Intense Pulsed Light System Research Articles

Nd:YAG laser combined with IPL treatment improves clinical results in non‐ablative photorejuvenation

BACKGROUND: Intense pulsed light (IPL) sources have been reported in non‐ablative photorejuvenation, but the excellent histological findings do not always coincide with the clinical results and patient satisfaction index (SI).METHODS: Ten female patients (two forehead, four periocular and four perioral), ages ranging from 28 to 46 years, skin types II–IV, wrinkle types I–III, participated in the study. The IPL system was applied with the yellow (570 nm) cut‐off filter, 30 J/cm2, single pulse, followed by the Nd:YAG at 120 J/cm2, double pulse (7 ms per shot with 20 ms between pulses) on the wrinkled areas only. Three sessions were given at monthly intervals, and an assessment was made 1 and 6 months after the third session. Biopsies were taken from four consenting patients as a cross‐section before the first treatment and then 1 and 6 months after the third session. For clinical control and contrast of tissue results, a group of 10 patients (two forehead, four periocular and four perioral; ages ranging from 27 to 47 years, skin types II–IV, wrinkle types I–III) was treated only with IPL, using the same parameters and sessions. Histologies were taken from four consenting patients.RESULTS: The histology showed thickening of the epidermis with good dermal collagen organization in both groups. However, the combined treatment showed more dramatic changes in histological tissue condition, and ectatic blood vessels were seen in the deeper dermis. The patient SI values, related to the results, were lower when IPL was used alone. All patients completed the study. In the combined treatment group, overall SIs of 8 (80%) and 8 (80%) were obtained at the control points of 1 and 6 months, respectively, after session 3, compared with SIs of 6 (60%) and 4 (40%) scored by patients in the IPL group at the same points. Discomfort and side effects were minimal in both groups.CONCLUSIONS: The addition of the Nd:YAG laser to the IPL regimen in non‐ablative skin rejuvenation gave very good histological results, which were echoed by stronger patient satisfaction than in the control group treated only with IPL. Visible improvement in the skin condition of both groups was achieved, but was better in the combined treatment group.

Facial photo rejuvenation using two different intense pulsed light (IPL) wavelength bands.

Intense pulsed light (IPL) systems are increasingly used for treatment of photo damaged skin. In the present study, we investigated the clinical efficacy and safety of two different wavelength bands generated by the same IPL device. An IPL device was equipped with either a 555-950 nm filter (VL), or a 530-750 nm filter (PR). Fair, good or excellent clearance of visible telangiectasias was obtained in 81.8% of the patients (PR) and in 58.8% (VL). In the treatment of diffuse erythema, fair, good or excellent clearance was obtained in 72.7% (PR) and in 35.0% (VL). The PR filter was more efficient (P = 0.025) in reduction of diffuse erythema. The average number of treatments was 1.75 (PR) and 1.82 (VL). For the treatment of irregular pigmentation, fair, good or excellent clearance was obtained in 54.5% (PR) and in 61.9% (VL). Multiple treatments of irregular pigmentation were also evaluated. Using the VL filter more than two treatments did not induce further clinical improvement. The patients also scored their over-all satisfaction. Either fair, good or excellent results were reported by 66.7% (PR) and by 76.2% (VL). No skin atrophy, scarring or pigment disturbances were noted after the treatments. Swelling and erythema were registered by 2/3 (PR) and 1/3 (VL) of the patients. The two IPL wavelength bands were both found to be effective in the treatment of photo damaged facial skin. The clinical efficacy and safety of the two different treatment procedures were comparable to those reported in earlier studies, and finally treatment with these filter combinations required less than half the fluence, no active cooling and fewer treatments.

Efficacy of long‐ and short pulse alexandrite lasers compared with an intense pulsed light source for epilation: a study on 532 sites in 389 patients

BACKGROUND: Undesirable hair growth presents a significant problem for many patients, and photoepilation has become a very popular procedure in aesthetic and cosmetic practice. Among the systems used are the long‐ and short‐pulsed alexandrite lasers (LP‐Alex, SP‐Alex) and intense pulsed light (IPL) sources. The present study retrospectively examined the outcome of these systems from the viewpoint of efficacy and side effects.PATIENTS AND METHODS: Three hundred and eighty‐nine patients (370 females and 19 males, mean age 36.4 yrs, skin types II–V) were admitted to the study, with a total of 532 treated sites. They were treated either with the LP‐Alex, SP‐Alex or IPL. Subjective evaluation and interview of the patients was held prior to every treatment session. Six to eight treatments were required with the alexandrite lasers, 2.4–2.8 months between treatments, and the IPL source required 8–9 treatments, 2–2.5 months apart.RESULTS: No significant difference was seen between the LP‐ and SP‐Alex, or between both of them and the IPL source, although the period to regrowth was longer for the lasers. Erythema and oedema were more noticeable with the LP‐Alex, as were crusting and hyper‐ and hypopigmentation. Discomfort was greatest with the LP‐Alex and the IPL source. Hair induction at the borders of the treated area on the face and neck was seen only with the LP‐Alex, and correlated statistically significantly with any episode of severe erythema, crusting or hyperpigmentation.CONCLUSIONS: There was no statistically significant difference between the LP‐, SP‐Alex and IPL photoepilation with regard to efficacy. Transient side effects were highest with the LP‐Alex, and least with the IPL system. In the LP‐Alex treated face and neck sites, 3.1% had hair induction in the borders of the treated areas.

