Didn't Get the 'Coffee Ground' Look After IPL?

Question

I had an IPL photofacial 2 days ago. I've gotten one 6 years ago and my freckles got that "coffee ground" look almost immediately and flaked off in the next few days. With my most recent IPL, only a handful of freckles got that coffee ground look and most of the other freckles stayed exactly the same. When I spoke to the RN that provided the treatment, she stated that the newer machines no longer cause the coffee ground look. She said I would see the results in the 2nd / 3rd week. Is this true?

Sonia Badreshia-Bansal, MD · Answer

Thank you for your question. The darkening of the spots or the "coffee ground" appearance may or may not appear depending on the settings, depth of pigment, and amount of pigment remaining. I would still recommend continuing your treatments as long there is improvement. I would also recommend being treated under the supervision of a Board Certified Dermatologist or Plastic Surgeon for safest and best treatment option. I hope this helps.

Sam Naficy, MD, FACS · Answer

Whether the machine is new or not, you should still experience the "coffee ground" effects at about 24-48 hrs from the time of your treatment, depending on how much dyschromia you had.

Joseph A. Eviatar, MD, FACS · Answer

Different machines cause different amounts of pigment absorption. Some of the newer machines do cause less skin trauma. I would wait several weeks because you can’t judge the final result based on the immediate inflammatory response.

Jacque P. LeBeau, MD · Answer

If you have facial dyschromias amenable to treatment with an IPL device you will typically see the "coffee ground" appearance within the first 24 hours and can expect this pigmentation to exfoliate and resolve within 1-2 weeks.  It is not true that "newer" IPL devices do not cause this post treatment appearance.

	Jacque P. LeBeau, MD

F. Victor Rueckl, MD (in memoriam) · Answer

Coffee grounds typically occur after 24-48 hours. No, new machines still get the same coffee grounding effect, as it's still IPL. Remember though that your treatment shouldn't produce the same amount of coffee grounds every single time though. As some of those marks sluff off, they won't need to do it again, so you shouldn't have the exact same each time and having less could just mean that more of the surface ones went away with the first treatment.

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