Intense pulsed light or IPL, is a relatively new technology that utilizes filtered light to treat various conditions of the skin including excessive redness, brown spots, photodamage from sun exposure, and small veins. It can improve skin texture, pore size, and give the skin a healthy overall glow.
Photodynamic therapy or PDT is a well established technique for treating skin cancers, and inflammatory diseases of the skin. Chemicals that photosensitize the skin are applied directly to the skin and then treated with various frequencies of light. These various chemicals enhance the effectiveness of light.
Recently, we and others have been combining a naturally occurring photosensitizing chemical called 5-aminolevulinic acid (ALA) and IPL. 5-aminolevulinic acid and other chemical photosensitizers will revolutionize the use of intense pulsed light therapies. By combining IPL with ALA, we are able to treat difficult skin conditions that were not well treated by either of these modalities on their own.
Take acne for instance. Acne is one of the leading skin disorders that results in embarrassment, shame, and a lack of self esteem. Patients with acne are at times frustrated with the lack of truly successful therapies. Accutane is a highly effective drug taken orally, but has so many side effects and potential problems that deter many people from using it. Using combined ALA-IPL cystic, active acne has responded remarkably well. More importantly, there are no side effects from the treatment. Many patients respond to a single treatment, although most require two to four treatments spread one month apart.
The theory behind the success of these combined modalities is that the ALA chemical is absorbed preferentially by the bacteria that cause acne, Proprionobacterium Acnes. This bacterium resides in the skin sweat glands and hair follicles and is metabolically more active than the surrounding skin cells. The ALA is then activated by the appropriate wavelength of intense pulsed light, thus killing the bacteria directly in the skin. This leads to control and improvement of cystic acne, active acne, and the inflammatory changes caused by this skin condition. We have noticed considerable changes in pore size and skin quality in non-acne patients using these combined treatments, and as such this regimen can be utilized for other skin conditions such as early skin cancers or precancerous skin changes as well.
The down side is that there is a brisk skin reaction that lasts up to 48 hours so sun exposure must be avoided and at least a 30 SPF sun block needs to be applied to the treated areas. When deciding on choosing a practitioner for IPL it is imperative to remember that the treatments are extremely dependent on the operator, not on the equipment. Choose your provider carefully and ask appropriate questions of their training and experience.
Marc M. Kerner, MD, FACS
Assistant Clinical Professor of Surgery
UCLA School of Medicine