Dermatological Use of Skinlite Intense Pulsed Light IPL
Principles
The Skinlite flash Lamp is gas-discharge, the Skinlite lamps are of high intensity and filled with a rare gas (xenon, more rarely krypton).
These sources of light produce an optical radiation when an electrical curent is fed through the gas.
These Skinlite lamps generally function on a pulsated mode and convert electric power stored in intense salvos radiant energy covering the areas of UV, visible and infra-red of the spectrum (polychromatism).
Various fields of clinical use using Skinlite IPL
For hair removal,, generally, one seeks to treat beyond 600 nm, for acting on the melanin of the hairs (eumelanin for dark or brown hair).
However the Skinlite lamps can treat red and fair hair effectively by the use of shorter wavelength (about 525nm).
In fact these clear hairs contain first phaeomelanin whose absorption field is shifted towards the lowest wave lenghts.
For vascular problems and rejuvenation, we can use a cut off around 515-550 Nm.
In case of melalocytic lesions, we prefer to use a cut off around 500 to 550 nm.
Depilation
In their referential publication Dierickx and Ross claim the efficiency of the flash lamp.
The photothermolysis principle is the same as lasers': that is to say acting on the melanin pilar structure of the hair.
After only one session, all types of hairs and phototypes included,, the reduction of the pilosity reach's an average of 52 % into 12 weeks, (Fitzpatrick 1997, Weiss 1998, Gold MH 1998). The carried out studies, give very interesting results after numerous sessions of photo epilation.
One obtain identical results as to the lasers: around 75% even 80% of good result after a period of 12 to 18 months (Smith SR, Sadik NS, Schroter CA, Tse Y ). The most recent issue published by Sadik based on 34 cases give 74 % of good result after 3.7 sessions on average ( with filter of 615-695 Nm, 34-42 J, 2.6-3.3 ms).
The number of sessions using the Skinlite IPL ranges from 3 to 6 varying with the photo type, the colour of the hairs and the treated spot.
The result is due to be obtained in the first three sessions.
The treatment is carried out on close - shaven hairs, after a layer of transparent ointment with optical transmission.
The first assessed effect is an extrusion of some hairs or at least of their modifications (dilatation of the remaining bulb) and the surge of follicular papules in the first few minutes..
Up-rooting the hair with a pair of tweezers is easy and sufficient to prove the results of correct Skinlite Treatments.
The patients feel a sudden degree of heating or of burning which decreases promptly.
The counter-indications are as followed:
- Sun tan, dark photo types (+/-) photosensitizing drugs.
As for the dark photo types one begins to obtain good results without side effect, by using not only high wavelength filter but also with Wave of impulsion separated with very long interval of interpulses (Johnson F, 3 cases of hirsutism, phototype V or VI).
During the pregnancy there is a risk of paradoxical hairs growing and melasma darkening.
Vascular lesions
Generally, the indications are those of the vascular lasers in general:
Erythrosis, telangiectasias (Bjerring )
Planus angioma in complement or after failure of the other vascular lasers (Raulin)
Erythrosis colli (Weiss, Goldman)
Congestive, telangiectasic or hypertrophic scars
Purple stretch marks - ruby tasks - venous lakes (Jay H) - venous malformations (Raulin )
For phlebology, the results depend on blood pressure €¦
Pigmentary Disorders ( solar lentigos and ephelids..)
The best indication of the flash lamp compared to others treatments, is pigmentary disorders.
Especially on fine and sun exposed skins, like the low neckline or the back of the hands, are the quasi absence of a social eviction and the lowest risk of the side effects (achromy, "mish-mash" and scars).
Kawada's study on 60 Asian patients
- more than 50% of improvement in 40 % of the cases
more than 75 % of improvement in 16 % of the cases
EADV
> 50% improvement in 65 % of the cases
> 70% improvement in 48% of the cases
Rejuvenation of photoaged skin:
5 years results with intense pulsed light of the face, neck, and chest
Weiss RA. Dermatol Surg. 2002
80 patients
3 sessions
4 years following initial treatment
skin textural improvement was noted in
83% of the subjects
Telangiectasias inprovement 82%
Pigmentation inprovement: 79 %
Most common side-effects included
temporary mild crusting (19%),
erythema (15%)
purpura (6%).
Crusts were observed in more half of the cases, disappearing in less than 2 weeks and without secondary hyperpigmentation except in a case.
Cases of melasma were improved by the lamps but the retreat misses on the long term like on the frequency of the possible pigmentary rebounds.
In our experiment the sign of a good absorption is a blackening of the brown tasks on a bottom of a minor erythema ("grayed "or increase in pigmentation of at least a tone of the treated lesions).
