Intense Pulsed Light Treatment

IPL therapy, also called photofacial, is a non-invasive skin treatment that uses broad-spectrum light to target various skin concerns. Unlike lasers, which use a single wavelength of light, IPL emits light in multiple wavelengths, making it versatile for treating different skin issues. (12)

Developed in 1992 by Doctors Goldman, Fitzpatrick, and Eckhouse, IPL was initially used for treating a vascular condition called telangiectasia (broken capillaries, or "spider veins") in the legs. The first IPL device was approved by the United States Food and Drug Administration (FDA) in 1995, and since then, the technology has evolved to address a wide range of cosmetic concerns. (12)

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How IPL Treatment Works

IPL uses a device called a flashlamp to deliver light to the targeted area. The technician can control the light wavelengths, the duration of the light pulses, the energy density (fluence), and the size of the treatment area (spot size). This flexibility increases the versatility of IPL for treating different skin conditions by adjusting the light to match the specific needs of the treatment. (12)

IPL therapy targets substances in the skin called chromophores, which absorb light energy. These chromophores include hemoglobin (the iron-containing protein in red blood cells), water, and melanin (a natural pigment in skin, hair, and eyes). (15)

Unlike lasers, which use a single wavelength of concentrated light, IPL can simultaneously emit multiple wavelengths ranging from 500 to 1,200 nm, dispersing light over a broader area. IPL relies on the principle of selective photothermolysis, where heat generated by the light effectively destroys targeted cells without harming surrounding tissues. (15)

Uses of IPL Treatment

The FDA has approved the use of IPL for a variety of dermatological concerns, including:

Vascular lesions: telangiectasias, port-wine stains, venous malformations, hemangiomas
Acne
Rosacea
Discoloration and hyperpigmentation: lentigines (liver or age spots), freckles, melasma (darkened patches on the face), Poikiloderma of Civatte (reddish-brown spots on the neck and cheeks)
Hair removal from the underarms, bikini line, face, neck, back, chest, and legs
Photorejuvenation and anti-aging: sun damage, fine lines, wrinkles, improved skin texture

In 2021, the FDA approved IPL to treat dry eye disease caused by dysfunction of the meibomian glands. Meibomian glands are located in the eyelids and produce a component of tears called meibum, which prevents tears from evaporating too quickly.

Who Should Avoid IPL Treatment?

When IPL is generally safe, it is not suitable for everyone. Factors that may make individuals less qualified for IPL therapy include (3, 12):

Age younger than 10 years
Pregnancy and breastfeeding
Recent sunburn
Active herpes simplex virus (HSV) outbreak or other skin infection
Taking blood thinners or medications that increase sensitivity to light (e.g., isotretinoin for acne)
History of keloid scarring
Darker skin type

Preparation for IPL Treatment

If you are interested in IPL, consult a dermatologist. They will examine your skin and tell you what to expect during the procedure.

According to the American Society for Dermatologic Surgery (ASDS), patients should prepare for IPL by avoiding the following for two weeks before the procedure:

Sunbathing
Tanning beds
Waxing
Chemical peels
Collagen injections

Immediately before the procedure, patients should not apply perfumes or deodorant to the treatment site to prevent skin irritation. Patients should also avoid taking aspirin, anti-inflammatory drugs, and natural supplements to reduce the risk of bleeding. (20)

The IPL Procedure

Before starting, the technician performing the procedure will prepare your skin, which may involve applying an anesthetic gel or cooling gel to minimize discomfort. You will also be given protective eyewear to wear during treatment to shield your eyes from the light. (26)

During a session, a handheld device is applied to the skin, delivering light pulses that may feel like a rubber band snapping against the skin or a mild sting. This is generally brief and tolerable. Each IPL session typically lasts about 20 minutes. This may vary depending on the size of the treatment area. (26)

Multiple sessions are often needed for optimal results, ranging from four to six sessions spaced about one month apart on average (26).

Side Effects and Risks of IPL Treatment

Side effects of IPL therapy are generally mild and self-resolving within a few hours to days after the procedure is complete. The most common symptoms patients experience following an IPL treatment are:

Redness
Pain
Swelling

More severe risks can include (12):

Burns
Scarring, including keloid formation
Discoloration (either a darkening or a loss of skin pigmentation)
Infection

These risks are higher in patients with thinner and darker skin tones or when higher fluences and pulse durations have been used during the treatment (12).

