Ok, let me begin this by saying that some of the reviews on here are absolutely terrifying. So much so that I almost backed out an hour before my appointment! In the end, I decided to go and at least discuss some of my concerns with the laser nurse. After doing so, I decided to go ahead with it.
I am 28 and have sun damage with extensive hyperpigmentation and melasma. Remarkably, I have no wrinkles. I really just wanted to address the discoloration because I am sick of feeling like a monster when don't have make up on.
When I went to the initial consult with the Aesthetician 2 weeks ago, she was fairly upfront about the IPL and did not try to sell it as a "no down time" fix. She admitted that all of my dark spots would in fact turn darker, perhaps almost black or even purple in places, and that it would be a 7-10 day process of these darker patches sloughing off with some additional redness in the first few days. This seems to be part of some people's dismay with the IPL... they were not informed that this is what will happen?! I will say, she did not mention to me that I could need a series of treatments for dramatic results but I was aware the IPL is usually done in more than one session.
Today when I spoke to the laser nurse (note-they offered for a Dr. to do the procedure but he was booked for quite a while and they assured me the laser nurse is wonderful and experienced), I expressed some of my concerns which all originated from reading reviews on this site. She said my skin tone is the best for IPL. I am fair skinned with pinkish tone and blonde hair. She said the majority of these "horror" stories occur when either A) a very inexperienced non-doctor, non-nurse does the IPL and uses a setting way too high and/or B) the patient has a darker skin tone, perhaps Mediterranean, Hispanic or Native American background, because for whatever reason their skin responds and heals differently.
After I decided to continue, she went over that I would have redness and burning for anywhere from 2-24 hours. She applied a numbing cream to my entire face which is intended to numb in 20 minutes. However, she waited a full 45 minutes to ensure my face was as numb as possible. The actual procedure only took about 20 minutes and it was not painful at all but rather slightly uncomfortable. She told me my dark spots were immediately becoming darker which apparently means I should respond really well to the treatment and may not even need to do it more than once. By the time she was finished, I definitely could begin to feel some burning. She used a stronger setting on my cheeks than she did on my forehead since there is more fatty tissue in the cheeks and chin, so that is mostly where I felt like my face was on fire. She applied ice and cold compresses, which I continued to do for the first 1-2 hours after I got home but then I felt like I no longer needed it because the burning was very tolerable.
It has been about 6 hours since I left the Med Spa and I'd say about 75% of my face is dark brown. A few places where I had no sun damage or discoloration are white even though she used the laser in those areas. I am prepared to hide in my apartment for the next 3-5 days.
Of course, I will update later because if somehow these huge dark brown patches do not slough off, I will be a very unhappy camper! But for now, it sounds like everything is going according to plan and I am pleased. I think knowing what you're getting yourself into (as many have said- this is NOT a lunch time procedure!) and going to a trustworthy and experienced Doctor or Nurse is crucial with this treatment.