Monday, February 13th, 2017
Sun damage produces a number of skin changes, the most common of which are red and brown spots. The brown spots vary from generalized “freckles” to scattered small spots to larger spots. Genes and hormones may contribute to larger dark areas called melasma. The red caused by sun damage is a form of “rosacea,” or “red skin,” more properly called telangiectasia. It is essentially an abnormal increase of the small capillary blood vessels just under the skin. Another type of rosacea is natural flushing, or dilatation of those normal capillaries due to heat, drinking, exercise or other stimulus. Frequently, with good skin care, when you remove the thick outer layer of the skin, also caused by sun damage, the underlying red is exposed making it appear darker. An IPL can be used to treat both these problems.
An IPL, or Intense Pulsed Light, is a laser like machine. However, instead of producing a single wavelength of light, it produces a spectrum of wavelengths. This allows it to target several areas where the target absorbs light and avoid having to use a very strong light pulse that can injure areas that are not targeted. For instance, Hemoglobin, the target when treating small vessels, absorbs light at 418, 542 and 577 nm (nanometers, a measurement of the wavelength of light). No laser puts out just one of those. The Ellipse IPL, on one setting, emits light from 400-620 nm, thus encompassing all absorption areas, allowing it to work at a lower power setting, thus causing less discomfort and less risk of injury to anything other than what is being treated. Melanin, the target in brown spots absorbs between 550-950 nm. Another setting of the Ellipse IPL targets this spectrum and does not extend above 1000 nm where water in all cells absorbs the light, thus not causing heat damage to the skin.
Treatment consists of exposing the area to be treated to the light using a rectangular lens placed on the skin. Each treatment takes from 10-20 minutes. It is slightly uncomfortable when administered, but all discomfort resolves in about 5 minutes. There is usually some increased redness when treating red that lasts about 4-6 hours. When treating brown spots, they generally turn darker. Some or all of the red fades in 2-3 weeks. The brown spots either fall off or also fade over the same time period. Any residual can be treated again in 3-4 weeks. To completely remove the problem may take 1-6 treatments, depending on the severity of the problem and your individual response. Although possible, blisters or other skin irritation is extremely rare, unlike with treatment of these problems with a laser. Most people can return to normal activities immediately after treatment.
The IPL can also be used to treat more severe sun damage like actinic keratoses. When this is done, the involved area is treated with amino levulinic acid that is absorbed over 6-18 hours into the severely sun damaged cell and converted to a porphyrin that has a very high affinity for blue light. The skin is then treated with high doses of blue light (400-500 nm). Because only the severely sun damaged cells contain the porphyrin and absorb the blue light, only those cells are superheated by the light energy and destroyed. This method is as effective as using chemotherapy like 5FU (Efudex, Fluroplex) and imiquimod (Aldara, Zyclara), but, instead of taking 6 weeks or more, treatment takes only a day and recovery only a week or so for the places to crust and fall off.
Because active Acne areas are inflamed and also absorb amino levulinic acid, a similar treatment is available for severe Acne not controlled by standard means.
If you are bothered by any of these problems, call The Center for Plastic Surgery to see if an IPL treatment can help you.