Should I continue IPL for freckle removal? (photo)

Question

Hi there, I went for my first IPL treatment for freckle removal 2 days ago.I have fair skin with lots of freckles.The dermatologist was unsure about IPL and kept saying it all will be very dark. I already knew all that because I had done my research. But after the first treatment only 10-20% of my freckles got dark (see the pic).Is it because she brought the strength of IPL lower? My next treatment is in a month. Do I continue IPL or do fraxel or chemical peel?

Jason Emer, MD · Answer

Freckles require a combination approach with lasers (IPL, fraxel) and peels. It may take a series of treatments. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

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

Jeff Angobaldo, MD · Answer

Thank you for your question.  IPL treatment treats red vessels, hyperpigmentation and it improves the texture of your skin by producing collagen and elastin.  Laser hair removal is best performed with a diode, yag, and alexandrite laser.  Always consult with a physician to make sure you are a good candidate.

Shareef Jandali, MD · Answer

Thank you for your question. IPL is a very safe and effective treatment for minimizing brown pigmented areas of the skin when used appropriately. Typically I recommend 3 treatments to my patients for optimal results. If you are unsure of your results be sure to follow up with your provider.

Glenn Murray, MBBS · Answer

Hi and thank you for your question.IPL photo rejuvination can take 1- 6 monthly treatments to remove years of sun damage. It is normal for your freckles to darken and microcrust on the first few sessions. As your pigment can be a combination of freckles, age spots, melasma they can be different shades and sit slightly in different levels. Therefore, some darken and fall off quicker then others. I would continue with IPL treatments and ensure you are wearing SPF 50+ daily to prevent more sun damage occurring. With your skin type, IPL is usually safe and very effective for pigmentation/freckle removal. If you are not seeing any improvement after 4 sessions, I would look at the settings with your practitioner or look into Picosure or Dot Laser. 
  
I would recommend having a complementary consultation with a professional to determine the best option for you.
Wishing you all the best,
  
Stay absolutely safe and well,

Dr. Murray from Absolute Cosmetic Medicine

Diane I. Duncan, MD, FACS · Answer

Thanks for including a photo with your question! Many times practitioners will start on the safe side of treatment intensity in order to assess your skin response.  Despite good understanding of Fitzpatrick skin types, IPL can still have a variety of side effects that vary person to person. Gradually increasing treatment intensity will help address your freckling - I recently had a patient that had a wonderful outcome with her freckling after IPL. However, we started light with the first treatment to assess her reaction, and then got more aggressive with the next. Give it another shot! Best of luck!

Mira Mahajan, MD · Answer

Hello Roxin80,
Thank you for your question. From looking at your picture you are a great candidate for an IPL treatment. You should at least do a minimum of 2. But to get the results you desire it can take up to 3 treatments. I would recommend that you do your second IPL 6-8 weeks after your first procedure to see better results. Be sure to avoid sun and heat exposure. Keep your skin moisturized at all times along with SPF. Cleanse with a gentle cleanser nothing with exfoliation and gently wash. Good luck on your voyage. I am sure you would like your results.

Manish Khanna, MD, FRCP(C) · Answer

Hi Roxin80, Thanks for your question. IPL is a great treatment for the removal of freckles. In our clinic, we offer BBL (Broad Band Light) which is a more sophisticated technology and provides consistent and predictable results. Most people who choose BBL or IPL do so because of the no downtime feature. If all the spots didn't get darker, it doesn't mean that they will not improve over time. Fraxel is also a great option but involves at least 5-7 days downtime. I would be comfortable recommending a second IPL and then you can always evaluate your before and after pictures to assess progress. It is typically a series of treatments when it comes to IPL as it is a more gradual process for those who don;t have a lot of social downtime opportunities. Hope this helps. Best, Manish Khanna, MD FRCPC

Raminder Saluja, MD · Answer

Hello,I am a big fan of the IPL.  Granted, not all IPL are the same.  I prefer the ones with a skin melanin readers on it (Max G), to allow for an aggressive enough treatment (while still safe to the skin).  Often times, it takes 1-3 IPL to get to goal.  The best would be to check back with your clinician and he or she can assess and give their recommendations.  Remember to sun protect with a physical blocking sunscreen (zinc/titanium) at all times.  Hope that helps!

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