Pigmentation and skin rejuvenation
What is IPL?
IPL is a commonly used abbreviation for Intense Pulsed Light.
At Tristram Clinic, Deborah uses Quantum® IPL for treating brown spots and pigmentation as well as for skin rejuvenation. IPL can also be used to treat vascular lesions and for hair removal.
How does it work?
The IPL machine produces light of all wavelengths, and therefore colour. A filter is attached to remove the wavelengths not required for a specific treatment, as the machine is multipurpose. Once the desired filter is applied, the light is directed at its target colour, i.e., brown for melanin and red for blood vessels. When it reaches its target, the light is absorbed and converted into heat, effectively destroying the target cells. The wavelength also determines the depth of penetration – this is very superficial for pigment, slightly deeper for red vessels and deeper again for hair follicles.
Pigmentation
Pigmentation is challenging to treat. Surface pigmented lesions are more easily treated than pigmentation originating deeper in the skin, as is the case in chloasma / melasma. The definition of the edges of the pigmentation is an indication of its depth – well-defined edges mean a superficial lesion and ill-defined, or smudgy edges, mean the lesion is deeper.
Before treatment
Appropriate settings for the IPL machine are highly individual. Clients are asked to complete a detailed medical history form to ensure there are no contra-indications to treatment, or factors that may affect the skin's absorption of light. This information will help determine the appropriate settings. Treatment starts at a lower power setting than is likely to be effective, and increases gradually until the appropriate response, or end point, is found. Treatment is then carried out at this setting, which is the starting point for subsequent treatments.
Tanned skin
It is inappropriate to treat tanned skin at any time so tanned clients may be sent away for up to six weeks and asked to apply SPF30+ sunscreen daily. This is advisable whether the tan is due to exposure to the sun or a sunbed, or due to fake tan applied to the areas to be treated.
Aftercare
- After treatment the treated area will most likely be quite pink. This lasts for 2 to 24 hours.
- Brown or pigmented areas will darken at the time of treatment and usually continue to get darker over the next few hours. This is called the 'Milo' effect. These areas peel off over the next 2 to 10 days taking much of the colour with them. Makeup can be applied during the peeling phase, as the skin is not actually broken so there is no risk of infection. It is important to follow the post-care instructions, particularly in regard to keeping the area well moisturised and protected from the sun.
- Swelling is not uncommon for a few days, or up to one week afterwards. Women are more likely to get swelling than men. Severity varies from localised lumpiness around the treated lesions, noticed when applying products the next day, to significant swelling and puffiness particularly around the eyes. The degree of swelling is dependent on skin type, intensity of treatment, number of pulses used and proximity to the eyes.
- There is also a chance of bruising. The bruises are usually quite small and localised to the treated area, but can be difficult to hide with makeup. If it is inappropriate to have either swelling or bruising because of social commitments or work demands, this is taken in to account and the settings are adjusted accordingly. It may mean an extra 1 or 2 treatments overall, but does not detract from the end result. Treatments are done at 4 to 6-week intervals.
- Blistering is uncommon but can occur on rare occasions.
- The most important aftercare is sun protection. If melanin-producing cells are 'upset' by the treatment and then the area exposed to the sun without protection, an overproduction of melanin can occur and either new brown areas will appear, or existing one darken. SPF30+ sunscreen should be applied daily for a minimum of 30 days after treatment, regardless of weather or season. Anyone about to go on a holiday in the sun should postpone treatment until their return.
How many treatments are needed?
For pigmented lesions, 2 to 5 treatments are generally necessary. Less than two treatments may lead to disappointment. Treatment stops when the client is happy, or there are no longer signs of improvement. There is, however, continued rejuvenation of the skin, resulting in improvement in texture, pore size and tone. For this reason many people will continue to have five sessions even if the pigmented spots have gone after two or three treatments.
Cost
A full face IPL treatment costs NZ$350 per session. Chest and necks cost between $200 and $350 depending on the size of the treated area. It will normally cost around $500 if more than one area at a time is treated.
Safety
The Tristram Clinic's Quantum™ IPL machine is considered very predictable and effective. The IPL therapists are trained and experienced registered nurses. Because extreme heat is involved, the main risk is burning the skin, which can leave temporary or permanent pale or dark marks. This will be discussed more fully at the time of consultation and/or first treatment.
CPatients are asked to sign a consent form prior to treatment, which outlines the side effects and risks. IPL can damage eyesight so shields are placed over the patient's eyes, and anyone accompanying them will be asked to wear safety goggles. It is therefore not suitable to take young children to your treatment.