IPL Treatment Effectiveness

Evidence obtained through clinical research and case studies supports using IPL in various contexts. Let's review some of these findings:

Hair Removal

IPL is an effective means of hair removal. It works best on people with light skin and dark hair (15). One study found that people saw an 83.3% reduction in hair growth after one month and 78.1% after three months and that results could last for years or even permanently. Another study found that 95% of patients saw a reduction in hair count after six biweekly treatments, with a 78% reduction at one month and 72% at three months.

Vascular Lesions

IPL is a safe treatment option for port-wine stains and can even be effective in reducing the appearance of lesions by 50-100%, even on marks that are resistant to other treatments. Evidence suggests that IPL is most effective when used in combination with other laser types.

Anti-Aging

IPL therapy is effective for anti-aging treatments, particularly in improving skin texture and reducing dark spots. IPL stimulates the production of collagen, a protein that maintains skin elasticity and firmness. As IPL promotes collagen synthesis, it helps smooth fine lines and wrinkles, resulting in a more even skin texture. (2)

IPL can also target and break up melanin, the pigment responsible for dark spots. This process reduces the appearance of dark spots and evens out skin tone.

Dry Eyes

Results from a small prospective study that followed 28 participants with meibomian gland dysfunction undergoing IPL treatment suggest IPL is a promising therapeutic option for managing dry eyes. IPL therapy appeared to improve eye dryness and tear secretion quality significantly.

Recovery After IPL Treatment

It is typical for the treated area to appear red, pink, and swollen and feel like a mild sunburn after the procedure. Redness and stinging typically resolve four to eight hours after the procedure, and swelling may persist for up to three days. (20)

In addition to avoiding sun exposure and topical products that can irritate the treated skin, patients should avoid applying makeup to the area for at least 24 hours, ideally until all redness and stinging have dissipated. One day after the procedure, patients can begin applying a good-quality moisturizer to the treated area twice daily for at least three months after the final treatment to support healthy skin. (20)

Costs and Insurance Coverage

Insurance coverage often depends on the individual insurance policy. Some plans may cover IPL treatments if they are used to treat a documented medical condition and if other, less expensive treatments have been exhausted. It's important to check the specifics of the policy or contact the insurance provider directly to understand what is covered.

IPL treatments for medical conditions, such as acne or rosacea, might be more likely to receive insurance coverage compared to cosmetic procedures aimed at improving skin appearance, such as reducing age spots or wrinkles. Insurance companies typically cover treatments that are deemed medically necessary, but cosmetic treatments are often excluded.

For medically necessary IPL treatments, pre-authorization from the insurance company may be required. This involves providing detailed information about the condition being treated and why IPL is recommended. The insurance company will then decide if the treatment meets their criteria for coverage.

If IPL is not covered by insurance, patients may need to pay out-of-pocket. Out-of-pocket costs will vary by office. According to the American Society of Plastic Surgeons (ASPS), the average price of one IPL treatment was $412 in 2020. Some practices offer payment plans or financing options to help manage the costs.

At-Home IPL Devices

At-home IPL devices have gained popularity as a more affordable and convenient alternative to professional treatments for addressing various skin concerns, such as hair removal, acne, and skin rejuvenation. These devices bring some of the benefits of professional IPL treatments into a home setting, but generally use lower energy levels than those used in professional settings. This increases their safety, but they usually require more frequent use and longer treatment durations to achieve desired results compared to professional treatments. (17)

At-home IPL devices have built-in safety features to reduce the risk of burns or other adverse effects. However, proper usage according to the manufacturer's instructions is essential to minimize risks. This includes wearing protective eyewear if recommended and avoiding treatment on sensitive areas or areas with existing skin conditions.

Alternatives to IPL Treatment

IPL treatment may not be the best option for everyone. Fortunately, there are alternative options that may be better suited for you:

Fractional resurfacing is a type of laser therapy that delivers laser light into the lower layers of the skin, stimulating tissue healing and regeneration of healthy tissue to reduce signs of aging. It can be performed on the neck, chest, arms, and hands. Compared to IPL, fewer sessions may be required for long-lasting results.
Chemical peels involve applying a chemical solution to the skin to remove damaged outer layers, promoting the growth of new, smoother skin. They are commonly used to improve skin texture, reduce wrinkles, and treat hyperpigmentation.
Microdermabrasion removes the outer, dead layers of skin. Although it generally does not produce results that are as long-lasting as IPL, it is less painful, more affordable, safe for all skin colors, and has a reduced risk of scarring and hyperpigmentation.