Why Do I Have No Visible Side Effects After 1 IPL?

Question

I just had my first IPL treatment for minor acne scars, light sun spots, and mild discoloration on fair un-tanned skin. It has been 4 days since the treatment and I have no brown "coffee ground" marks, scabs, redness, irritation, or visible side effects whatsoever. Did the IPL treatment work? Is this normal?

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Leyda Elizabeth Bowes, MD · Answer

Your doctor probably chose conservative mid energy levels for your first treatment. This is fairly common practice. During your next treatment, describe to your doctor this process so she/he may choose the next appropriate step of energy level increase. Additionally, the lighter your brown spots, the less of a reaction or crusting you should expect with the IPL, regardless of energy settings.

Melanie L. Petro, MD · Answer

You probably had a very conservative treatment, which is far better than an overaggressive one. I would let your physician know. You do need to see some skin changes (darkening of spots) to get a result.

Emily Altman, MD · Answer

Usually the first treatment is as much diagnostic as therapeutic, meaning the intent is definitely to treat the skin problems but the settings on the first treatment are more conservative because we don't know how your skin will react.

	That said, I don't always see coffee grounds after treatments but there is still a decrease in brown spots when you look with the Visia Complexion Analysis machine. 

	In addition, the increased collagen production that we see with IPL treatments usually takes several weeks to become visible.  Give it a little more time.  There should be more changes.  However, it does usually take several treatments to see dramatic differences.

Mark Taylor, MD · Answer

If you do not see much benefit from the IPL treatment, It may be because you have fairly clear skin to begin with or it may be that your treatment was too conservative. There is also a great variation in types of IPL devices, operator experience and skin types. All of these factors will contribute to your ultimate response to an IPL treatment. Even in fairly clear skin, you will see an improvement in the texture and fine wrinkles with IPL. This change will be fairly subtle.

Joseph Campanelli, MD · Answer

You are right to expect to see visible changes to the skin after your IPL.  The normal appearance is that of localized dark pigment spots known as 'peppering'.  Since this was your first treatment, I would not be too discouraged but contact your physician and let them know that you did not get a response after your treatment.

	Normally, in the summer, we will be conservative in our settings for IPL.  Tanned skin will pick up the light energy and can lead to more intense treatments than anticipated.  I suspect that your physician was just being careful.

Why Do I Have No Visible Side Effects After 1 IPL?

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