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.
