IPL for Type IV Skin Tone

I am a 42 year old woman who is noticing more sun spots/freckles and brown spots lately (mainily after giving birth). I am considering IPL, but am a little reluctant because my mother had a bad reaction about 15 years ago when she had laser resurfacing under her eyes...turned to hyperpigmentation which she had to treat with Renova for months. Is there an alternative for darker skin gals or am I a viable candidate for this procedure? The Medispa I consulted with seems to think I will be fine.

Doctor Answers 4

Darker skin types and IPL

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I think you are right to raise this question. Darker skin types are at increased risk for developed pigmentary problems after treatment with lasers/peels/ and light based devices. In your case, you have several options:

1. a good MD directed skin care reg. should be part of any treatment you decide to do; 2. IPL can be done in darker skin types with caution. Make sure you see someone with experience and has MD oversight ( if you are choosing a medispa); 3. Light peels work really well for superficial pigmentation and are really safe.

Dallas Plastic Surgeon

IPL for skin type IV

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First and foremost, who is doing your treatment?  What are they licensed for?  For example, in the state of Florida; only a Nurse Practitioner, Physicians Assistant, or a MD can perform IPL treatments.  There are parameters for skin type IV on an IPL laser.  You mentioned that you noticed more after pregnancy which brings up another skin condition called melasma which is hormonal.  I would have an assessment under a skin scope to see the level of damage.  There are alternatives to laser such as skin lighteners and chemical peels. Hope this helps.

David V. Poole, MD
Altamonte Springs Plastic Surgeon


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If you noticed brown spots particularly after giving birth, my first inclination is to ask if you have melasma. IPL treatments can exacerbate the issue if this is indeed the case. Although IPL treatments can be performed on Fitz IV skin tones, there is usually much caution taken with settings that one may not see the amount of resolve you're looking for immediately.

Dermaplaning, a peel series, and home care that includes a skin lightener, such as, hydroquinone would be a good place to start. You may find that you achieve the results you desire by investing in monthly skin care treatments with an aesthetician.

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IPL can be used safely but cautiously in type IV skin

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There should be settings and filters that would allow you to do that.  A couple of words of caution though:

1. pigmentation after pregnancy can be melasma, even though it may look like freckles.  Melasma can sometimes get worse with IPL.  So it needs to be looked at with a Woods lamp to see where the pigmentation is.  If it is strictly superficial (epidermal) it may do fine with IPL.

2. make sure they do a proper evaluation to determine what skin type you are.  It's easy to make assumptions but they don't always hold true.  There are a series of questions you need to answer to determine your skin type.

Emily Altman, MD
Short Hills Dermatologic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.