Institute of Aesthetic Plastic & Reconstructive Surgery, LLC
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PHOTOREJUVENATION/PHOTOFACIAL
INTENSE PULSED LIGHT (IPL)
GENERAL INFORMATION AND FREQUENTLY-ASKED QUESTIONS
Intense pulsed light (IPL) technology is a revolutionary treatment breakthrough that can correct a
variety of benign cosmetic skin problems. A broad band of light energy is flashed at the surface of
the skin which penetrates deeply to correct various skin conditions. This therapy differs from laser
therapy in that it is individualized and has more versatility in therapeutic treatment. Skin
conditions such as unwanted broken capillaries (telangiectasia), age spots and freckles, early
wrinkling, skin surface irregularities and an uneven, blemished complexion, enlarged pores,
birthmarks, and unwanted hair can be improved. Because intense pulsed light treats multiple
factors that contribute to skin aging, this treatment is ideal for many patients. In addition, it is a
procedure that fits the lifestyle of active people because it requires no “downtime” – you can
resume work or other activities immediately.
(I) Telangiectasia; Rosacea; Acne Rosacea
As we age, gradual degradation of the skin may result in irregular, broken capillaries on the
surface of the skin. These broken capillaries (telangiectasia) are small unsightly red, purplish
vessels found on the face, upper chest, neck and rarely on other parts of the body.
Telangiectasia on the face are caused by anything that stimulates the circulation to flush or
blush. Heredity, aging, sun and environmental exposure, hot and spicy food, exercise, alcohol,
emotions, hormones, cortisone medication, skin diseases, and acne rosacea (an adult form of
acne) can all lead to telangiectasia. Large patches of blood vessels on the face leading to
excessive redness is often attributed to rosacea. This can be quite severe and may be
accompanied by episodes of flushing that are very difficult to control. Many rosacea patients
are desperate for a solution to this annoying and embarrassing problem, as topical creams and
other treatments as to date are rarely effective.
(II) Photoaging (Sun Damage): Lentigines (Age Spots): Ephelides (Freckles); Nevi
(Moles); Melasma
The second major category of skin changes is photoaging; the production of irregular pigment
and color brought about by exposure to the sun. Regardless of where we live, our bodies are
constantly exposed to the damaging ultraviolet (invisible) rays of the sun.
Typically,
individuals begin to develop freckles and sun damage spots. Lentigines (age spots) and
ephelides (freckles) are tan, brown or black spots that appear over time on sun exposed areas
of the skin. These spots normally occur on the face, chest, shoulders, hands and extremities.
Lentigines are superficial collections of skin pigment called melanin which have accumulated
within the top layer of the skin called the epidermis. Lentigines usually appear later in life and
can occur in all skin types. Ephelides (freckles), often begin in childhood and are common in
lighter skinned type individuals who sunburn easily. Common moles (nevi) are inherited and
appear in many different sizes, shapes and colors. Abnormally dark moles which demonstrate
irregularity and progressive changes in shape, size, or color are at risk for being a malignant
melanoma (a serious type of skin cancer). Suspicious moles should be checked by your
physician and may need to be biopsied or removed entirely. Pigmented birthmarks are
common and appear in multiple varieties. Congenital pigmented nevi are brown or black moles
that are usually quite large and may appear anywhere on the body. If these moles contain
hair, they are called giant pigmented hairy nevi. Café-au-lait macules (coffee and cream
Photorejuvenation Patient Information
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spots) are flat, tanned patches which present at birth and rarely may be associated with some
other medical condition, such as neurofibromatosis. If multiple, large, pigmented spots are
present especially in the mouth or gums, there may be an association with internal medical
condition (Peutz-Jaeger syndrome) which needs to be investigated further. There are a large
variety of pigmented birthmarks. Melasma is a patchy brown, tan or black zone of pigment
which commonly occurs on the face or neck in women. Melasma will usually darken during
pregnancy, while taking birth control pills or hormones, and is made worse by sun exposure.
Post inflammatory hyperpigmentation is pigmentation that appears in the skin following
inflammation. It may occur after injuries, superficial burns, skin irritation, acne, or surgery, as
well as from other skin conditions which cause inflammation of the skin. When the skin is
inflamed and red, it is most at risk for turning deeply pigmented, especially if exposed directly
to sunlight.
