transforms into fine fuzz (vellus hair). Success rates vary depending on the phototype and treated areas. For instance, fair skin with dark hair responds more effectively, while certain regions such as the back of the hands or fingers might not respond at all.
IPL has no effect on white, red, and blonde hairs as its target is melanin; the more pigmented the hair, the more it will be affected. In individuals with even mild endocrine dysfunctions or those undergoing cortisone or hormonal treatments (e.g., contraceptive pills), treated hairs can regrow or new ones may appear. Consequently, while this treatment proves effective for most individuals, there's no prior guarantee of success.
Pre and Post Intense Pulsed Light Treatment Guidelines
The treatment is conducted over several weekly sessions (on average 6-8), followed by one or two maintenance sessions annually.
In the 4-6 weeks leading up to the treatment, waxing and/or tweezing should be avoided, and hair should not be bleached. However, shaving is permissible up to 3 days before the treatment.
In the 2 days prior to the session and in the days following it, the use of a loofah glove, at-home peeling with exfoliating creams, as well as the use of perfumes or alcohol-based tonics must be avoided. Throughout the month leading up to and during the treatment phases, sun exposure and tanning lamps must be avoided, and the application of self-tanning creams should be suspended. Saunas, steam baths, or exposure to any other sources of heat should also be refrained from during the entire treatment period.
After IPL therapy, the skin may become more or less intensely red, and this redness may persist for at least 1-5 days. Pinpoint areas of swelling and edema may also appear at the level of hair follicles. This simply the result of hair follicles being damaged due to the explosion of the hair within the follicle itself. This mechanism is the basis of permanent hair removal and indicates the successful outcome of the therapy.
After the treatment, it's important to use total sun protection. If you are undergoing antibiotic and/or anti-acne therapy or taking other medications, you should inform your doctor during the evaluation visit so that they can establish the correct start date for the treatment.
Contraindications and Side Effects
The treatment with Intense Pulsed Light (IPL) is not recommended in the following cases: pregnancy, suspected skin lesions in the areas that need to be treated, wound healing disorders, intake of vitamin A or isotretinoin, epilepsy.
Intense Pulsed Light (IPL) treatment can have some common side effects, including transient erythema (redness), tenderness, itching, swelling, and transient hyperpigmentation. There is also a possibility of hyperpigmentation or hypopigmentation occurring if the treated areas are not adequately protected from sunlight.
The quality of clinical outcomes from the treatment cannot be evaluated in advance, nor can precise guarantees be provided about the achievable results, as individual conditions are essential in determining the patient's clinical response.