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IPL (Intense Pulse Light) aka Photo Facial aka Photo Rejuvenation 

What is IPL
Intense Pulsed Light (IPL) are non-laser devices that can emit high-intensity light pulses at 500 to 1200 nm wavelength range, depending on the treated problem and device configuration (Goldberg DJ 2012). 
An IPL treatment is a non-invasive, practically no downtime procedure. Over 650,000 Photorejuvenation (IPL) procedures were performed in the USA in 2016, making them the 4th most popular non-invasive procedure on the country (ASAPS, 2017).
​
IPL can treat one of the three skin problem types - 
1. Dark/brown discoloration: dyschromia aka brown spots aka age spots aka sun damage aka photo aged skin;
2. Vascular discoloration: capillaries and tiny veins close to the skin surface (telangiectasia), redness, rosacea;
3. Overall rejuvenations of the skin tone and texture: enlarged pores, wrinkles, uneven skin texture and tone, collagen production (Goldberg DJ, 2000; Prieto VG, 2005).

​IPL treatments may be performed not only on the face, but on any other sun exposed skin areas - hands, arms, shoulders, and chest. 

Sun damaged skin IPL treatment
IPL treatment on the sun damaged skin of the chest - dark spots, minor redness and an overall complexion improvement after 4 treatments
It is important to understand that an IPL device does not treat all these problems at once. 
A specific light wavelength setting is used depending on what problem group is treated. It means that if you would like to have your face treated for the brown/sun spots, and for the vascular issues, and to have an overall rejuvenation effect, then your IPL esthetician will have to do at least three passes over the same area on the three different IPL device settings. ​

​An IPL treatment 
cannot help with the age related facial volume loss and facial sagging. For example, IPL will not help with a nasolabial fold, flattening cheeks, or under-the-eye hollows.
An IPL treatment can help addressing skin aging, especially that caused by extrinsic factors such as sun damage, smoking, alcohol consumption, and other lifestyle and environmental factors.   ​​
How many treatments are required and the price

- In some cases, one treatment may be sufficient for the dark discoloration. Typically, a series of three to six treatments are required to achieve the optimal results for either the dark spots or for the vascular issues.
- For the rejuvenation treatment regimen by IPL, there are no set in stone guidelines, but it appears that two to four maintenance treatments a year will keep the skin looking years younger. 
- The price per one procedures varies between $70 and $400.
​Most IPL devices are rather similar. What matters is whether the technician/esthetician chooses the most appropriate device settings for your skin type so that, on one hand, the treatment is effective, on the other hand, it does not burn your skin.  


Besides the wavelength, other settings of an IPL device are joules and milliseconds that define the strength and the effectiveness of the treatment. Some devices are pre-configured by the manufacturer depending on the patient's Fitzpatrick skin type. Some allow flexible setting configurations by an esthetician depending on the patient skin. ​
How the IPL treatment is performed
​

Skin is cleansed and covered with a conductive gel. Sometimes a topical anaesthetic is applied. Eyes are covered with protective eyewear. 
An esthetician moves along the treated area the device head that delivers pulses of light. The sensation can be compared to a tiny hot rubber band snap. Device settings are adjusted to avoid excessive pain or skin burning. The entire treatment takes 10 to 20 minutes depending on the area treated.

With the rejuvenation treatment, two passes should be performed to achieve full and even coverage. 
A preventative photofacial treatment
A preventative IPL procedure on the face with rejuvenation settings

After the treatment and the downtime 

- Immediately after the treatment, skin may be pink for 10 minutes to several hours;
- Several days after the treatment, small patches of skin right where the brown spots were will begin to crust and look very dark, and in two - three days after that the crust will fall off. Those small dark crust patches are not very visible. But if your face needs to be in the top shape for a photo session or a an event, give yourself two weeks after the treatment.
- It is highly recommended to avoid sun exposure for two weeks before and two weeks after the procedure.
- There is no other downtime or inconvenience except for the above. ​

Treatment Specific References and Literature

American Society for Aesthetic Plastic Surgery. 2017.
2016 Cosmetic Surgery National Data Bank Statistics.
https://www.surgery.org/sites/default/files/ASAPS-Stats2016.pdf

Goldberg DJ. Current Trends in Intense Pulsed Light. 
The Journal of Clinical and Aesthetic Dermatology. 2012;5(6):45-53.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3390232/ 

Goldberg DJ. New collagen formation after dermal remodeling with an intense pulsed light source. Journal of Cutaneous Laser Therapy. 2000;2:59-61
​
https://www.ncbi.nlm.nih.gov/pubmed/11360318​ 

Husain Z, Alster TS. The role of lasers and intense pulsed light technology in dermatology. Clinical, Cosmetic and Investigational Dermatology. 2016;9:29-40. doi:10.2147/CCID.S69106.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4745852/

Martella A, Raichi M. Case Histories of Intense Pulsed Light Phototherapy in Dermatology - the HPPLTM and IFLTM Technologies. Dermatology Reports. 2017;9(1):7118. doi:10.4081/dr.2017.7118.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5475416/  

Prieto VG, Diwan AH, Shea CR, et al. Effects of intense pulsed light and the 1,064 nm Nd:YAG laser on sun-damaged human skin: histologic and immunohistochemical analysis. Dermatologic Surgery 2005;31:522-5.
https://www.ncbi.nlm.nih.gov/pubmed/15962734 
​
​http://foreveryoungbbl.com/pdfs/2600-003-14_Rev_A_PBitter_WP_Skin_Aging_FYBBL_I-V.pdf​
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