Intense pulsed light (IPL) (500 -1200 nm)
Intense pulsed light (IPL) or flashlamp therapy is a non-invasive and non-ablative treatment that uses high intensity pulses of light to improve the appearance of the skin problems. IPL is a flashlamp (flashtube) device that employing a noncoherent-pulsed light source that emits light within the 500- to 1200-nm portion of the electromagnetic spectrum. IPL systems use a special computer-controlled flashtube to generate high-energy broad spectrum light. The light beam thus generated can be filtered to allow predominantly wavelength in a particular narrow range, enabling it to treat a particular skin condition or sign of aging by selecting the filters used. Longer wavelengths penetrate deeper into the target, longer wavelengths are used to treat deeper targets, and to avoid and protect superficial parts of the skin. Shorter wavelengths are used to treat more superficial targets and avoid damaging deeper skin parts. This capability allows the experienced Intense Pulsed Light Physician to vary the light delivered in order to match the depth of the target and avoid the areas that are not to be treated. Pulsed Light delivered in pulses or bursts of light varies from 1 to 5 pulses at a time. This system is operator-dependent and allows treatment parameters (wavelength, pulse duration, delays between pulses) to be tailored for each use. The “duration” of each pulse and the “delay” time between pulses can be modified with each treatment site. Longer durations are generally better for treating larger targets. Shorter pulse durations are generally better for treating smaller structures. ). Limited treatment setting in Laser or in “simpler” Intense Pulsed Light machines offer the experienced physician operator fewer choices. Even though fewer choices may be “simpler” or “easier”, the restriction in operator flexibility caused by less customizable settings can produce suboptimal results and more undesirable side effects.
The advantage of IPL therapy is its minimal downtime. The pulses of light produced by IPL equipment are very short in duration, so discomfort and damage to non-target tissues is minor. Pulsed Light can deliver total pulse durations up to 25 msec or 1235 msec while most Laser can deliver pulse durations up to 40-100msec (and 1 machine can deliver 1000 msec but at only 800nm). Pulsed Light’s larger light beam size allows for faster treatment and deeper light penetration. The disadvantages of using an IPL source include the absence of an inherent skin-cooling protective mechanism, the need to learn specialized techniques to minimize or avoid epidermal injury, and the large size of the IPL device. The risk for side effects in patients that have darker skin types is higher and in these patients we generally advise alternative treatments. Intense Pulsed light systems vary considerably. Basic systems found in spas and performed by non physicians do not have the necessary power to provide the type of results that more advanced systems are capable of producing. Furthermore, they do not have internal safety mechanisms required to ensure predictable and safe results. The older Intense Pulsed Light systems needed a cold gel to be applied to the skin before treatment. Earlier systems of IPL use a single system with a set of filters to treat all eligible conditions. More specialized systems were later developed which improved specificity and effectiveness to prevent less experienced, and usually non-physician operators from producing undesirable side effects, but reduced versatility. Individual machines may be specially designed to focus on certain problems but may not be equally effective. IPL therapy can treat the following skin conditions:
- Vascular lesions including spider angiomas, port wine stains, broken facial veins, rosy cheeks, rosacea and red thread veins of the legs
- Freckles and age marks and other skin discolouration problems such as melasma / chloasma and erythromelanosis of the neck (poikiloderma of Civatte).
- Facial lines and wrinkles
- Removal of unwanted dark hair
- mild to moderate acne and stretch marks.
FotoFacial™ – This is the only trademarked term that may be used to describe the actual treatment as invented and taught by the originator of this treatment – Dr. Patrick Bitter, Jr. Only with the true correctly spelled FotoFacial™ can you be assured that the doctor and his staff that are treating you have the proper machine, and have actually attended the official intense FotoFacial™ training session. Anything less than this implies nothing – just that someone bought any machine and didn’t necessarily receive this specific, intense, hands-on training.
Common IPL devices use cutoff filters of varying wavelengths 515 nm, 550 nm, 570 nm, 590 nm. For example, if the cutoff filter is 590 nm, then the wavelength range of the operation is 590nm-1200 nm (green, yellow, red, and infrared light). The designated 550-nm wavelength is strongly attracted to melanin, limiting its use in darker-skinned patients and increasing the risk of skin burns in tanned patients. Lumenis (originally ESC medical system) is the leading manufacturer of IPL equipments.