Intense Pulsed Light Photofacial - Results, Alternatives

When do you recommend IPL photo facial for your patients? For what skin conditions is it best?  Are there better alternatives to IPL photo rejuvenation for sun damaged skin?

Doctor Answers 11

Intense Pulse Light is good for treating sun spots, red spots, and fine wrinkles

Intense Pulse Light can treat sun spots, small veins, rosacea, and other forms of skin discoloration. This machine uses light to target your pigment and blood within your skin while sparing the other structures of the skin for less down time. You usually need 3-4 treatments to be fully effective often times but because of the essentially no downtime, this form of treatment is very popular. Intense Pulse Light can also be used to reduce unwanted hair as well.

Here is what I usually tell people during a consultation: Intense Pulse Light treatments are indicated for cosmetic and reconstructive applications requiring selective photo thermolysis of soft tissue in the medical specialties of plastic surgery and dermatology. The wavelengths used in intense pulse light are between 515 and 1200 nm for the treatment:

• Benign pigmented epidermal and skin lesions including dyschromia, hyperpigmentation, melasma, scars, striae
• Benign skin vascular lesions, including port wine stains, hemangiomas, facial and truncal telangiectasias, rosacea, erythema of rosacea, angiomas, spider angiomas, poikiloderma of Civatte, leg veins, and venous malformations
• In other words, Intense Pulse Light can be used to treat red and dark spots that are at risk for cancer.

Contraindications for Intense Pulse Light include but are not limited to:

• Current or history of cancer, especially malignant melanoma, or recurrent non-melanoma skin cancer, or pre-cancerous lesions such as multiple dysplastic nevi.
• Any active infection.
• Disease which may be stimulated by light at 560nm to 1200nm, such as history of recurrent Herpes simplex, systemic lupus erythematosus, or porphyria.
• Use of photosensitive medication and / or herbs that may cause sensitivity to 560-1200m light exposure such as isotretinoin, tetracycline, or St John’s Wort (Best Avoided for at least one year before your resurfacing).
• Immunosuppressive disease, including AIDS and HIV infection, or use of immunosuprressive medications.
• Patient history of Hormonal or endocrine disorders, such as polycystic ovary syndrome or diabetes, unless under control.
• History of bleeding coagulopathies, or use of anticoagulants.
• History of keloid or hypertrophic scarring.
• Very dry skin.
• Exposure to sun or artificial tanning during the 3-4 weeks prior to treatment. Sunblock should be applied 2 weeks or more before your procedure using a product that is sensitive for the skin and contains titanium dioxide or zinc oxide-containing sunblock.
• Skin type V1 or very dark, black skin types
• Pregnancy and nursing.
• Ectropion, outward turning of the lower eyelid and excessively dry eyes, previous lower blepharoplasty.
• koebnerizing diseases, prior radiation therapy leading to a loss of adnexal structures, extensive fibrosis resulting from prior cosmetic treatments (e.g., dermabrasion, deep chemical peels, silicone injections).

Intense Pulse Light is not intended to substitute for a surgical facelift, ablative skin resurfacing, or procedures that treat deep wrinkles and saggin skin. It is inended for patients desiring eveness of color in their complexions, or those showing signs of sun damage and photoaging. Intense Pulse Light skin treatments have a great appeal to individuals with active lifestyles who cannot set aside healing time, as required with ablative procedures or surgery. The procedure requires not “downtime”, ie, patients can resume all activities immediately after treatment, except sun exposure.

What can you expect:

• There may be some discomfort or pain associated with treatment
• Transient erythema/edema may appear immediately following treatment
• Pigmented lesions may become darker for up to fourteen days following treatment
• Acceptable results will likely take a number of treatments, usually four to six. The entire program should be planned at the outset so that you can have a set schedule to come in and to help you to have realistic expectations.
• There is a very small risk of adverse reactions such as changes in the testure and pigmentation of the skin. These are usually transient and rare.

Possible side effects of treatment:

Intense Pulse Light are typically administered in a series of four to six treatments, performed at intervals of a minimum of three weeks. A Three week interval has proven optimal. However larger intervals do not appear to adversely influence treatment results. Spreading the treatment over this period provides a gradual improvement of the skin, a minimal risk of adverse effects, and preserves the importrant “no downtime” feature of the program. In rare cases where side effects do occur, postpone further treatments until after complete healing. The most common side effects are:

Discomfort: When a pulse is triggered, it may cause a various degrees of discomfort. Some describe the sensation as stinging, while others liken it to a rubber band snap. A burning sensation may last up to an hour after treatment.

