Intense Pulsed Light Source Research Articles

Survey of the cosmetic use of lasers and other strong optical radiation sources

A survey was undertaken regarding the extent to which optical radiation is used incosmetic treatments and the compliance with national regulations. Questionnaires weresent to 65 clinics, and 23 of these were later inspected. Only one of 41 class 4 lasers hadbeen reported to the authorities according to the regulations prior to the survey. Amongsources other than lasers, intense pulsed light (IPL) sources were the most frequent.Although qualified health personnel should be in charge of the treatment, it was observedthat 30% of the clinics did not fulfil this requirement. Deviations with respect to personneltraining, availability of written procedures, protective equipment and warning signs werefrequently observed. The results give rise to concern about the safety of patients andemployees.

Photorejuvenation

Aging is an ongoing process. The ultraviolet rays of the sun cause cutaneous changes such as damage to collagen, solar elastosis, telangiectasias, lentigines, and rhytid formation; the collective description of these negative effects is photodamage. Photorejuvenation is the process of using laser and light sources for returning skin to a more youthful appearance. This article explores the technology, clinical applications, side effects, and future directions of photorejuvenation with vascular lasers, pigmented lasers, and intense pulsed light sources.

Assessment of the optical radiation hazard from a home‐use intense pulsed light (IPL) source

Intense pulsed light (IPL) systems have evolved and crossed over from the clinic to the home. Studies have shown home-use IPLs to be clinically effective but there has been no published data on ocular safety. It was our aim to measure the spectral and temporal optical radiation output from a home-use IPL and assess the ocular hazard. The iPulse Personal is a new home-use IPL hair reduction system. We measured its optical radiation spectral output using a calibrated diode array spectrometer that was traceable to national standards. Pulse duration was determined by measurement with a fast photodiode. The results from these measurements were used to assess the optical radiation hazard to the human eye. Retinal thermal hazard (RTH), blue light hazard (BLH), and infrared radiation hazard to the cornea and lens were assessed in accordance with IEC TR 60825-9 and the International Committee on Non-Ionizing Radiation Protection (ICNIRP) Guidelines on Limits of Exposure to Broad-band Incoherent Optical Radiation, as there are no specific international IPL standards. Neither the BLH radiance dose nor the infrared radiation hazard to the cornea and lens irradiance exceeded the exposure limit values (ELVs) set by the ICNIRP. The RTH radiance, however, was exceeded at a fluence of 11 J cm(-2) and pulse duration of 16 milliseconds. Following these results the settings on the IPL were adjusted and the RTH was no longer exceeded at a new fluence of 10 J cm(-2) and pulse duration of 26 milliseconds. The home-use device that we assessed does not present an optical hazard according to currently available international standards.

Hair Removal Using a New Intense Pulsed Light Source in Chinese Patients

Background: Unwanted hair is a widespread cosmetic problem. Several lasers and intense pulsed light (IPL) have been utilized for this purpose. A new IPL device (Lumenis One™) with OPT is one of the newer modalities to be studied in Chinese patients. Objective: This study evaluates the short-term efficacy and side effects of the new IPL device for epilation in Chinese patients. Methods: Eighteen Chinese women with Fitzpatrick skin types III–V and black hair, were treated four times at 4 to 6-week intervals using IPL (Lumenis One™) on the axillae (n=13) and the upper lip (n=5). The energy density for treatment ranged from 14 to 22 J/cm2. Parameters utilized were 695-/755-nm filters, triple pulse for patients on the axillae, and 640-/695-nm filters, double pulse for patients on the upper lip (3.5- to 7-ms pulse, 30- to 90-ms pulse delay, 15×35 mm spot size). Hair reduction was assessed at baseline, immediately before each treatment session, and at 4 weeks after the fourth treatment. Patient's satisfaction on a 5-point scale was also evaluated. Results: The average hair reduction for all sites was 49.9% after one session, 58.6% after two sessions, 79.3% after three sessions, and 83.8% after four sessions (p=0.001). The hair reduction of 44.1%, 52.1%, 81.1%, and 86.0% were achieved after each treatment for axillae, with 65.1%, 75.7%, 74.6%, and 78.0% for upper lip. Patients got more satisfaction after four sessions (score 3.1) than that after two sessions (2.0) (p=0.001). In both the assessments, upper lip appeared to show a better response than axillae after two IPL treatments, which reversed after four treatments. No significant complications or adverse events were reported. Conclusion: The new IPL device provides a safe and effective means of hair removal for Chinese patients. Treatment efficacy varies with the anatomic location and number of treatments. However, further study is necessary to determine the long-term clinical efficacy in Chinese patients.

