Intense Pulsed Light Therapy Overview

Intense pulsed light is a new minimally invasive skin procedure that can diminish or remove age or liver spots, fine wrinkles, facial flushing, redness, broken capillaries, telangiectasia (purple or blue veins on the face), hemangiomas (red, purple, or blue birthmarks formed by blood vessels), freckles, minor sun damage, port wine stains, tattoos, varicose veins, spider veins, flat birth marks, and hypopigmentation (pale spots). These light systems are also used to remove body hair. There is almost no "downtime," no days or weeks when you feel you need to stay out of the public eye as your face heals.

Intense pulsed light therapy gives you the benefits of a medium depth laser or chemical peel or other resurfacing procedure without the blisters, burns or long recovery time. It can help alleviate redness from rosacea, flushing, and other conditions. Many patients report a reduction in pore size, smoother skin, and fewer wrinkles.

Intense Pulsed Light: What is it? Where did it come from?

This therapy was pioneered by dermatologist Patrick Bitter Jr., MD, and is based on emitting high-intensity pulses of light to penetrate the skin. The light that the system emits is not laser light, which is monochromatic light that is specially concentrated and aligned.

There are several different machines that emit different wavelengths of intense pulsed light that penetrate to different distances into the skin. The different types of light and the different penetration depths allow for treating different skin problems. Different wavelengths of light determine the color of the light and the color of the tissue that is absorbed by that light. For example, light that is absorbed by red and purple is used to treat spider and varicose veins, as well as vascular birthmarks like port wine stain. This is because it is absorbed by the red hemoglobin in the blood, which heats the targeted blood vessels but not the surrounding tissue. The penetration depth and degree of heat is tightly controlled by computers.

Other wavelengths of light are used to treat age spots, freckles, flat pigmented birthmarks, and other types of discolorations. The tissue targeted is the melanin, the color in skin cells in the epidermis. The light heats up and destroys the melanin and rids you of the unwanted hyperpigmentations (darker spots).

To remove body hair permanently or almost permanently, intense pulsed light is used to heat up the hair follicles and kill them. However, hair grows in cycles and some follicles are lying dormant at any given time. Light therapy must hit the hair follicle during its growing phase to work properly. A few weeks later, it may look like the treatment did not work, but it is just the dormant follicles that were not killed that have started growing.

Are You a Candidate for Intense Pulsed Light?

You may not be a good candidate for intense pulsed light therapy if you are prone to keloids or excess scarring, hyper- or hypopigmentation, and are dark-skinned, darkly tanned or do not react well to burns. People of certain ethnic backgrounds, such as like Greek, Italian or African-American may be prone to hyperpigmentation or hypopigmentation problems after this type of treatment. Only a qualified doctor or dermatologist can determine if you are eligible for treatment.

You are also not a good candidate for intense pulsed light therapy if you are an insulin-dependent diabetic. Diabetics tend not to heal well from any wounds.  Insulin-dependent diabetics run the risk of wound-healing and infection problems after intense light therapy.

If you take any blood thinners such as Coumadin, warfarin, heparin, aspirin or similar drugs, you may not be a good candidate for this treatment. Certain herbal medications can also thin the blood and interfere with clotting. These include garlic, ginger, and cayenne pepper supplements, and gingko. Also, if you have a blood disorder that interferes with clotting, the same goes.

If you are pregnant, wait until after your pregnancy is over to have pulsed light treatment. Although pulsed light treatment does not emit radiation of any kind and is safe for treatment during pregnancy, it is still a bit of a stress on the body.

What to Expect at Your Consultation

At a consultation appointment, you will meet with the dermatologist and he or she will determine if you are a good candidate for intense pulsed light treatment. The two of you will discuss your health, your family history, and what medications you take. He or she will examine your skin and any scars you have. You may need to have a spot test or patch test done, where the doctor treats a very small spot on your arm or torso to see if there are adverse reactions. You will probably have to pay an additional fee for the spot test. The doctor will also advise you on about how many treatments and pulses per treatment will be needed to achieve your desired goal.

After your test patch/spot treatment, you have to wait and watch the test area for several days for negative reactions such as blistering, pigmentation problems, rashes, or persistent redness. Report any problems to the doctor's office or skin clinic.

If all is well, you can schedule an appointment. You will be instructed on what and what not to do for the next two weeks before your first treatment. You will also be instructed to avoid tanning.

How Pulsed Light Therapy Is Performed

Your technician or doctor will offer you a topical anesthetic if you want or if you are sensitive to pain. After the treatment area is numb from the anesthetic, a cold gel will be applied to the treatment area. A glass prism will then be placed over the treatment area. Pulses of intense light will be flashed through the prism and directed at the treatment area.

You will receive several treatments. Your first treatment may not be as aggressive as the following ones because your doctor or technician will be determining your skin's tolerance to intense light therapy. Treatments are usually performed every 3 to 4 weeks.

The Road to Recovery

There is no real recovery time after a pulsed light treatment and you can you may resume your normal activities. 

The area may be slightly pink or red right after your treatment and you may have mild swelling. Pinkness and swelling should subside in a few days. If they don't, inform your doctor/technician.

You must protect the treated area from UV light, either sunlight or tanning beds.

Risks and Complications of Intense Pulsed Light

Although rare, blistering or slight bleeding is possible after intense pulsed light therapy. So are hypopigmentation and hyperpigmentation. If pigmentation problems occur, it may be anywhere from 3 to 12 months before normal skin color returns. This is especially true with hypopigmentation. Be aware that some patients may experience permanent skin pigmentation changes. Scarring is possible, although it is rare.

The Average Price of Intense Pulsed Light Therapy

Treatment prices vary significantly between areas of the country and surgeon. Of course, if you need treatment over a larger area it will cost more than having a small mole or other spot removed. 

On average, a spot-test can cost from $20 to $75. Treatments are about $10. per pulse with a minimum of $100 per visit. You can purchase a package of several treatment visits, which can reduce the costs.