Clinical outcomes of intense pulsed light combined with non-crosslinked sodium hyaluronate, tranexamic acid, and vitamin C mesotherapy for facial photoaging: a retrospective study

IntroductionLaser in situ keratomelieusis (LASIK) is one of the most frequently performed refractive treatments. Dry eye (DE) is common in patients after LASIK and can be bothersome postoperatively. Therapies such as intense pulsed light (IPL), sodium hyaluronate (SH) and heated eye mask (HEM) have been reported to improve signs and symptoms of DE .AimThe purpose of this prospective study was to evaluate and compare the effects of IPL and 0.1% SH (IPL group, 50 eyes) and IPL in combination with 0.1% SH and HEM (IPL + group, 50 eyes) in participants with persistent post-LASIK DE.MethodsThe final analysis included 100 patients (100 eyes) who had LASIK for myopic correction and had been experiencing moderate to severe DE following LASIK for over a year. Participants were randomly assigned to either the IPL group (2 IPL sessions) or IPL + group (2 IPL sessions and daily HEM for 4 weeks), and both groups continued the use of daily 0.1% SH (HYLO-COMOD®) preservative-free eye drops. Non-invasive tear break-up time (NITBUT), tear film lipid layer (TFLL), lower tear meniscus height (LTMH), meibomian gland quality (MGQ), meibomian gland expressibility (MGEx), corneal fluorescein staining (CFS), ocular surface disease index (OSDI) and artificial tear usage (ATU) survey were assessed at baseline (BL) and follow-up at 2 (F1) and 4 weeks (F2).ResultsFollowing the treatment protocol, all dry eye (DE) parameters assessed in this study improved significantly (P < 0.05) in both groups at F2 compared with their respective BL measurements. Inter-group comparison at F2 found significant differences in their NITBUT (IPL: 6.06 ± 0.59 vs. IPL +: 6.67 ± 0.86, P < 0.001), TFLL (IPL: 1.90 ± 0.65 vs. IPL +: 1.60 ± 0.64, P = 0.021), LTMH (IPL: 0.186 ± 0.053 vs. 0.204 ± 0.034, P = 0.003), MGQ (IPL: 1.48 ± 0.54 vs. IPL +: 1.26 ± 0.56, P = 0.026), MGEx (IPL: 1.62 ± 0.53 vs. IPL +: 1.44 ± 0.50, P = 0.038) and OSDI (IPL: 32.54 ± 6.85 vs. IPL +: 29.76 ± 4.74, P = 0.001), while CFS score (IPL: 4.02 ± 0.65 vs. IPL +: 3.96 ± 0.73, P = 0.652) and ATU (IPL: 1.88 ± 0.63 vs. IPL +: 1.72 ± 0.50, P = 0.159) showed no significant difference.ConclusionPost-LASIK DE signs and symptoms can be improved by combining therapies such as IPL, HEM and 0.1% SH. Increased TFLL due to a combination of IPL, 0.1% SH and HEM had a greater positive impact on the subjective and objective DE measurements in participants with persistent post-LASIK DE.

Intense pulsed light combined with meibomian gland expression for chalazion management

Cutaneous hyperpigmentation is one of the most cosmetically disturbing sequel of drug-induced toxic epidermal necrolysis. Intense pulsed light is a promising tool for treating some melanocytic lesions. The objective was to assess the effect of intense pulsed light in treating post-toxic epidermal necrolysis facial hypermelanosis. Two Caucasian men aged 35 and 50 years presented with long-standing (32 and 39 years) severe hypermelanosis of the face after sulfonamide-induced toxic epidermal necrolysis. They were treated by intense pulsed light. Cutoff filters of 550, 590, and 615 nm were employed for five intense pulsed light sessions at 4-week intervals. The treatment was characterized by energy fluence of 25 to 32 J/cm2, pulse width of 2.2 to 3.2 ms, and double- to triple-pulse mode respecting a 30-ms delay. Before intense pulsed light treatment, and 2 months after the fifth intense pulsed light session, clinical photographs and skin biopsies were performed in combination with quantitative narrow-band remittance spectrophotometry of melanin pigmentation. Patients were clinically followed-up for 8 months after the end of the treatment. In both patients, clinical, histologic, and spectrophotometric assessments showed an average of 80% decrease in the hypermelanosis. No clinical recurrence of the hypermelanosis developed during the 8-month follow-up after intense pulsed light treatment. No major persistent side effects were experienced, especially hypopigmentation. Intense pulsed light appears to be effective and safe for treating post-toxic epidermal necrolysis hypermelanosis in Caucasian patients.

