How do you combine laser/IPL/RF treatments when multiple conditions co-present?

Consumers of cosmetic treatments present their conditions and issues, which can be grouped as follows:

  • pigmentation (uneven, too dark, too light)
  • age or “coffin” spots
  • red face, flushing (basal redness/excessive redness when flushed)
  • spider veins and prominent blood vessels
  • tired-looking, sagging or lax skin of the face, neck, hands and body
  • rhytids, wrinkles (at rest or dynamic)

Other than counselling or psychological support, which is always required, the options for treatment are:

A) Light-based

  • intense pulsed light (IPL)
  • 532nm KTP, 585/595nm pulse dye laser
  • 1064nm Nd:YAG, 1320 Nd:YAG
  • 2940nm erbium YAG
  • 10,600nm carbon dioxide (CO2)

B) Radiofrequency (RF)

C) Dermabrasion

D) Chemical peels

E) Topical

F) Dermal fillers and injectables

Complicated skin conditions require complex approach and a program, which may include several treatment options.

Lasers almost always work. About the only serious contradiction for a light-based treatment is for the skin with unusually low light tolerance level. Such patient may not respond well to an IPL and, very rarely, even to a laser treatment. That’s why a test patching is always a good idea. The physician is then faced with a limited number of options. Each patient is different, and we have to deal with them one at a time.