I've had 4 IPL sessions to treat sun spots on my hands without any improvement. Is it worth having any more?

Typically with IPL, you continue to see results after 4-5 treatments. However, if you havn't demonstrated any change by your 4th treatment there is one of two things happening. One, it may not be effective on your hands and thus I would stop the treatment. However, this is difficult to determine. One of the problems with IPL is it is user dependent, meaning if the settings are too low it will not do anything.So the other option, is to visit another provider and see if they can help with 1 or 2 treatments. Sometimes you need to make sure its the equipment and not your hands. Nevertheless, its very difficult to know exactly what the issue is.I recently wrote a long article on IPL and perhaps it may give you some insight into what to do and how it should work. James P. Bonaparte, MD, MSc, FRCSCJB Cosmetics and Facial Surgery Center of OttawaHead and Neck Surgerypracticing in Facial Plastic and Reconstructive SurgeryAssistant Professor, University of OttawaOttawa, Ontario, Canada

Our office has many different treatments for the skin and scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture. Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Thank you for your
question.IPL works well when treating spots of sun damage. Depending on what machine is being used along with the settings could be a factor. Also, using hydroquinone/brightening agent to help continue to lighten the brown spots would help along with being sure to protect the treatment area with sunscreen that blocks UVA and UVB rays. To be sure what treatment is best for you, see two
or more board-certified providers in your area for a complete evaluation to
make sure you are a good candidate and that it is safe for you to have
treatment.

I hope this helps.

Generally speaking brown spots caused by sun damage respond well to IPL treatment.  However there are number of factors that can be involved such is how dark the sponsor, which IPL device is used, and how proficient the user is.  You may wish to seek a second opinion.

I am not much of a fan of IPLs or lasers, for that matter, having encountered quite a few patients with your disappointing experience. For over three decades I have been treating brown sunspots on the face and hands (solar lentigines) with either TCA in low concentrations, between 15%-25% applied directly to the spots followed by a more superficial peel to the surrounding skin for blending. Alternatively, light electrodessication of the very superficial surface of the spots may be used to the point where the pigment can literally be wiped away with a gauze pad. As a rule, I try each method on a test site to see which method works better in a particular individual.These procedures are quick, simple and inexpensive and worth discussing with your physician, especially after lack of success with four IPL treatments. 

you should have IPL done with Q switched lasers or factional laser to get improvement in wrinkles as well.  If you have gotten no improvement you should get a second opinion.  The person performing the procedure may not be experienced enough or know the best options for you skin type.  Best, Dr. Emer.

hand pigmentation can be treated a number of ways - devices like IPL/BBL's, q-switched lasers, alexandrite lasers all work as does long term skin care. In your case the lack of results may be operator dependent - wrong settings etc or device dependent - (ie cheapo machine). get another opinion from an experienced laser office

It really depends on the settings but also the spots on the arm are difficult to treat depending on how many are there.  I have pretreated them with Hydroquinone and Retin- A, as long as you wear sunscreen on them for weeks before treating with IPL, or used intermittent chemical peels- and sometimes a Q-switched laser.  It rarely will be that one modality will be enough.  Sometimes even Irbium will be used.