Luz pulsada intensa combinada con expresión de las glándulas de Meibomio para el tratamiento del chalación

To evaluate the efficacy and safety of photodynamic therapy (PDT) with the novel 10% aminolevulinic acid (ALA) hydrochloride gel (10% ALA gel) and BF-RhodoLED® light (635 nm; 37 J/cm2 ) in combination with intense pulsed light (IPL) to augment the medical and aesthetic improvement of photodamaged skin of the décolleté. This was a single-site prospective, randomized, intraindividual split chest pilot study with 20 female subjects with moderate to severe photodamage of the décolleté. Subjects were randomized to ALA-PDT + IPL to one split-side of the chest and ALA-PDT only to the contralateral side. Three blinded raters assessed aesthetic improvement using the global aesthetic improvement scale (GAIS). Eighteen subjects completed the study. Superior GAIS results were achieved on the ALA-PDT + IPL treatment side than on the ALA-PDT only treatment side (p < 0.001) after 24 weeks of follow-up. ALA-PDT using 10% ALA hydrochloride gel and BF-RhodoLED® light had superior rejuvenation effects on the décolleté when combined with IPL compared to ALA-PDT alone.

Background:There is always a necessity for newer acne treatments. Intense pulsed light (IPL) technology has been used for this purpose but there are limited studies in this field. As macular and erythematous remnants of acne inflammatory lesions are very common, resistant, and long lasting, we decided to evaluate the efficacy of IPL (as a tool for diminishing erythematous reactions in the tissues) for the treatment of residual erythematous macules following facial acne.Materials and Methods:Thirty-five patients were registered in the study. Patient recruitment occurred between January 2010 and June 2011, and the study was completed in October 2011. Every patient received three IPL sessions, with a 2 week interval, on the right side of his/her face. Also, we recommended the patients to apply topical erythromycin solution 2% twice daily on their entire face from start to end of the study (i.e. until 3 months after the third IPL session). An independent physician counted the number of erythematous macules before every IPL session and 1 and 3 months after the last session.Results:Thirty-three patients completed the study and were enrolled in analysis. Results of the study show that IPL therapy decreases the number of erythematous macules along the time.Conclusions:IPL can accelerate the improvement rate of persistent erythematous macules remained after inflammatory acne subsides. More studies are needed to explain the exact role of it.

Prospective evaluation of a new intense pulsed light, thermaeye plus, in the treatment of dry eye disease due to meibomian gland dysfunction

BackgroundRosacea is a chronic inflammatory skin condition of varying severity that can significantly impact patient quality of life. Intense pulsed light (IPL) is an established treatment for rosacea‐associated telangiectasia, inflammation, and erythema.This study assessed whether application of a phyto‐corrective mask, gel, and resveratrol antioxidant serum after IPL treatment can improve outcomes and reduce procedure‐related adverse effects.MethodsIn a prospective, open‐label, split‐face, 3‐month study, 10 subjects with moderate‐to‐severe facial rosacea underwent IPL treatment on both sides of the face. The following were applied to the right side of the face only: phyto‐corrective mask once weekly starting immediately after IPL; phyto‐corrective gel twice daily; and resveratrol antioxidant treatment at night. Both sides of the face were treated with sunscreen. Subjects were assessed on Day 1, 1 and 3 months after IPL by three, independent evaluators using the 5‐point Global Aesthetic Improvement Scale (GAIS). All subjects rated skin redness, hydration, and overall improvement on Day 1 and completed a patient satisfaction questionnaire at the 1‐ and 3‐month visits.ResultsTen women were enrolled, aged 44–72 years old, with moderate (n = 6) to severe (n = 4) rosacea. IPL was effective at reducing symptoms with rosacea classified as absent in five women and mild in five at the final 3‐month visit. GAIS scores also revealed improvements on both sides of the face, but the skincare treated side showed continuous improvement over 3 months with all patients remaining at least “Improved”, whereas there appeared to be a waning effect after 1 month with IPL alone. On Day 1 after IPL, all women reported less redness, improved hydration, and improved skin appearance on the right side of the face. Patient satisfaction was consistently rated higher on the right side of the face.ConclusionApplication of a phyto‐corrective mask, gel, and resveratrol antioxidant serum may complement IPL treatment for rosacea by enhancing treatment outcomes and reducing procedure‐related symptoms.

