IPL Technology Primer (incl. Lumenis One)

Written by on February 21, 2006 in IPL with 0 Comments

This 2003 paper from Lasers in Surgery and Medicine gives some good information about IPL Technology. Whilst it doesn’t deal with rosacea directly, it will help those interested in IPL technology and treatment. The devices reviewed include Photoderm, EpiLight, Vasculight and IPL Quantum.

In 2004 a new IPL Treatment platform, Lumenis One was introduced. The Lumenis One incorporates 3 treatment technologies; IPL, Nd:YAG and LightSheer. Whilst not comparable to a journal article, the whitepaper titled Lumenis One – An expandable Technology Platform for Comprehensive Aesthetic Treatments might prove a useful primer.

Since 2003 several good papers relating to IPL and Rosacea have been published (see below).

IPL Technology: A Review, Lasers in Surgery and Medicine, 32:78..87, 2003.Christian Raulin, MD Barbel Greve, MD, and Hortensia Grema, MD, Laserklinik Karlsruhe, Karlsruhe, Germany. Department of Dermatology, University Hospital of Heidelberg, Heidelberg, Germany

Background and Objectives: Intense pulsed light (IPL) systems are high-intensity light sources, which emit polychromatic light. Unlike laser systems, these flashlamps work with noncoherent light in a broad wavelength spectrum of 515–1,200 nm. These properties allow for great variability in selecting individual treatment parameters and adapting to different types of skin types and indications. The purpose of this article was to critically review international medical publications of the many indication in which IPL technology can be used, including our own evaluations and experiences.

Study Design/Materials and Methods: The range of therapeutic uses for high-intensity flashlamps was reviewed, ranging from benign cavernous hemangiomas, benign venous malformations, essential telangiectasias, leg telangiectasias, poikiloderma of Civatte, and port-wine stains to pigmented lesions, cosmetically undesired hypertrichosis, and facial rhydids. The relative benefits and risks were discussed in detail and compared with other laser systems.

Results: Because of the wide spectrum of potential combinations of wavelengths, pulse durations, pulse frequency, and fluences, a great deal of experience is required when using IPL technology. Proper patient selection and critical diagnostics serve to keep the adverse effects of the treatment to a minimum.

Conclusions: The distinctive technical conditions involved combine to make IPL technology an alternative and auxiliary treatment option to existing laser systems and conventional therapies

The wavelength determines not only the absorption behavior but also the penetration depth of the light. In the visible spectral range, the latter increases with the wavelength. With the aid of different cut-off filters (515– 755 nm), which only allow a defined wavelength spectrum to penetrate, the optimal wavelength spectrum can be filtered out to correspond to the depth of the target structure (vessels of different depths and sizes, hair follicles, pigmented structures). Similarly, the wavelength can be adapted to the patient’s individual skin type, since higher filters reduce the absorption of melanin and can thus be used to prevent strong adverse effects such as severe erythema, blistering, and crusting in those with darker skin types.The pulse duration of IPL systems can be set to ranges between 0.5–88.5 milliseconds and should be lower than the thermal relaxation time of the target structure so that the surrounding tissue is not damaged. The use of single pulses is possible, and high fluences can be split into multiple pulses as well; the intervals between the individual pulses can be set at values between 1 and 300 milliseconds. This delay allows the epidermis cells and smaller vessels to cool down between pulses while the heat is retained in the larger (target) vessels/hair follicles, resulting in selective thermal damage (the principle of thermokinetic selectivity). The extent of the maximum fluences and the size of the spot size vary, depending on the kind of equipment used.

Essential Telangiectasias

Teleangiectasias on the nose and cheeks present a significant cosmetic problem for many patients. Older forms of treatment such as electric cauterization with a diathermy needle or sclerotherapy treatment not only entail severe adverse effects but are also much less widely used due to the much more effective therapeutic options of laser and IPL technology. With the pulsed 0.5 milliseconds dye laser, which is still the preferred method of treatment, very good results are achievable. However, the intracutaneous hematomas that occurred post-treatment are a complication that many patients would not tolerate well. For this reason, IPL systems have been growing increasingly widespread in treating essential telangiectasias over the past years. The high success rates and low occurrences of adverse effects have been confirmed in several publications.

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About the Author: David Pascoe started the Rosacea Support Group in October 1998. .

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