Damage to natural skin texture: A crust or blister may form, which may take from five to ten days to heal

Change of Pigmentation: There may be a change of pigmentation in the treated area. Most cases of hypo- or hyper-pigmentation occur in people with darker skin, or when the treated area has been exposed to sunlight before or after treatment. In some patients, hyper-pigmentation occurs despite protection from the sun. This discoloration usually fades in three to six months, but in rare cases, mainly hypopigmentation, the change of pigment may last longer or be permanent.

Scarring: There is a very small chance of scarring, such as enlarged hypertrophic scars. In very rare cases, abnormal, large, raised keloid scars may appear. To reduce the chance of scarring, it is important to carefully follow all post-treatment instructions and exclude patients that have a genetic tendency for scarring.

Excessive Swelling: Immediately after treatment, especially around the nose and eyes the skin may swell temporarily. Swelling usually subsides within hours to as much as seven days.

Fragile skin: The skin at or near the treatment site may become fragile. If this happens, avoid makeup and do not rub the area, as this might tear the skin.

Bruising: Very rarely, a blue-purple bruise may appear on the treated area. It may last from five to fifteen days. As the bruise fades, there may be rust-brown discoloration of this skin, which fades in one to three months.

Burns: There is a small chance of burns occurring on the skin. To reduce the possibility of burns from occurring, it is important to carefully follow all treatment instructions, and in particular performing test patches can be an option.

Post Treatment:

General: cold packs should be applied immediately after treatment, to cool the treatment site, reduce swelling and ease discomfort. Chemical cold packs are not recommended, if their temperature is below 4 degrees celcius. Alternatively, frozen 4 x 4 gauze, previously moistened with water and inserted into small plastic bags or in plastic wrap, could be used after treatment..

In most cases, the low energy, low risk nature of IPL skin treatments make is safe to resume vitually all activities except excessive sun exposure.

Exposure to Sunlight: Patients should use high factor (30-35spf) sunblock and protect the treated area from exposure to sunlight for at least one month following treatment. Tanning after treatment sessions may enhance melanin regeneration, which may result in hyper-pigmentation.

Makeup: You can use makeup immediately but if there is any reaction you should notify us as soon as possible.

Follow-up: We will have you return every three weeks until your program is completed

Adverse effects: If there is any adverse effects, treatment should be discontinued until the treatment site has healed and the reason for the adverse reactions are understood.

Concluding treatment:
Determining when treatment should be concluded will be discussed with you and we will do everything to make sure that you are happy!

Bellevue Facial Plastic Surgeon
4.2 out of 5 stars 84 reviews

I really like IPL for certain patients

IPL uses a range of wavelengths of light to target brown (and, to a lesser degree, red) discoloration. This discoloration occurs over time and after many years of sun exposure. Filters are used to cut off wavelengths of light that could be harmful (in darker skinned patients, filters decrease the risk of damaging the normal pigment in the skin).

I recommend IPL for my fairer skinned patients who have brown discoloration, age spots, and freckles, particularly on the face, chest, and hands. I also use retinoid creams to help even skin tone and pigmentation.

In some people I also use creams containing hydroquinone and kojic acid, to decrease the activity of the pigment cells and fade brown spots.

IPL is best for fair complexions. The light targets the pigmented spots. Immediately after treatment the area is red and swollen, almost like a burn. Over the next few days the redness fades but the brown gets darker- it can get very very dark. Then the brown peels off.

At about 2 weeks after treatment the peeling should be complete. There may be small untreated patches of skin that are still visible among the lighter, more even skin that was treated. That is why most patients need multiple treatments.

Also, each treatment may use a slightly higher energy depending on the previous outcome. It is important to have a test spot performed before treating a large area of skin. That way you can determine what energy level is best for you.

I treat conservatively with low energies until I know how the patient will react. It is much better to have to come in for more treatments than to use a high energy setting and get a burn that may leave a permanent mark.

Jordana S. Gilman, MD
Washington Dermatologic Surgeon
5.0 out of 5 stars 2 reviews

IPL reduces the irregular discoloration of the skin caused by sun damage

Chronic sun damage causes irregular brown and red discoloration of the skin. These " sun spots" and "broken capillaries" are in the surface of the skin and make the skin look old.