But we can expect 70% of improvement in one to 3 sessions.
Photo - Rejuvenation
The Skinlite IPL flashlamp has a dramatical effect on two of the major components of ageing heliodermic: telangiectasias and lentigos.
Many trained experts claim a clear improvement of skin complexion,, a tightening of the pores, softer texture, even a collagenic stimulation with a better tonicity and the disappearance of ridules.
The protocols of treatment generally consist in a series of 4 to 5 sessions with a range of 2 to 6 weeks, and repeated sessions are generally proposed.
Negishi among 73 Asian patients noticed a clinical improvement of more than:
60% at 80% of the patients compared to the hyperpigmented cases
78 % compared to the telangiectasias,
56 % compared to the fine wrinkles (no result in the deep wrinkles)
86 % improvement for the texture of the skin (total improvement of more than 60% per 90% of the patients).
The objective data in this study showed in to 3 biopsies an increase of the collagen I and III most in the surperficial layer of the derm.
Hernandez-Perez has just published a preliminary study with histology among 5 women and noticed a good clinical efficacy on them as well as on the epidermal and dermal damages confirmed by histology.
Prieto, also brought back a study on 5 patients with histology, but he does not find noticeable modifications of elastic or collagenous fibres.
Side Effects
Pain: The level of pain depends on the patient, on the treated zone, on the filter type and indeed on the fluence. But the more the filters will go towards the yellow wawe, the more the penetration of the light will decrease with more significant pain superficialy. The cooling system (freezing gel, handpiece) improves the comfort of the patient and reduces the risk of burns.
Burns and scars: In theory these lamps are not indicated in the darkest phototypes. For a phototype > III B, the fluence has to be lowered and/or impulsion durations to be increased. The sun tan may even be more dangerous.
Long-lasting hyper or hypopigmentations with flashlamp: on dyschromic heliodermy, sun tanned skins as L.A.S.E.R sources
Leucotrichy: The Radmanesh recent study out of 821 patients treated for undesirable hairs by lampflash found only 29 cases of leucotrichy (0.04%).
Paradoxical Pushback as with the lasers has rarely been studied. It is always necessary to research hormonal disorders. In most cases, the adverse effects or no answer are related to non adapted parameters and especially in case of too low fluences.
The Skinlite flash Lamp is gas-discharge, the Skinlite lamps are of high intensity and filled with a rare gas (xenon, more rarely krypton).
These sources of light produce an optical radiation when an electrical curent is fed through the gas.
These Skinlite lamps generally function on a pulsated mode and convert electric power stored in intense salvos radiant energy covering the areas of UV, visible and infra-red of the spectrum (polychromatism).
Various fields of clinical use using Skinlite IPL
For hair removal,, generally, one seeks to treat beyond 600 nm, for acting on the melanin of the hairs (eumelanin for dark or brown hair).
However the Skinlite lamps can treat red and fair hair effectively by the use of shorter wavelength (about 525nm).
In fact these clear hairs contain first phaeomelanin whose absorption field is shifted towards the lowest wave lenghts.
For vascular problems and rejuvenation, we can use a cut off around 515-550 Nm.
In case of melalocytic lesions, we prefer to use a cut off around 500 to 550 nm.
Depilation
In their referential publication Dierickx and Ross claim the efficiency of the flash lamp.
The photothermolysis principle is the same as lasers': that is to say acting on the melanin pilar structure of the hair.
After only one session, all types of hairs and phototypes included,, the reduction of the pilosity reach's an average of 52 % into 12 weeks, (Fitzpatrick 1997, Weiss 1998, Gold MH 1998). The carried out studies, give very interesting results after numerous sessions of photo epilation.
One obtain identical results as to the lasers: around 75% even 80% of good result after a period of 12 to 18 months (Smith SR, Sadik NS, Schroter CA, Tse Y ). The most recent issue published by Sadik based on 34 cases give 74 % of good result after 3.7 sessions on average ( with filter of 615-695 Nm, 34-42 J, 2.6-3.3 ms).
The number of sessions using the Skinlite IPL ranges from 3 to 6 varying with the photo type, the colour of the hairs and the treated spot.
The result is due to be obtained in the first three sessions.
The treatment is carried out on close - shaven hairs, after a layer of transparent ointment with optical transmission.
The first assessed effect is an extrusion of some hairs or at least of their modifications (dilatation of the remaining bulb) and the surge of follicular papules in the first few minutes..
Up-rooting the hair with a pair of tweezers is easy and sufficient to prove the results of correct Skinlite Treatments.