(III) Rhytids (wrinkles); Elasticity; Texture
And third, the texture and elasticity of the skin is lost with aging as the collagen and elastin
content in the skin degenerates. Fine lines and wrinkles that appear around the eyes, mouth
or forehead are attributed to this gradual loss of collagen in the skin. As this process
progresses deep wrinkles, furrows and loose skin develop.
TREATMENT OPTIONS AND EVOLUTION:
For extreme cases of any of the aforementioned problems, surgical procedures have been
developed with good success, including laser skin resurfacing (CO2), chemical peels, and surgical
lifting procedures (i.e. facelifts, forehead lifts, eyelid lifts). Many people do not require involved
surgical procedures demanding considerable healing and downtime. They can now be treated with
noninvasive, intense pulsed light therapy (IPL). Though not a panacea for all aging problems, it is
an excellent addition to the armamentarium to combat aging. Intense pulsed light therapy offers a
comfortable treatment option with excellent results and little or no downtime. IPL treatments
generally produce fewer side effects with subtle, yet convincing results. For men and women, IPL
is a therapy which has begun where many therapies have left off. Traditionally, previous
procedures have required downtime and prolonged recovery periods which include isolation or the
utilization of camouflage cosmetics; often unpractical for men. IPL technology gives men and
women a youthful and vital appearance without drawing attention to themselves during the
recovery phase. With advanced IPL therapy, the traces of photodamaged skin; namely, skin
irregularities, early wrinkles, rough texture, irregular pigmentation and age spots, broken
capillaries, enlarged pores, and excessive hair may be improved efficiently and cost effectively.
PHOTOREJUVENATION/PHOTOFACIAL PROGRAM:
The application of intense pulsed light to the face and neck areas is a patented procedure called the
“PhotoFacial.” The PhotoFacial, due to its versatility, allows for a safe, noninvasive solution that
can be tailored to each individual skin condition and type. PhotoFacials are performed in our
private surgical suite. The program usually consists of several treatments (average five) at three
week intervals. The program gives you a gradual (not sudden) improvement in improving the
targeted adverse cosmetic conditions. Each treatment takes about 30 minutes. Intense pulsed
light is transmitted through a small handpiece and crystal. The handpiece is held gently against
your skin and cooling gel is applied to the area to be treated. Dark glasses are provided during the
treatment to protect your eyes from the bright light. The smooth glass surface of the IPL
handpiece is applied to your skin and pulses of light are administered. Depending upon the region
being treated, you may feel a mild stinging sensation, like the snapping of a rubberband. Any
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Institute of Aesthetic Plastic & Reconstructive Surgery, LLC
Expertise  Integrity  Artistry
discomfort is minimal, especially with the utilization of an anesthetic cream. Although your eyes
are closed and covered during the treatment; you will sense a bright flash (Please understand that
the broad band of light being applied to the skin is a safe wavelength and does not contain harmful
ultraviolet radiation).
Treatment is generally administered in a series of procedures that provide optimal long term
results, minimal adverse effects, and high satisfaction. The number of treatments needed will
depend on the number of conditions you are treating and the severity of the individual problems.
By dividing the full program into several treatments, the procedure provides gradual improvement
at a low risk – and it preserves the wonderful “no downtime” feature that people appreciate so
much. The initial treatments are most effective on the pigmented lesions and age spots; the later
treatments improve the broken capillaries, telangiectasia and stimulate deep collagen production to
improve the irregularities of the complexion. Some telangiectasia may be completely removed in
one treatment. Age spots and freckle spots are frequently diminished or completely removed
within one to two treatments. Several treatments or sessions are required to treat more extensive,
deeper and stubborn lesions.
QUESTIONS:
What does the area look like after the treatment? Are there any side effects from the
treatment?
The areas treated may have temporary redness, swelling, or a purple discoloration. Blisters may
rarely occur following treatment. Skin discoloration, mild swelling and minor blistering of the skin
are the most common side effects. In rare cases, a treated area may heal with increased (dark) or
decreased (light) pigmentation. Scars are possible, but occur rarely. Some spots may not go
away completely, even with multiple treatments. This is especially true of large or deeper lesions,
or birthmarks. These lesions are limited in treatment due to their depth in the skin which reside
beyond the penetration of IPL. Post inflammatory pigmentation (a brown discoloration that occurs
after minor burns or wounds) may occur after treatment with intense pulsed light therapy.
