IPL and Fraxel be recommended together for sun damage?

Question

52 Yr Old Male, Freckles, Light Skinned, Blue Eyed with some actinic keratosis on cheeks and around the temples/forehead. In looking to clean up my complexion, I'm being advised to do both IPL and Fraxel treatments? Seems redundant from what I have read? Is this correct?

Janet Allenby, DO · Answer

Hello,

Thank you for your question. IPL and Fraxel are combined often. The IPL will address the sun-damage in your complexion . So it will help the brown spots fade, and the redness will dissipate. While the Fraxel will help tighten the skin, and improve the texture. It will improve fine lines and wrinkles. The IPL will show results in 1-2 weeks, the brown spots will get darker and then slowly peel off. The Fraxel takes about 2 months to see results because it takes time for the collagen to grow. Good luck!

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for 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

Alex Eshaghian, MD, PhD · Answer

Thank you for your question cdavefly. IPL is a great treatment for facial rejuvenation. We routinely combine it with other treatments to enhance results. While I do not have experience with Fraxel, I have seen outstanding results when IPL is combined with fractional erbium or CO2 lasers. Please consult with a doctor for specific recommendations. Good luck!

Diane I. Duncan, MD, FACS · Answer

I have not personally had good results with Fraxel, I would say that IPL would be a good place to start. I agree that both treatments are probably not necessary to see improvement, however you may need more than one IPL treatment to get the best result. Consider treatments 2-4 weeks apart due to the rate of healing (the first treatment should be healed before a subsequent treatment is performed).

Laura Riehm, MD · Answer

Thanks for your question.  We address these issues with similar patients every day.  Fraxel is the brand name for a laser, typically firing at 1540 nm.  We offer the same treatment with the ICON IPL & 1540 combination.  We use the IPL (Intense Pulsed Light) to make 2 passes treating brown spots and then 2 passes treating vascular lesions or red spots.  We follow it with the 1540 nm laser for correcting texture like acne scars, fine lines and wrinkles.  Your downtime is typically 24-48 with redness and puffiness.  Thanks and good luck.

David A. Sieber, MD, FACS · Answer

Thanks for the great question and this can be kind of confusing. So IPL alone only treats browns and reds (ex. sun spots and rosecea). However, it takes multiple (usually 3-5) IPL treatments to be totally satisfied with the improvement in sun damage. So with IPL you might have a 20-30% in improvement in sun spots. Fraxel also is able to treat sun spots. Because Fraxel is a fractionated laser it is only treated a certain percentage of the skin. So if you have a 20% Fraxel treatment you will have a 20% improvement in your pigment. By combining Fraxel and IPL they have a synergistic effect. You need to know however that IPL may damage your hair follicles, to if you have a beard, there may be areas of hair loss from the IPL. This is something you should talk about with you doctor. Best of luck!~Dr. Sieber

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