Is IPL safe to have done for severe cystic acne?

Doctor Answers 4

Facial Acne -- Clear + Brilliant, Microneedling, Chemical Peels, Venus Viva, IPL

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I find that clear + brilliant, micro needling, peels and skin care are much better for acne than IPL. Please consult with an expert. Best, Dr. Emer

Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

IPL is safe for acne treatment, but it may not be the best device to treat acne. Other treatments are also needed

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Thank you for the question. You are asking if IPL is safe for severe cystic acne. It’s a very straight forward question, but unfortunately acne is a complex problem, particularly cystic acne.
A little of my background - I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon practicing in Manhattan and Long Island for over 20 years.  Cosmetic dermatology is a significant part of the services we offer in our practice, and solving problems related to acne, although it is not focused on teenagers but more with adults with acne. I can tell you there are a lot of ways to approach acne, but we will address this question specifically.
In the past 5-10 years, the idea of light-based therapy for acne became more popular, and it was based on the idea of trying to treat the bacteria called propionibacterium acnes that are within what is called pilosebaceous unit. This is a bacteria associated with inflammation causing acne, as well as other modalities such as reducing the blood supply, the vessels contributing to the acne, as well as the inflammation.
IPL stands for intense pulsed light, meaning there are many different wavelengths that are filtered. A laser has a single wavelength. IPL is multiple wavelengths, and within that particular device, you can put on different hand pieces which filter different wavelengths to help treat particular target tissues. So IPL may be reasonably safe enough for cystic acne, but it may not be the best light energy based device for the treatment of acne. This is where a lot of doctors will conflict about this type of situation.
When you are dealing with cystic acne, you have to think about management from a systemic level, as well as the topical treatment level with an external device. Generally, one would consider oral antibiotics drugs such as doxycycline, as well as steroid injection to treat the acne directly, not to mention in some cases you want to do incisional opening and manual expression of the keratin plug within the acne lesions. On top of that, the use of a light energy device, so I’ll share with you how I decided to choose the one I use in my practice.
I’ve had several different intense pulsed light machines over the years. One of the challenges I’ve always dealt with is controlling the amount of heat being applied to the skin. I used cooling gel, pre-cool, cold packs, and cold rollers to protect the superficial skin so the therapeutic energy will be delivered deeper. The skin still has the tendency to get heated up so I decided ultimately to go with the laser called the Nd:YAG laser. This laser allows me to treat the acne without having to do this level of pre-cooling. We still can cool the skin, but it is more convenient and safer for the patient in terms of the amount of heat being delivered to the skin. In the end, it is just much easier for the patient to tolerate, and instead dealing with some redness afterwards, we can avoid it. In my practice I use a very specific type of Nd:YAG laser with a particular method and treatment plan, but I would say it is part of the treatment plan as it is not just the only thing we do.
So, the answer to your question is IPL safe for cystic acne? It can be, but you should meet with doctors who have experience using light-based energy devices. Learn about why they choose their particular device and why they feel that’s the better choice, and see what works for you. These decisions are made based on skin type, the age, the type of acne, and many other factors beyond just these simple questions. Meet with doctors, learn about your options, and see where does this light energy device fit for the treatment of your acne. I hope that was helpful, I wish you the best of luck and thank you for your question.

Amiya Prasad, MD
New York Oculoplastic Surgeon
4.4 out of 5 stars 80 reviews

Cystic Acne

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In general yes, but consult with your physician first. Blue light treatment is a form of IPL that may be beneficial to you.

Nicole Schrader, MD, FACS
Princeton Facial Plastic Surgeon
5.0 out of 5 stars 30 reviews

Severe Cystic Acne Requires Appropriate Aggressive Treatment, Not IPL

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Without more history and your medical background, I can only comment in the most general of terms. I would say that it is generally safe to treat any form of acne, including cystic acne with IPL. That having been said, I also have to add that I don't think it is worth it.

Cystic acne is a severe, potentially scarring condition that must be treated quickly and aggressively to try not only to control the acne but, at least as importantly, to prevent and minimize the development of devastating, disfiguring scarring in the aftermath. 

Acne cysts are deep and often confluent and destructive to normal collagen and elastic fibers, and IPL is a rather superficial treatment that I would at best restrict to use in only relatively mild forms of acne (and frankly don't recommend it at all, since for mild cases of acne proper topical prescription therapy is usually more than sufficient to achieve gratifying improvement). 

Be sure that you seek treatment by a board certified dermatologist before proceeding with any treatment. I would hate for you to waste money and precious time (during which permanent scarring may be taking place) with treatments whose true efficacy is equivocal. Good luck to you.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.9 out of 5 stars 33 reviews

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.