Can all lesions be treated successfully?
Almost all telangiectasia, blood vessels and pigmented spots can be treated successfully. Patients
with dark, tanned, or pigmented skin are usually not treated until the tan has faded. IPL is most
effective on stubborn, extensive telangiectasia that occur in patches instead of the single vessels.
Not all age spots can be completely removed. Some spots are more difficult to treat than others
due to the depth of the pigment and other characteristics of the skin. Extensive areas of skin
involvement become increasingly difficult because of the amount of treatment required. In such
instances, it may be best to concentrate on the most visible area first. Some pigmented spots or
lesions are malignant or premalignant. If this is suspected by your doctor, a biopsy will be taken of
any suspicious lesions before IPL treatments are performed. People who heal poorly or tend to
form severe scars after minor injuries to the skin require careful consideration of the benefits and
risks of treatment. A test patch may be performed on a small area of skin to determine if the skin
will heal normally.
Are there any restrictions after treatment?
Normal activities can be resumed after treatment. The treated areas should be protected from
sunlight or tanning until the skin color has returned to normal (four weeks). You must avoid
unprotected sun exposure or tanning throughout the treatment course. Chronic, unprotected sun
Photorejuvenation Patient Information
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exposure will reverse the effects of IPL therapy with the recurrence of numerous skin conditions.
Gentle cleansing of the skin and application of an antibiotic ointment (Polysporin or bacitracin)
should be used if any blistering, crusting or scabbing is seen.
Will my vascular or pigmented lesions come back after treatment?
People who spend a lot of time in the sun, and lighter skin types that tend to freckle easily will
form new pigmented spots after repeated sun exposure. People with darker skin types tend to tan
more evenly than lighter skin types. Good sun protection with clothing and broad spectrum
sunscreen products (UVA/UVB SPF 45) will help reduce the potential for reappearance of pigmented
spots. Patients being treated for melasma should understand that this condition is an inherent
process which will require long term management to keep the over-pigmentation at rest. Most
people cannot avoid the sun totally and, so on occasion, touchup treatments will be necessary to
remove new pigmented spots. Individuals who have an underlying condition which causes
telangiectasia (broken capillaries) will gradually redevelop new vessels throughout life, especially if
they frequently flush or blush. Some causes of telangiectasia are not correctable (inherited fair
skin). Sun protection will reduce the predisposition for recurrent telangiectasia which resulted from
repeated sunburns. Periodic touchup treatments every year or so will likely be required to get rid
of new telangiectasia. Telangiectasia at the corners of the nose are most likely to recur because of
the high pressure vessels feeding this area of the face. These vessels may require combination
therapy to include IPL and electrocautery. Treatment of an underlying skin condition such as acne
rosacea may prevent new telangiectasia from forming.
How much does the treatment cost? Will my insurance plan cover it?
Treatment costs depend on the extent of treatment necessary and will vary. You will be given a
cost estimate before the treatments are initiated. Most treatments of telangiectasia or pigmented
spots are considered to be cosmetic by insurance companies and will not be paid for unless they
are caused by some illness or skin disease. Payment for treatment of skin lesions with IPL is
required in full at the time of treatment unless prior authorization has been received from your
insurance company.
GETTING STARTED:
A consultation appointment is necessary to evaluate your skin condition, consider your candidacy,
and discuss the treatment options. A test spot can be easily done during your consultation
appointment if necessary. The test spot site will be reevaluated at one to two weeks at which time
your initial PhotoFacial can be scheduled and treatment initiated. Preparatory medications are
needed before treatment for some. Prescriptions or medications will be available for you at the
time of your consultation so you will have the medication before your treatment is started.
SUMMARY:
Photorejuvenation by intense pulsed light (IPL) offers a revolutionary treatment for a variety of
aging skin conditions with minimal downtime. IPL Photorejuvenation is indicated for broken
capillaries, vascular blemishes, pigment spots or lesions, dull complexions, skin irregularities,
enlarged pores, rosacea, acne, and for hair removal. PhotoFacial therapy is a noninvasive
treatment that erases skin damage without disruption of the skin surface, hence no downtime and
limited recovery. It provides an effective and convenient cosmetic treatment for individuals in face
of busy lifestyles and demands.
Please feel free to contact our office for any questions regarding IPL PhotoFacial and
Photorejuvenation (303) 651-6846.
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