There has been a school of thought that a strong flush before IPL treatment would lead to easier to treat blood vessels and therefore a better outcome for the patient. Recently on Rosacea Support, Dr. Soldo has given some of this thoughts on this topic.
“Happy to give you what 6+ yrs of doing Photofacials many times daily have taught me. ALL flushing is undesirable in that new vessels (angioneogenesis) are formed. If a patient is already erythemic (red) to start then there is very little reason to preflush If a patient tells me they are flushing by do not appear to have much erythema then preflushing is done to create a larger and more superficial target. I have attained great results even in prior years when I never preflushedDr Bitter and I have compared notes over the years and he always impressed me in that he generally only produced gentle and mild preflushing. During the period between treatments it is imperative to avoid as many triggers as possible. I know that is easier said than done but every effort should be made Most patients will notice some improvement a week or so after IPL then backslide. Totally normal.”
A further message ;
“I recognize there are other contrary opinions and I can only give you mine. I have recognized however that having done Photofacials longer than anyone other than Dr Bitter and having done ALL of my own IPLs on a daily basis (as many as 12 in one day). I think I can speak with some degree of authority. I have not preflushed, I have mildly preflushed, severely preflushed and everything in between and in my experience I can tell you that the patients with no preflush have in general fared better than those who were preflushed.Preflushing generally dictates lower fluences and this could be counterproductive in that treatment. Also if a person is already flushing, the newer more powerful laser/IPL devices will handle superficial and deep vessels. Plus every flushing episode of any kind generates more unwanted vessels.
I do however on occassion do a mild/moderate preflush if the patient tells me they still flush but their face appears to have no erythema when I see them.
Hope this gives you some insight to my approach for preflushing. I am aware of the many theories that abound but I am not interested in theories but only in what goes on in the trenches everyday.”
And, a third message from Dr. Soldo.
“Let me start by saying I have performed IPLs daily for over 6 yrs and have done every single one of the procedures myself and may well have personally performed more than anyone during that period–I have preflushed, used aggressive fluences, etc and at long last can tell you that my personal belief (and results) have proven to me that preflush is not only not necesasary been even counterproductive in most cases. It is not that I dont on infrequent occassions do so but with very specific indications. And treatment levels should be moderate at best. If too aggressive then I believe more harm than good can occur. Just one man’s opinion.”
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1 comment so far ↓
I don’t buy into what dr soldo is saying. I had treatments done by Dr Bitter and we tried everything to preflush me. A lot of the facial vessels are not noticeable untill you flush. I strongly disagree with Dr Soldo. As a matter in fact it ticks me off that he even says that.
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