Best IPL Photofacial machines?

Question

I am interested in the IPL Photofacial to help remove the permanent redness (broken capillaries?) on my face. However, I want to make sure I go somewhere that uses good machines. Do you have any suggestions for which machines would be best or what to look for in a machine's capabilities? Thank you.

Nelson Lee Novick, MD · Answer

I find it so interesting that IPL is so often the first thought that comes to mind for treating facial telangiectasias (aka "broken" capillaries or dilated capillaries). It is a tremendous testimony to the power of industry-backed marketing hype (so often not backed by hard science) that the supposedly "latest and greatest" IPL, fraxel laser, or other energy-based device comes immediately to the public's mind to solve any skin problem, including telangiectasias. Rather than which treatment is the most effective, quickest or least expensive, the question typically is which laser, or which radiofrequency device, or in this case which IPL, is the best. For well over three decades I have personally been using quick, simple, relatively inexpensive, very effective, and tried and true electrodessication using a super fine epilating needle to treat facial and nasal "broken" blood vessels. Be sure you seek consultation and treatment by a board certified aesthetic physician and make sure to check out his/her before and after photos before agreeing to proceed. Good luck to you.

Alex Eshaghian, MD, PhD · Answer

Thank you for your question anonnnnn534. I understand your concern.
IPL is a great treatment for facial rejuvenation. It is more important to look for a good doctor than the best device as outstanding results can be achieve by many different devices. Look for experience, before and after pictures, and testimonials. Please consult with a doctor for specific recommendations. Good luck!

Martie Gidon, MD, FRCPC, FAAD · Answer

The make of the IPL machine is not as important as the experience of the technician.  An expensive IPL device in a cosmetic dermatologist's or plastic surgeon's office would be a more effective device than a less expensive one that might be found in a salon.

Katherine Dee, MD · Answer

This is a great question. There are two components to a great IPL machine: 1) is it a well-made machine and 2) how old are the flash lamps. But the most important part of a good IPL treatment is an expert operator.
1) I demoed so many machines I can hardly remember all their names before I bought mine. The bottom line is they were all well-made. They use different proprietary ways of using the light flashes, but they all basically work the same way. I did not encounter any new machine that was not what it was supposed to be. Even the DEKA IPL that looks like an airstream camper worked great (no I didn't buy that one-- too noisy)
2) The flash lamps that are used in IPL machines lose their power over time. The more flashes they've done, the weaker the energy, the higher the settings have to be turned up to get the same effect. After so many flashes, they lamps will fail and need to be replaced. You can ask how old the machines are and when was the last time the lamps were replaced. If the place has no idea-- they may not be maintaining it properly.
The most important question to ask is: who does your IPL treatments-- is that person experienced? Do they get great results with the machine they have?
I hope that's helpful.

David A. Sieber, MD, FACS · Answer

Thanks for the great question. Just like all SUVs aren't the same, IPL machines aren't the same either. I use a Sciton in my office and my patients have been very pleased with the results. There are a lot of patients on realself who write questions about IPL not working. When done properly with a good machine, IPL is the best treatment for removal of brown and red pigment in the machine. A lot of companies have doctor locators on their websites. Maybe try looking into that. Best of luck!~Dr. Sieber

Amiya Prasad, MD - Account Suspended · Answer

You submitted a question without a photo stating you’re concerned about vessels on the face, and you want to find a place that has good IPL machines to treat it.
I can certainly give you some guidance on how to make this type of decision for laser treatment for vessels on the face. It’s a problem that we deal with in our practice as part of the many services we offer. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. In both of my offices, we have a range of thermal energy devices, lasers and pulsed light devices amongst many other technologies for various medispa type treatments for problems such as vessels on the face.
You are certainly focused on the machine, but I think it’s important to focus on the practitioner. The industry of lasers and devices is very strategic in creating consumer demand and interest, pretty much the same playbook as pharmaceutical companies. They bring to the consumer flashy new products they message to the point where it becomes a brand name, then people start asking their doctors if they have that machine. So the star of the show is actually the machine.
These devices evolved over years, and the principles are still critically important. From my perspective of the devices I use, in our office we’ve had many generations of IPL or pulsed light machines which use multiple wavelengths that can be selected through filters when applied to the skin. With certain protocols such as cooling the skin etc., you deliver a certain amount of energy into the skin. The goal is to target the blood vessel, specifically the hemoglobin in the blood. When you understand that principle, there’s a wide array of choices that can serve this particular purpose.
How does one decide the best choice? In our practice, we regularly, like computers, upgrade our devices. The devices become more efficient, and more advanced in terms of protocol.
From my experience, with IPL, the multiple wavelengths and the challenge being selective, puts IPL second to different lasers we have in our practice. The goal is to make sure the minimal amount of energy or heat is delivered to the skin, while the maximal amount of absorption occurs, and the risks of any unnecessary redness and inflammation are minimized. At the same time, we want to get great results and maximize safety.
There is a lot of judgement on the part of the doctor. Although there are standard protocols which are starting points when using these devices, experienced physicians are able to work with those protocols because we realize there’s a wide range of practitioners, particularly in the state of New York where there is no specific licensure that limits who can use lasers. Everybody from non-physicians to physicians perform laser procedures. However, I would argue the experienced physician understands the physiology and the principle so they can be a little more adept and flexible. Experience is critically important, and I’m not saying all non-physicians are not capable.
When doing your research, don’t just focus on the machine, and be evaluated by a physician who performs these procedures as they will be very involved in your treatment. I think we understate the significance of these medical devices because there are so many stripmall medispas around that people don’t take the technology of laser and its impact on the skin as seriously. I find that when we see a lot of patients, they are often frustrated because they feel like they bought packages, but didn’t quite get what they wanted.
Here’s a basic principle about vessels you have to understand. Vessels, when treated, can respond by closing and diminishing, or by creating more vessels. Typically, a protocol that involves treating vessels can include where a person comes in once a month for several sessions until we reach a certain plateau, then periodically, let’s say, every six months or so, for some kind of maintenance.
It’s imperative the physician has the state-of-the-art technology, but I think it’s also very important for the individual ooking for treatment to find a physician to provide the guidance as to what is optimal for them. We have a lot of options, and we certainly want to use good judgement to get the best results and t have the dialogue so the patient understands what the limitations are. There are a lot of choices, everything from: pulsed light, different wavelengths of lasers, and even just traditional electrocautery using a wire of radiofrequency that can a accomplish a similar result. Again, the goal is to make it as comfortable,safe, predictable, and optimal for every patient. Instead of jumping on the world IPL because there are many different IPL devices, meet with a doctor who can give you guidance on what would work best for you. I hope that was helpful, I wish you the best of luck, and thank you for your question.

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