What it is.
Photorejuvenation is the use of intense pulsed light (IPL) or broad band light (BBL) to treat effects of the sun and aging on the skin. IPL is a non-invasive and non-ablative treatment that uses high intensity pulses of visible light (not a laser) to improve age spots and wrinkles. IPL is also used to treat vascular lesions such as port wine stains, spider angiomas, broken facial veins and rosacea. IPL can also be used to remove unwanted hair.
Photorejuvenation using IPL is considered to be the gold standard in non-ablative treatment of type A photorejuvenation changes. Type A changes are pigmentary changes associated with photoaging.
What it is not.
IPL is not a laser. LASER, which is an acronym of Light Amplification by Stimulated Emission of Radiation, is a device that generates an intense beam of monochromatic light (singular wavelength). IPL is broad spectrum light therapy which means that it is comprised of multiple wavelengths of visible light.
Skin resurfacing is divided into two categories: ablative and non-ablative. Ablative laser therapy removes thin layers of skin and non-ablative therapy does not remove skin, but instead, stimulates collagen growth and tightens underlying skin. IPL is considered a non-ablative therapy because it does not remove skin, by targeting the dermis instead of the epidermis.
Because the dermis is treated and not the epidermis, the outcome is not as dramatic as ablative or laser therapy, but patients can often have IPL treatments with minimal downtime. Most procedures could be performed during lunch and the patient could return to work with minimal flushing or redness.
How does it work?
IPL uses non-coherent intense pulsed light at a low fluence, non-ablative level to improve skin texture and appearance. Different skin conditions are sensitive to different wavelength combinations, enabling the practioner to use different filters on the IPL device to treat different conditions. The light energy is absorbed into particular target cells in the skin. The light energy is turned into heat energy and that treats the target condition.
For vascular lesions, the light targets hemoglobin which has a red pigment and for pigmented lesions such as age spots, freckles, melasma (mask of pregnancy) or birthmarks, the light targets the melanin.
Treatments usually involve 4 or 5 sessions (or more) separated by 3 to 4 weeks. Sun exposure should be avoided in the days and weeks before and after treatment.
Most people will experience a mild sunburn and rarely mild blistering. Temporary hypo- or hyperpigmentation can occur. Use of topical anesthetic and cooling devices will minimize pain. Bruising can occur as well as hair loss if the treated area is hair-bearing.
IPL is a great stand-alone procedure, and new combination therapy of IPL and other treatments are proving to be phenomenal. IPL can be combined with non-ablative laser treatments such as 1064nm and 1320nm, microdermabrasion, and Botulinum toxin A to improve and treat photoaging conditions.
1. Nestor, et al. New Perspectives on Photorejuvenation. Skin and Aging. 2003: 68-73.
2. Ngan, V. Intense pulsed light therapy. DermNet New Zealand. 2005.
By Melynda Barnes, M.D. - Expert Facial Plastic Surgeon