The Asian Dermatologic Patient

The Asian patient with Fitzpatrick skin types III-V is rarely highlighted in publications on cutaneous disorders or cutaneous laser surgery. However, with changing demographics, Asians will become an increasingly important group in this context. Although high melanin content confers better photoprotection, photodamage in the form of pigmentary disorders is common. Melasma, freckles, and lentigines are the epidermal disorders commonly seen, whilst nevus of Ota and acquired bilateral nevus of Ota-like macules are common dermal pigmentary disorders. Post-inflammatory hyperpigmentation (PIH) occurring after cutaneous injury remains a hallmark of skin of color. With increasing use of lasers and light sources in Asians, prevention and management of PIH is of great research interest. Bleaching agents, chemical peels, intense pulsed light (IPL) treatments, and fractional skin resurfacing have all been used with some success for the management of melasma. Q-switched (QS) lasers are effective for the management of epidermal pigmentation but are associated with a high risk of PIH. Long-pulsed neodymium-doped yttrium aluminum garnet (Nd:YAG) lasers and IPL sources pose less of a PIH risk but require a greater number of treatment sessions. Dermal pigmentary disorders are better targeted by QS ruby, QS alexandrite, and QS 1064-nm Nd:YAG lasers, but hyper- and hypopigmentation may occur. Non-ablative skin rejuvenation using a combination approach with different lasers and light sources in conjunction with cooling devices allows different skin chromophores to be targeted and optimal results to be achieved, even in skin of color. Deep-tissue heating using radiofrequency and infra-red light sources affects the deep dermis and achieves enhanced skin tightening, resulting in eyebrow elevation, rhytide reduction, and contouring of the lower face and jawline. For management of severe degrees of photoaging, fractional resurfacing is useful for wrinkle and pigment reduction, as well as acne scarring. Acne, which is common in Asians, can be treated with topical and oral antibacterials, hormonal treatments, and isotretinoin. Infra-red diode lasers used with a low-fluence, multiple-pass approach have also been shown to be effective with few complications. Fractional skin resurfacing is very useful for improving the appearance of acne scarring. Hypertrophic and keloid scarring, another common condition seen in Asians, can be treated with the combined used of intralesional triamcinolone and fluorouracil, followed by pulsed-dye laser. Esthetic enhancement procedures such as botulinum toxin type A and fillers are becoming increasingly popular. These are effective for rhytide improvement and facial or body contouring. We highlight the differences between Asian skin and other skin types and review conditions common in skin of color together with treatment strategies.

Progressive Disseminated Essential Telangiectasia and Erythrosis Interfollicularis Colli as Examples for Successful Treatment with a High-Intensity Flashlamp

Background: Treatment of progressive disseminated essential telangiectasia and erythrosis interfollicularis colli by flashlamp pulsed dye laser frequently results in a mottled appearance and often leads to hypo- or hyperpigmentation after treatment. Furthermore, treatment is time-consuming due to the small spot size. Objective: To report the successful removal of thin vessels in patients with the above-mentioned indications by an intense pulsed light (IPL) source. Methods: Four patients with progressive disseminated telangiectasia on the extremities and 5 patients with erythrosis interfollicularis colli were treated with IPL. Results: A clearance of up to 90% of the telangiectasias was achieved. Conclusion: The superficial, thin vessels of progressive disseminated essential telangiectasia and erythrosis interfollicularis colli can be successfully treated by IPL.

