Intense pulsed light ipl in dermatology
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INTENSE PULSED LIGHT (IPL) IN DERMATOLOGY. Dr. Ruxandra Cutus Dr. Razvan Bucur Cabinet SANDERM-Cluj. Intensed pulsed light (IPL) systems are high intensity light sources which emit : polychromatic light; noncoherent light; broad wavelength spectrum ( 515-1200 nm)

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INTENSE PULSED LIGHT (IPL) IN DERMATOLOGY

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Intense pulsed light ipl in dermatology

INTENSE PULSED LIGHT (IPL) IN DERMATOLOGY

Dr. Ruxandra Cutus

Dr. Razvan Bucur

Cabinet SANDERM-Cluj


Intense pulsed light ipl in dermatology

  • Intensed pulsed light (IPL) systems are high intensity light sources which emit :

  • polychromatic light;

  • noncoherent light;

  • broad wavelength spectrum ( 515-1200 nm)

  • visbile light (white light)+ IR light

  • LASERS( Light Amplification by the Stimulated Emission of Radiation) emit :

  • monochromatic light (single wavelength)

  • coherent light

  • Light and LASER beams are all forms of electromagnetic radiation


Intense pulsed light ipl in dermatology

  • Adjustable IPL’s parameters:

  • energy-Joule

  • fluence-Joule/cm2=density of energy

  • filters-550, 560, 640nm

  • pulses parameters:-number of pulses(1-5)

  • -pulse duration(2-7ms)

  • -pulse delay(1-300ms)

  • Light Absobtion in Tissue- by the two natural cromophores: hemoglobin(580 nm) and melanin(400-750nm)

  • Light Tissue Effects-Photothermolysis=the matching of a specific wavelength, pulse duration and filter to obtain optimal effect on a targeted tissue with minimal effect to surounding tissues

  • Examples: - hair removal

  • -vascular lesions-thermocoagulation

  • -pigmented lesions-photorejuvenation (+ dermal remodelling by activation of cytokine and growth factors+increased production of colagen 1)


Intense pulsed light ipl in dermatology

  • Historical data:

  • 1976- Muhlbauer- first description of thermocoagulation of capillary hemangiomas and port-wine stains by means of polychromatic light

  • 1994-first market ready system, Photoderm( Lumenis Ltd., Israel)

  • -organised in programs

  • for hair removal-short (F I-II), medium (F II-IV) and long (F V-VI)-depending on Fitzpatrick types of skin

  • for skin rejuvenation(vascular pigmented lesions)-program 1 ( F I-II ); program 2( F II-IV ); program 3 ( F V-VI )

  • -different heads with different filters(560, 595, 640, etc) allowing to treat different body areas, different depths of skin lesions, different Fitzpatrick phototypes, different target structures


Intense pulsed light ipl in dermatology

  • INDICATIONS:

  • HAIR REMOVAL

  • -one of the most important indications of IPL

  • -photothermolysis induces damage to the hair follicle and hair shaft in anagen phase causing a long term interruption in the hair growth cycle

  • -for localised hypertrychosis; hairy grafts and flaps; hirsutism; aesthethic purposes

  • -6-8 treatments at 6 weeks interval

Advantages:

-quick spot size

-little pain

-efficiency (studies reveal 80-90% clearance rate after 4-8 treatments)

-safe-few side effects

Possible side effects:

-transient erythema(2-48 hours ± oedema

-late evanescent erythema

-mild pain; purpura-1-3 days

-crust formation; isolated vesicles

-transient hyper/hypopigmentation

-permanent scars are unlikely


Intense pulsed light ipl in dermatology

2.PIGMENTED LESIONS

-café au lait macules

-Ota’s, Ito’s naevus

-Becker’s and Spillus naevus

-seborhoeic keratoses

-actinic keratoses

-poikiloderma of Civatte

-melasma

-mottled pigmentation

-epidermal lentigines

-ephelides

-lentigo solaris

-postinflamatory hyperpigmentation

Mechanisms-melanosomes damaged by photothermolysis→melanin aggregates→macrophage transport

Advantages:-quick-1-5 sessions( frequent 1-3), 3 weeks apart )

-minimal disconfort

-lunch-time treatments

-efficiency

-safety-minimal or no side effects

-all facial and non-facial areas can be treated


Intense pulsed light ipl in dermatology

1.

2.


Intense pulsed light ipl in dermatology

  • 3.BENIGN VASCULAR LESIONS

  • -cuperosis( eythemato-telangiectatic rosacea )

  • -rosacea ( papulo-pustulous- demodex destruction )

  • acne and erythema associated with acne

  • -essential telangiectasias

  • hemangiomas

  • poikiloderma of Civatte

  • leg telangiectasias ( red, under 1 mm diameter )

  • venous malformations (ex. blue rubber bleb naevus)

  • erythematous stretch-marks


Intense pulsed light ipl in dermatology

4.SKIN REJUVENATION

-non-ablative skin-rejuvenation or “subsurfacing”-rhytides

-good effect( better when associated IPL+RF or IPL+IR )

-improvement in the quality of skin-no total resolution

-Mechanism: dermal remodelling occurs through increasing collagen 1 deposits, with collagen reorganisation into parallel arrays of compact fibriles

-general skin rejuvenation for face, neck, decoltaeum area: minimising the pores; coagulation of the dilated vessels; dissapearance of pygmentary spots


Intense pulsed light ipl in dermatology

  • 5.SCARS

  • -very good results; IPL treats:

  • hypertrophic scars ( post trauma; post surgery; post combustion )

  • atrophic erythematous scar ( post acne )

  • keloids ( post trauma; post surgery; post combustion and so on )


Intense pulsed light ipl in dermatology

1.Acute episode

2.Keloids and Hypertrophic Scars ; Postinflamatory hyperpigmentation


Intense pulsed light ipl in dermatology

3.During the first treatments

4. End of the treatment


Intense pulsed light ipl in dermatology

  • CONCLUSIONS: IPL treatments are:

  • successful and non-invasive means of treatment

  • a very good alternative to conventional therapeutic options

  • particularly useful for hair removal; cuperosis; scars and angiomas

  • low rate of side effects

  • high levels of patient satisfaction

  • because of the wide range of potential combinations of wavelength, pulse durations, pulse frequency and fluences, working with IPL is a complex matter (lack of proper legislation)

  • can be used for better results in aesthetic medicine in combination with: botulinum toxin, fillers, Nd:YAG LASERS ( especially for angiomas and telangiectasis ), microdermabrasion or chemical peeling, aesthetic surgery

  • the spectrum of possible indications is continuously increasing( ex: IPL+ aminolevulinic acid for treatment of actinic keratosis or superficial basal cell carcinoma)


Intense pulsed light ipl in dermatology

THANK YOU!


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