IPL reduces these discolorations and makes the skin tone more even and bright. It does this by heating up the structures that hold the color, damaging or destroying the blood vessel or the "sun spot".

The process is called Selective Photo - Thermo - Lysis.

  • Selective because it targets the color we don't like - the chromophore;
  • Photo because it uses light energy to heat up (Thermo) the color;
  • So that the heat damages or destroys (Lysis) the structure holding the color or chromophore.

The result is a more even skin color - even without makeup.

Robert Swanson, MD - RETIRED
Bay Area General Surgeon

IPL treats age spots, sun spots

IPL (or Photofacial, same thing) is an excellent way to safely and effectively treat sun damage, age and brown spots, freckles, rosacea, and wrinkles in one comprehensive treatment.

Although you will notice an improvement with just one treatment, I recommend a minimum of three treatments for more significant results.

Each Photo Laser Facial session lasts approximately 45 minutes (plus additional time to apply topical anesthetic prior to the procedure).

Usha Rajagopal, MD
San Francisco Plastic Surgeon
4.6 out of 5 stars 38 reviews

Skin conditions that can be treated with IPL.

Filters block specific wavelengths of light making the IPL more versatile.  IPL can lighten brown pigmentation (freckles, sun damage and melasma (pigmentation from pregnancy))..IPL can also lighten red pigmentation (capillaries, rosacea, pink stretch marks and scars).  The complexion is more even in colour.  There can be improvement in fine skin creases and pore size improving skin texture. Must be used with caution with darker skin types (potential superficial burns with hyperpigmentation.

Robert Sleightholm, MD
Brampton Plastic Surgeon
5.0 out of 5 stars 9 reviews

Photofacial Results and Alternatives

IPL/Photofacial treatments are best suited for Fitzpatrick skin types 1-3. I recommend photofacials for patients who have a significant amount of sun damage(brown spots, freckling), rosacea, broken capillaries and acne.  A series of 3 -6 treatments (based on the skin condition and severity) are typically recommended to yield an optimal result. Maintenance treatments once a year are strongly recommended to maintain the desired result. Lastly, there are alternatives for addressing sun damaged skin. If looking for an alternative to addressing the pigment, the Obagi Blue peel is excellent and restoring a more even skin tone.  If looking to address the laxity in the skin as a result of years of sun damage, laser resurfacing or even micro-needling are options to consider.  Be sure to cover all of your areas of concern with your clinician when consulting.  This will allow them to develop a treatment plan best suited to address your concerns in accordance with your lifestyle. 

Larry C. Leverett, MD, FACS
Phoenix Plastic Surgeon
4.7 out of 5 stars 17 reviews

Photofacials are great for brown spots, red spots, acne, rosacea, and skin discolorations.

Photofacials (and BBL or IPL) are a very effective treatment for brown spots, red spots, acne, and skin discolorations. Using highly specialized filtered light, photofacials target specific skin lesions, while minimizing trauma to the surrounding skin. Some generalized redness, like a sunburn, may be present for a few days after treatment. After a photofacial, pigmented spots will initially become darker, and will then flake off around 2 weeks after the treatment.  

Dara Liotta, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 30 reviews

IPL laser for sun damage and redness and pigmentation

IPL laser is an easy way to treat broken blood vessels, telangiectasias, pigmentation, and fine lines.  Photo facials are best performed on skin types 1 through 3.  When you have skin types 4 or darker then the IPL may create pigmentation.  A series of IPL treatments is indicated and depending on desired results anywhere from 3 to 6 treatments spaced several weeks apart may be indicated.  It is extremely important to find a board certified dermatologist in your city who has a great deal of cosmetic experience.

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 76 reviews

It is great for cleaning vascular and pigmented lesions

Intense Pulsed Light ( Photofacial) is best to use on brown pigmented lesions  like sun spots, freckles or vascular lesions ( redness or dileted blood vessels), also to reduce pores and stimulate collagen in the skin.  It works very well when the right device is used and also is technician depended.  Alternative treatment to reduce pigmented lesions is Fraxel laser which is resurfacing procedure but  it does not work for redness.  Make sure you talk to a doctor who specialize and have great experience treating patients with IPL.

Gregory Turowski, MD, PhD, FACS
Chicago Plastic Surgeon
4.5 out of 5 stars 58 reviews

Intense Pulse Light

Intense Pulse Light can be a good treatment for brown spots and red pigmentation of the skin.  Typically, you will need 3-5 treatments to see good results and maintenance treatment thereafter.  

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 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.