Pigmentation due to Stasis Dermatitis Treated Successfully with a Noncoherent Intense Pulsed Light Source

Pigmentation due to Stasis Dermatitis Treated Successfully with a Noncoherent Intense Pulsed Light Source

Comparison of intense pulsed light (IPL) and pulsed dye laser (PDL) in port-wine stain treatment

Abstract Objective The pulsed dye laser (PDL) is the gold standard for the treatment of port-wine stains (PWS). However, intense pulsed light sources (IPLS) have often been used recently for PWS treatment not only due to their broader wavelength span which covers more than one absorption peak of hemoglobin, but also their larger spot size, and less purpura formation. An open 4-year prospective study was carried out to evaluate the clearing efficacy of second generation IPLS compared with PDL for the treatment of PWS. Materials and methods PWS patients were treated with both a PDL (PhotoGenica V-Star, Cynosure, USA; parameters: 595 nm, 7–10 mm, 0.5 ms, 4.6–7.8 J/cm 2 ) and an IPLS (Ellipse Flex, Ellipse A/S, Denmark; parameters: 555–950 nm, 8 ms, 14–19 J/cm 2 ). Each PWS was divided into pairs of equally red areas at the same localization. The left–right trial was continued with repeated treatments at 6–8 weekly intervals until one side showed improvement (partial or complete clearing) or caused side effects. The clearing of PWS was rated by clinical evaluation and the patient's decision regarding further treatment was documented. If the clinical evaluation was considered insufficient, before and after images, which were rated by impartial non-professionals, were included in the rating. Results One hundred patients (69 females, 31 males, aged 0.1–74.2 years, average 23.4±14.9 years) with 130 PWS areas completed the comparison study after an average of 4.1±2.0 repeated treatments (range 1–13). Sixty-four percent of the patients had not been treated before. Superior clearing of PWS by IPLS was found in 57.7% of the treated areas and this result is statistically significant ( P Conclusion Second generation IPL technology proved to be superior in clearing PWS and was preferred by the patients for continuing treatment compared with PDL as long as it was used in non-tanned patients.

Verification of switched liquid crystal eye protection filters

Protective eye-wear which utilizes switched liquid crystal can provide protection for operators using intense pulsed light sources (IPLs). Such eye protection devices combine the properties of useful visual transmittance in the nonactivated state and low light transmission in the active blocking state. The performance of a specific LightSpeed device has been determined using a series of bandpass optical filters coupled to photodiode detectors with signals being captured using a USB interface. Such measurements have allowed key switching parameters of these devices to be determined as part of the process of assessing their effectiveness. Measurements of optical density of transmitting state and blocking state were also determined using a double grating spectroradiometer. A simple model of active filter function was developed and applied to specific IPL pulse profiles.

Pigmentation due to Stasis Dermatitis Treated Successfully with a Noncoherent Intense Pulsed Light Source

A 69-year-old Caucasian female consulted our department for treatment of pigmentary ochre dermatitis secondary to a chronic venous insufficiency of 25 years’ duration. She presented purpuric macules and patches, ochre-brownish in color, on the lower third of both legs with no discomfort except her aesthetic problem (Figure 1). The patient made no reference to taking any medication or to having a medical history of interest with the exception of venous insufficiency. She had consulted various specialists who offered no solution to the aesthetic problem and who had prescribed, as a treatment, a chelating decoloring gel, which she used for several months with no improvement. After informed consent was obtained, we chose noncoherent IPL source (Harmony system, Alma Lasers Ltd., Caesarea, Israel) as a treatment.