Facial rhytides--subsurfacing or resurfacing? A review.

STUDY DESIGN/BACKGROUND AND OBJECTIVES: Currently, ablative laser therapy (with CO2/Er:YAG lasers) is considered an effective and promising method of skin rejuvenation. The induction of collagen synthesis was observed after treatments with the CO2 laser and with the long-pulsed Er:Yag laser. In past years, the undesirable side effects and risks of these methods have led to intensified research efforts in the fields of non-ablative facial rejuvenation as well as subsurfacing by means of non-ablative laser systems and intense pulsed light systems. The objective is to achieve selective, heat-induced denaturalization of dermal collagen that leads to subsequent reactive synthesis of neocollagen but does not damage the epidermis. This article reviews the use of different types of lasers and intense pulsed light sources for the non-ablative treatment of facial rhytides. The results of numerous clinical and histological investigations have recently indicated that these new technologies are successful. Some studies demonstrated remarkable effects with non-ablative systems; others, however, showed only limited cosmetic improvement or none at all. After critical review and assessment of current literature on the treatment of rhytides, we have found that non-ablative methods do not appear to be a comparable alternative to ablative skin resurfacing in terms of their efficacy and side effects.

IPL technology: a review.

Intense pulsed light (IPL) systems are high-intensity light sources, which emit polychromatic light. Unlike laser systems, these flashlamps work with noncoherent light in a broad wavelength spectrum of 515-1,200 nm. These properties allow for great variability in selecting individual treatment parameters and adapting to different types of skin types and indications. The purpose of this article was to critically review international medical publications of the many indication in which IPL technology can be used, including our own evaluations and experiences. The range of therapeutic uses for high-intensity flashlamps was reviewed, ranging from benign cavernous hemangiomas, benign venous malformations, essential telangiectasias, leg telangiectasias, poikiloderma of Civatte, and port-wine stains to pigmented lesions, cosmetically undesired hypertrichosis, and facial rhydids. The relative benefits and risks were discussed in detail and compared with other laser systems. Because of the wide spectrum of potential combinations of wavelengths, pulse durations, pulse frequency, and fluences, a great deal of experience is required when using IPL technology. Proper patient selection and critical diagnostics serve to keep the adverse effects of the treatment to a minimum. The distinctive technical conditions involved combine to make IPL technology an alternative and auxiliary treatment option to existing laser systems and conventional therapies.

Intense pulsed light source for the treatment of dye laser resistant port‐wine stains

OBJECTIVE: The purpose of this clinical study was to evaluate the efficacy of an intense pulsed light (IPL) irradiator system for the treatment of port‐wine stains (PWS) resistant to multiple pulsed dye laser (PDL) treatments.MATERIALS AND METHODS: Fifteen PWS patients, who were previously found to be resistant to multiple PDL treatments, were treated four times with a second generation IPL system. The clinical efficacy was evaluated on close‐up photographs 2 months after the last treatment.RESULTS: Patients with dye laser resistant PWS could be divided into two groups: responders to IPL treatments (46.7%) and non‐responders (53.3%). All responders obtained more than 50% reduction, and 85.7% of the responders obtained between 75% and 100% reduction of their lesions. The group of non‐responders was defined as patients who obtained less than 25% clearance.CONCLUSIONS: Approximately half of a group of PWS patients, who did not respond to previous PDL treatments, obtained good or excellent clinical effect after four treatments with the IPL system. All PWS, except those located in the V2 area of the face, responded to the treatments. The IPL treatment modality was found to be safe and efficient for the treatment of PWS, except for those located in the V2 area.

Leukotrichia developed following application of intense pulsed light for hair removal.

Lasers and light sources are now used worldwide for permanent or prolonged hair removal. Patients now prefer lasers and light sources for hair removal because of their noninvasiveness and fewer reported side effects. To study and report on leukotrichia that developed following application of intense pulsed light (IPL). From February 9, 2001 to February 14, 2002 a total of 821 patients were treated for unwanted hair. The system used was a noncoherent IPL system, with a 650 nm flashlamp filter; the parameters used varied with different Fitzpatrick skin types. The patients were treated monthly, with the rate of hair loss, measured by hair counts, and possible side effects recorded. Twenty-nine of 821 patients treated developed leukotrichia. Thirteen patients had no white or gray hairs before IPL therapy; the remaining 16 patients, who had few white hairs before treatment reported accelerated development of new white hairs starting after the first or second IPL therapy. Restoration of hair color occurred in 9 patients and the remaining 20 patients had no improvement or worsening of the condition within the next 2-6 months. Temporary or permanent leukotrichia may develop following IPL and laser hair removal therapy. This finding may be explained by the difference in the thermal relaxation times of melanocytes and germinative cells. The light absorbed and the heat produced by melanin may be sufficient enough to destroy or impair the function of melanocytes but insufficient to damage the hair follicle cells.

Intense pulsed light source for treatment of small melanocytic nevi and solar lentigines.

The purpose of this clinical study was to evaluate the effectiveness of an intense pulsed light (IPL) irradiator system for the treatment of benign pigmented lesions. A total of 18 patients with lentigo solaris and eight patients with melanocytic nevi were treated once with an IPL system. After 2 months, the effect was evaluated on close-up photographs. Pigment reduction was obtained in 96% of the patients, and the average clearance was found to be 74.2% and 66.3% for lentigo solaris and melanocytic nevi, respectively. The IPL was found to be effective for removal of benign pigmented lesions.