Objective:To evaluate the efficacy and safety of photodynamic therapy (PDT) with the novel 10% aminolevulinic acid (ALA) hydrochloride gel (10% ALA gel) and BF-RhodoLED® light (635 nm; 37 J/cm² ) in combination with intense pulsed light (IPL) to augment the medical and aesthetic improvement of photodamaged skin of the décolleté. Methods:This was a single-site prospective, randomized, intraindividual split chest pilot study with 20 female subjects with moderate to severe photodamage of the décolleté. Subjects were randomized to ALA-PDT + IPL to one split-side of the chest and ALA-PDT only to the contralateral side. Three blinded raters assessed aesthetic improvement using the global aesthetic improvement scale (GAIS). Results:Eighteen subjects completed the study. Superior GAIS results were achieved on the ALA-PDT + IPL treatment side than on the ALA-PDT only treatment side (p < 0.001) after 24 weeks of follow-up. Conclusions:ALA-PDT using 10% ALA hydrochloride gel and BF-RhodoLED® light had superior rejuvenation effects on the décolleté when combined with IPL compared to ALA-PDT alone.

This study aimed to compare the efficacy and safety of triple therapy with oral tranexamic acid (TA), low-fluence intense pulsed light (IPL), and glycolic acid (GA) peels versus the same regimen without GA for treating mixed melasma. Patients with mixed melasma were randomly divided into 2 groups, with 20 patients in each group. The treatment duration was 4 months. Group A received oral TA (250 mg twice daily) combined with 2 sessions of low-fluence IPL per month (at a 2-week interval). Group B was treated with TA in combination with low-fluence IPL following the same procedure and weekly alternating treatment with GA. Both groups underwent a total of 8 IPL sessions over the course of the treatment. Patients were followed monthly for 3 months. At the end of the treatment, group B showed a lower mean modified Melasma Area and Severity Index (mMASI) score (3.14 ± 1.84) compared with group A (4.11 ± 2.05). The mean percentage improvement in mMASI scores was 46.81 ± 11.1 for group A and 60.70 ± 10.9 for group B (P < .05). Both groups exhibited a significant reduction in telangiectasia. Combining low-fluence IPL and GA with oral TA resulted in better cosmetic improvement than the treatment combination without GA.

To evaluate the clinical efficacy and safety of combination treatment with intense pulsed light (IPL), LipiFlow thermal pulsation, and manual meibomian gland expression (MGX) for patients with refractory meibomian gland dysfunction (MGD). A total of 23 eyes from 23 patients who underwent combination treatment with IPL, LipiFlow, and MGX for refractory MGD were included in the study. All patients were followed up for 12months after the first treatment. All patients were examined prior to treatment and underwent three sessions of IPL, LipiFlow, and MGX, a subsequent three sessions of IPL and MGX, and six subsequent sessions of MGX. Patients were examined 10weeks, 6months, and 12months after the first treatment. The ophthalmologic examination included ocular surface disease index (OSDI), non-invasive tearfilm break-up time (NIBUT), lipid layer thickness (LLT), meibomian gland expressibility (MGE), meibomian gland morphology (meiboscore), and tear meniscus height (TMH). OSDI, NIBUT, LLT, and MGE significantly improved with treatment, which was maintained during the follow-up period. TMH and meiboscore remained unchanged throughout follow-up. No serious adverse events occurred during follow-up. Combination therapy with IPL, LipiFlow, and MGX was clinically effective and safe for the treatment of refractory MGD. Combination treatment could be considered for patients with insufficient improvement despite conventional MGD treatments, including IPL treatment with MGX.