Treatment of Poikiloderma of Civatte Using Intense Pulsed Light Source

BACKGROUND AND OBJECTIVE The treatment of choice of poikiloderma of Civatte should address both pigmented and vascular lesions at the same time. A broad-spectrum, noncoherent intense pulsed light (IPL) source can be used to obtain this effect. In this study, we investigated the clinical efficacy and side effects of treating this condition with IPL. MATERIALS AND METHODS A total of 175 patients with poikiloderma of Civatte of the neck and chest were treated with IPL at various settings. The mean age of patients of various skin types (Fitzpatrick I to III) was 49 years. They were subjected to a treatment protocol including three sessions every 3 weeks. At follow-up visit, performed 3 months after the last treatment, clinical improvement was evaluated for all patients by comparing pre- and posttreatment photographs. The patients also scored their overall satisfaction. RESULTS Clearance of more than 80% of vascular and pigmented components of poikiloderma of Civatte was observed. Minimal and transient side effects occurred in 5% of the patients. No scarring or pigment disturbances were noted after the treatments. CONCLUSIONS The IPL source can be considered a safe and effective therapeutic option for poikiloderma of Civatte, allowing a marked improvement of vascular and pigmented lesions with minimal side effects.

Side effects and complications using intense pulsed light (IPL) sources

Abstract Lasers have been well known for about 50 years, while flash lamps, also called intense pulsed light (IPL) sources, have been available for clinical applications for less than 20 years. There are many differences between lasers and IPL: a laser emits monochromatic light, whereas an IPL emits a whole range of wavelengths between approximately 250 and 1200 nm. Cut-off filters reduce this range and enable the treatment of different skin conditions. Water acts as a cooling agent by absorbing the emitted infrared light. As a broad spectrum of wavelengths is not absorbed by the chromophores of skin, unspecific heating of the surrounding tissue occurs when using therapeutic energy densities. Flash lamps are used for a variety of indications, such as hair removal, treatment of vascular and pigmented lesions and photorejuvenation. All these applications can be performed with one device by changing the cut-off filters; however, the therapeutic range is rather small and therefore, negative side effects such as burns, blisters, vesicles, erosions and crust formation, as well as hypo- and hyperpigmentations are common. All precautions pertaining to laser treatment of the skin have to be observed with flash-lamp applications as well; in particular, a clear diagnosis has to be established before treatment, and if treatment is performed by non-medical staff it has to be supervised by a physician.

Observation of THz coherent transition radiation from single-bunch beam at KURRI-LINAC as an intense pulsed light source

A single-bunch beam has been generated using a developed high-speed avalanche-type pulser in KURRI-LINAC in order to lift restrictions of the spectral resolution in the spectroscopic study and the delay time in the time-resolved measurement. Both of the rise and fall times of the developed pulser are 110ps. The observation of CTR has confirmed the single-bunch beam. The degree of impurity of single bunch has been estimated to be 1.5% by the analysis of the interferogram.

Treatment of Poikiloderma of Civatte Using Intense Pulsed Light Source: 7 Years of Experience

The treatment of choice of poikiloderma of Civatte should address both pigmented and vascular lesions at the same time. A broad-spectrum, noncoherent intense pulsed light (IPL) source can be used to obtain this effect. In this study, we investigated the clinical efficacy and side effects of treating this condition with IPL. A total of 175 patients with poikiloderma of Civatte of the neck and chest were treated with IPL at various settings. The mean age of patients of various skin types (Fitzpatrick I to III) was 49 years. They were subjected to a treatment protocol including three sessions every 3 weeks. At follow-up visit, performed 3 months after the last treatment, clinical improvement was evaluated for all patients by comparing pre- and posttreatment photographs. The patients also scored their overall satisfaction. Clearance of more than 80% of vascular and pigmented components of poikiloderma of Civatte was observed. Minimal and transient side effects occurred in 5% of the patients. No scarring or pigment disturbances were noted after the treatments. The IPL source can be considered a safe and effective therapeutic option for poikiloderma of Civatte, allowing a marked improvement of vascular and pigmented lesions with minimal side effects.

