Laser-based devices for aesthetic treatments are the industry “gold-standard,” although the efficacy of devices based on Intense Pulsed Light (IPL) technology is improving and the gap between IPLs and lasers is closing. Laser technology is expected to remain the only effective light-based treatment in specialist areas such as large pigmented lesion removal, tattoo removal and deep vascular treatments, but IPL-based devices are becoming more popular for the more mainstream aesthetic treatments, especially in the high growth market of skin rejuvenation.

Medical experts, who have used both IPL devices and lasers, would point out the following reasons why they prefer lasers:

• It is harder to predict results with IPL due to its broad-spectrum of light and multiple wavelengths
• IPLs are not safe to use around the eye
• IPLs are not safe on the skin of color and tanned patients

Despite not quite matching the performance of some premium laser-based systems, IPL technology has its advantages for the core aesthetic treatments such as hair removal and skin rejuvenation.

Various sources and study groups forecast IPL-based devices to enjoy growth rates of 10-12% in hair removal and skin rejuvenation. Unlike for laser-based devices, the IPL-based device market is more accessible to non-physicians, and hence IPL-based devices are commonly found in spas across the U.S. and Europe.

As IPL-based devices are not designed to treat complex skin conditions, practitioners do not have to be as highly trained as they do for laser-based devices. IPL-based devices typically come with two simple-to-use handsets, one for each of the most popular applications, hair removal and skin rejuvenation. Adding to the appeal of IPL-based devices for a non-physician is the lower price with respect to a laser-based system, whilst maintaining the core applications essential to a light-based aesthetic practice or medical spa.

Medical Spas and a lot of aesthetic physicians have adopted IPL devices to treat a variety of skin conditions, from hair removal to age spots.

Intense Pulsed Light (IPL) is a non-laser flash lamp light source that emits broad spectrum, high-intensity visible and infrared (IR) light and is used for permanent hair reduction, acne (including photo dynamic therapy, aka PDT), Rosacea, dyschromias and telangiectasias, and age related treatment of facial lines and creases.

Wavelengths are chosen by selecting a particular wavelength filter or attaching a specific treatment head or hand piece that is configured with the filter already attached. Since IPL medical devices use a ‘pulse’ of light they deliver their energy into the dermis over a longer time than a laser, providing different treatments and usually resulting in significantly more pain for the patient.

Shorter wavelengths in the visible spectrum are used to target hemoglobin (red skin conditions like acne and Rosacea) and melanin (brown spots). Longer infrared (IR) wavelengths target water in the skin and can treat other conditions. Since IPL devices use a ‘pulsed’ light instead of a high-intensity focused beam like lasers do, IPLs emit more scattered light (feathering) and are less selective than a laser in heating the skin. With IPL devices there are often additional treatments needed to achieve optimal results than with lasers.

Practitioners more or less agree on the applications of different wavelength available in IPL devices:  

Major manufacturers of IPL Intense Pulsed Light devices: Candela, Palomar, Cutera, Lumenis and Sciton. 

IPL Pros

• Cheaper than lasers
• More compact than most lasers
• Results are comparable to the 810 nm Diode or the 770 nm Alexandrite lasers for hair and to the 532 nm KTP Laser, the 595 Pulsed Dye Laser for the treatment of Rosacea and vascular lesions

IPL Cons

• Cannot be used safely on darker skin types (IV-VI) or tanned skin
• Filters (heads) have a short life span (50,000-75,000 pulses)
• Filter/head replacement is expensive
• Many different wavelengths, settings, cooling requiremnts may be confusing for the operator
• Maintenance and service required

LaserOffers.com Comment:

More and more experts agree that from the practical standpoint Nd:YAG 1064 nm may have established itself as the single most versatile wavelength for all of the treatments mentioned above. For all skin types and tanned skin.

Treating colored skin poses difficulties, as many practitioners have experienced. Dr Mukta Sachdev says good technique hinges on good pre-, intra- and post-operative care and choice of patient.

Colored skin has the tendency to hyperpigment following trauma, so in the wake of procedures such as lasers, chemical peels or microdermabrasion, there is a chance that hyperpigmentation will occur at the treatment site. This post-inflammatory hyperpigmentation is a common adverse event in darker skin. According to one expert, maximising the success of an aesthetic procedure can be better achieved if the proper pre-, intra- and post-operative precautions are taken. Dr Mukta Sachdev, a consultant dermatologist at the Manipal Hospital in Bangalore, India, says that treating coloured skin can be particularly challenging, even for the most experienced cosmetic physician. “In India we have found that the patients do not use sunscreens as much as they should, as compared with the West, and Indian people are simply not aware of the benefits of these creams. The cosmetic implications—especially in darker skin—is that following a procedure, such as laser or microdermabrasion, the risks of hyperpigmentation will increase,” Dr Sachdev says.

According to Dr Sachdev, the use of sunscreens is mandatory before cosmetic procedures, and the patient should get into the habit of using these two to three times a day, at least 14 days prior to procedures. This gets the patient into the habit of using them, and they help in preventing unwanted hyperpigmentation post-procedure. Dermal filler procedures are also a common cause of post-inflammatory hyperpigmentation. Dr Sachdev says that perhaps a normal Caucasian skin might tolerate a Restylane or Perlane filler very well in terms of decreased risk of developing a post-procedural hyperpigmentation. However, in a darker skin, skin types IV to VI, patients can frequently have a pigmentation of the injection puncture wound where the filler was introduced into the skin.

LaserOffers.com

See post-op and other recommended skin care.

In the Western world, more than 10% of the population have at least 1 tattoo. If the tattoo is removed, the tattoo pigment particles in the skin can be selectively destroyed by means of selective photothermolysis by different types of medical aesthetic lasers. This treatment requires laser pulses of short durations (nanoseconds) and high intensities (fluenses).

Dr. Wolfgang Bäumler, Department of Dermatology, University of Regensburg in Germany reports on 12 patients who received treatments with improper treatment parameters. In all patients, his group diagnosed hypo- or hyperpigmentations and scar formation at the treatment site. In particular, the pulse duration of the light sources or lasers applied were considerably longer than those required by the principles of selective photothermolysis. The light intensities of those devices are normally not sufficient to destroy the pigment particles. Instead of destruction, the pigment particles in the skin are heated up and the heat is conducted to the adjacent tissue causing unspecific tissue injury.

CONCLUSION

Lasers and especially intense pulsed light sources with more than 1 millisecond pulses and low light intensities are clearly not suitable to be applied for laser tattoo removal.

You get what you pay for – an old saying with 100% accuracy – applies as usual.

There have been many incidences in the media of late with reference to botched cosmetic surgery procedures and 9 times out of ten this seems to stem from paying too little and using unscrupulous practitioners who prey on the uniformed and the gullible.

Nothing against cosmetic dentists offering dermal fillers and simple laser treatments, but you should be very thorough in checking his background if he offers to perform breast augmentation surgery.

It really is crucial that you research any prospective cosmetic surgeon to ensure you will receive the best quality surgery and aftercare. You cannot guarantee this with a surgeon who is not accredited as they don’t have the strict regulation of association members.

These days, there are so many excellent non-invasive treatments, such as dermal fillers and/or laser treatments, and consumers should consider those first and well before taking the risks of any cosmetic surgery. Non-invasive procedures are effective, require minimum downtime if any, and can be safely done by a wide range of medical professionals.