Background: Acne vulgaris is a chronic inflammatory disease of the pilosebaceous follicle with polymorphic clinical manifestation typically found on facial, neck and/or back area. The pathogenesis is complex and multifactorial. Management of acne vulgaris is determined based on its severity. Adjuvant therapies, such as intense pulsed light (IPL), have been described in accelerating the healing process during treatment. Case Illustration: We report two cases regarding the usage of IPL as adjuvant therapy in acne vulgaris. Both patients were diagnosed with moderate acne vulgaris. The first patient was given topical adapalene 0.1% gel every night and sunscreen in the morning, and the other patient was given clindamycin gel applied twice a day, benzoyl peroxide 2.5% cream applied once a day at night, and sunscreen in the morning. Both patients were treated using IPL as their adjuvant therapy every three weeks, with a total of 2 IPL sessions in 2 months. Evaluation using clinical and ultraviolet-induced red fluorescence (UVRF) examination showed gradual improvement. Discussion: IPL as an adjuvant therapy of acne vulgaris has been thought to interfere with the function of the sebaceous glands by its direct phototoxic effects and thermal damage. It also has bactericidal effects on C. acnes through the formation of free radicals. The combination of topical treatment and IPL yielded clinical improvements in both patients. Conclusion: IPL may be beneficial as adjuvant therapy in acne vulgaris in this case series. Keywords : acne vulgaris, adjuvant therapy, intense pulsed light, UVRF

IPL devices emit a wide range of wavelengths that can be absorbed by different chromophores in the skin. Selective destruction of a specific chromophore with minimal side effects is controlled by wavelength, pulse duration, and fluence. This study aims to evaluate the treatment of vascular and pigmented lesions using narrow-band Intense Pulsed Light (IPL) with Advanced Fluorescence Technology (AFT), which offers more efficient energy usage per pulse to increase safety, and improve clinical outcomes. A retrospective analysis of data from 100 patients treated with narrow-band IPL for vascular and pigmented lesions. Efficacy was measured by the Global Aesthetic Improvement Scale (GAIS) and Patient Satisfaction Scale (0-10). Safety was assessed by evaluating pain levels and adverse events. Mean GAIS scores were 8.02 ± 0.84 for vascular and 8.14 ± 0.9 for pigmented lesions with no significant difference between groups (p=0.49, α=0.05). Patient satisfaction correlated with GAIS scores (correlation coefficient 0.8). No pain was reported and two patients experienced temporary and transient side effects. Overall, the advanced IPL treatments provided favorable outcomes for vascular and pigmented lesions.

Introduction: Intense Pulsed Light (IPL) technology is well accepted in the medical aesthetic field for the treatment of various skin lesions, including pigmented and vascular lesions. The light penetrates into the skin and is selectively absorbed by lesion chromophore. Absorbed energy is converted into heat, coagulating the lesion, which naturally fades following the treatment. The current article presents a retrospective efficacy evaluation of an IPL device with high peak power. Methods: Representative treatment results were collected from several clinics based on photographs taken at baseline and after treatments. Photos were evaluated and analyzed for aesthetic improvement of the various skin conditions in different facial and body areas. Results: Analysis included cases of pigmented and vascular lesions, textural lesions, and more specific conditions such as melasma and rosacea. The two evaluators’ scoring demonstrated improvement in all cases according to the Global Aesthetic Improvement Scale (GAIS) scale. Conclusion: The vast experience gathered from the market in treating various skin lesions supports the safety and efficacy of the investigated IPL device. The device’s particular specifications contribute to the successful results and ease of treatment for the practitioner and the patient.

Context:Striae distensae are linear atrophic dermal scars covered with flat atrophic epidermis. They may cause disfigurement, especially in females. Many factors may cause striae distensae such as steroids, obesity, and pregnancy. Although there is no standard treatment for striae; many topical applications, peeling, and light and laser systems have been tried.Aims:To evaluate and compare the efficacy of fractional CO2 laser with intense pulse light in treating striae distensae.Subjects and Methods:Forty patients with striae distensae were recruited. Twenty of them were treated by fractional CO2 laser and 20 were treated with intense pulse light. Length and width of the largest striae were measured pre- and post-treatment. Patient satisfaction was also evaluated and graded. Patients were photographed after each treatment session and photos were examined by a blinded physician who had no knowledge about the cases.Results:Both groups showed significant improvement after treatments (P < 0.05). Patients treated with fractional CO2 laser showed significant improvement after the fifth session compared with those treated with ten sessions of intense pulsed light (P < 0.05) in all parameters except in the length of striae (P > 0.05).Conclusions:The current study has provided supportive evidence to the effectiveness of both fractional CO2 laser and intense pulse light as treatments for striae distensae. Fractional CO2 laser was found to be more effective in the treatment of striae distensae compared with intense pulse light.