Within-patient right-left blinded comparison of diode (810 nm) laser therapy and intense pulsed light therapy for hair removal

Excessive facial hair in women can cause significant psychological distress. A variety of treatment methods are available, including lasers and, more recently, intense pulsed light (IPL) sources. There are very few studies comparing laser and IPL devices. The purpose of our study was to compare a laser diode device with an IPL, using a within-patient, right-left, assessor-blinded, controlled, study design. Hair counts were made, using coded close-up photographs. Treatments were carried out on three occasions at 6-week intervals, and a final assessment was made 6 weeks following the third treatment. Patient self-assessment was also included. Nine women were recruited, and seven completed the study. Average hair counts in a 16 cm(2) area before and after treatment were, respectively, 42.4 and 10.4 (laser), 38.1 and 20.4 (IPL), 45.3 and 44.7 (control). Both laser and IPL reduced the hair count substantially; laser vs control was significant at P=0.028, but IPL vs control had P=0.13, suggesting that more subjects or more treatments were required if statistical significance were to be achieved. Despite subjecting the patients to higher pain scores and more inflammation, laser was preferred by five patients; two preferred IPL and one had no preference.

Time-resolved measurement shows a spectral distribution shift in an intense pulsed light system

For an intense pulsed light (IPL) device, knowledge of the spectral output is useful in order to provide effective treatment and target specific structures in the skin. It is also a requirement in order to perform a safety assessment. A novel spectral measurement system has been developed to detect the optical radiation output of intense pulsed light devices. The system has a time resolution of 450 mus and a wavelength resolution of 0.6 nm. This enabled us to observe spectral changes, both within a pulse and between pulses, in a pulse train. The output from a free discharge IPL source and four different treatment handpieces was measured. A shift in the spectral distribution between pulses, and within a pulse, was discovered. The spectral shift is more prominent for higher radiant exposures.

Clinical effectiveness of a novel intense pulsed light source on facial pigmentary lesions

Intense pulsed light (IPL) therapy improves various clinical symptoms of photoaging skin. In this study we have investigated clinical effects of a novel IPL, Lumenis One (LUMENIS, Tokyo) on facial pigmentary lesions in 18 Japanese female patients. Measurement was performed after 3-5 treatments. IPL showed marked and slight improvements in 28 and 39%, respectively. The data of melanin index demonstrated the improvement after IPL therapy. These results indicated that IPL therapy using Lumenis One may be useful to treat solar lentigines and ephelides on the face.

Sporadic nonsyndromal anterior cervical hypertrichosis: case report and review of the literature

A 13-year-old girl presented with cosmetically disturbing excessive hair growth in the anterior cervical region that had been present since birth. An X-ray of the cervical and lumbosacral spine did not show any ossal changes. Based on the clinical findings, the diagnosis of anterior cervical hypertrichosis was made. We successfully treated the patient with an intense pulsed light source. Here, we briefly discuss and review the clinical presentation and causes of localized and generalized hypertrichosis as well as possible treatment modalities.

Treatment of lymphangioma circumscriptum with the intense pulsed light system

Lymphangioma circumscriptum is a superficial lymphatic malformation presenting with grouped translucent vesicles that often contain blood. In the past, several treatment modalities have been described. Here, we report for the first time on treatment with an intense pulsed light source that led to good cosmetic results.

Evaluation of safety and efficacy of variable pulsed light in the treatment of unwanted hair in 77 volunteers

Several studies on hair removal with intense pulsed light (IPL) and various laser sources have been done, but adequate data on long-term follow up are scarce. The present uncontrolled prospective pilot study evaluated safety and long-term efficacy of variable pulsed light (VPL) on hair removal in the face for medical and/or cosmetic indications. The VPL system (Energist Ltd, UK) was used for the treatment of hypertrichosis in the face, mainly hirsutism, in 77 female volunteers. The minimum follow-up time after the last treatment was 9 months (mean: 12.74 +/- 2.87 months). Over 50% of hair clearance was observed in 68 (88.3%) of all cases. Erythema and leucotrichia were the most often associated side-effects encountered. Transient pigmentary changes were not reported. The VPL System presents as a relatively efficient and safe treatment alternative for long-term removal of unwanted hair. It seems to be particularly effective in fair-skinned patients with dark hair (skin types II-III-IV). Adverse effects were minimal and transient and, in no patient, significant enough to interrupt treatment.