The patients feel a sudden degree of heating or of burning which decreases promptly.
The counter-indications are as followed:
- Sun tan, dark photo types (+/-) photosensitizing drugs.
As for the dark photo types one begins to obtain good results without side effect, by using not only high wavelength filter but also with Wave of impulsion separated with very long interval of interpulses (Johnson F, 3 cases of hirsutism, phototype V or VI).
During the pregnancy there is a risk of paradoxical hairs growing and melasma darkening.
Vascular lesions
Generally, the indications are those of the vascular lasers in general:
Erythrosis, telangiectasias (Bjerring )
Planus angioma in complement or after failure of the other vascular lasers (Raulin)
Erythrosis colli (Weiss, Goldman)
Congestive, telangiectasic or hypertrophic scars
Purple stretch marks - ruby tasks - venous lakes (Jay H) - venous malformations (Raulin )
For phlebology, the results depend on blood pressure €¦
Pigmentary Disorders ( solar lentigos and ephelids..)
The best indication of the flash lamp compared to others treatments, is pigmentary disorders.
Especially on fine and sun exposed skins, like the low neckline or the back of the hands, are the quasi absence of a social eviction and the lowest risk of the side effects (achromy, "mish-mash" and scars).
Kawada's study on 60 Asian patients
- more than 50% of improvement in 40 % of the cases
more than 75 % of improvement in 16 % of the cases
EADV
> 50% improvement in 65 % of the cases
> 70% improvement in 48% of the cases
Rejuvenation of photoaged skin:
5 years results with intense pulsed light of the face, neck, and chest
Weiss RA. Dermatol Surg. 2002
80 patients
3 sessions
4 years following initial treatment
skin textural improvement was noted in
83% of the subjects
Telangiectasias inprovement 82%
Pigmentation inprovement: 79 %
Most common side-effects included
temporary mild crusting (19%),
erythema (15%)
purpura (6%).
Crusts were observed in more half of the cases, disappearing in less than 2 weeks and without secondary hyperpigmentation except in a case.
Cases of melasma were improved by the lamps but the retreat misses on the long term like on the frequency of the possible pigmentary rebounds.
In our experiment the sign of a good absorption is a blackening of the brown tasks on a bottom of a minor erythema ("grayed "or increase in pigmentation of at least a tone of the treated lesions).
But we can expect 70% of improvement in one to 3 sessions.
Photo - Rejuvenation
The Skinlite IPL flashlamp has a dramatical effect on two of the major components of ageing heliodermic: telangiectasias and lentigos.
Many trained experts claim a clear improvement of skin complexion,, a tightening of the pores, softer texture, even a collagenic stimulation with a better tonicity and the disappearance of ridules.
The protocols of treatment generally consist in a series of 4 to 5 sessions with a range of 2 to 6 weeks, and repeated sessions are generally proposed.
Negishi among 73 Asian patients noticed a clinical improvement of more than:
60% at 80% of the patients compared to the hyperpigmented cases
78 % compared to the telangiectasias,
56 % compared to the fine wrinkles (no result in the deep wrinkles)
86 % improvement for the texture of the skin (total improvement of more than 60% per 90% of the patients).
The objective data in this study showed in to 3 biopsies an increase of the collagen I and III most in the surperficial layer of the derm.
Hernandez-Perez has just published a preliminary study with histology among 5 women and noticed a good clinical efficacy on them as well as on the epidermal and dermal damages confirmed by histology.
Prieto, also brought back a study on 5 patients with histology, but he does not find noticeable modifications of elastic or collagenous fibres.
Side Effects
Pain: The level of pain depends on the patient, on the treated zone, on the filter type and indeed on the fluence. But the more the filters will go towards the yellow wawe, the more the penetration of the light will decrease with more significant pain superficialy. The cooling system (freezing gel, handpiece) improves the comfort of the patient and reduces the risk of burns.
Burns and scars: In theory these lamps are not indicated in the darkest phototypes. For a phototype > III B, the fluence has to be lowered and/or impulsion durations to be increased. The sun tan may even be more dangerous.
Long-lasting hyper or hypopigmentations with flashlamp: on dyschromic heliodermy, sun tanned skins as L.A.S.E.R sources
Leucotrichy: The Radmanesh recent study out of 821 patients treated for undesirable hairs by lampflash found only 29 cases of leucotrichy (0.04%).
Paradoxical Pushback as with the lasers has rarely been studied. It is always necessary to research hormonal disorders. In most cases, the adverse effects or no answer are related to non adapted parameters and especially in case of too low fluences.
Source...