Thursday, March 27, 2008

What can an IPL face treatment do for you?

IPL, or intense pulsed light, is one of my favourite treatments.

Why? I have 2 big problems: lots of sun damage and lots of redness in my skin.

I was always freckly. Cute freckles when you're young turn into age spots in your 30s and 40s (and beyond). That's sun damage. And even if you have protected your skin faithfully for 10 years the damage will work its way to the surface of your skin and give you a mottled complexion.

The redness comes from 2 sources. Some of it is environmental damage in the form of broken capillaries. I remember when I was a 25-year old intern working in a dermatology clinic and the dermatologist pointed out (loudly!) to someone that I already had broken capillaries (except he used the term telangiectasia) in my cheeks.

The other source of the redness is rosacea, a chronic inflammatory condition of the skin that can include excessive flushing, acne-like blemishes, rhinophyma (think of W.C. Fields' nose) and eye involvement.

IPL is the perfect treatment for me because it specifically targets pigments, the melanin in the brown sun spots and the hemoglobin in the redness of flushing and broken capillaries.

Here's an example of how IPL eradicates sun damage:



I don't know if you've noticed in the media lately how everyone seems to have a perfect pale complexion. Of course, makeup plays a role but a large part of it is IPL treatments.

Here's an example of how IPL improves redness:



IPL works on redness from many different causes such as acne blemishes, hemangiomas (little round red spots), dilated capillaries and diffuse flushing. The principle is the same for all: the red pigment, hemoglobin, absorbs the flashes of intense light and becomes heated up. The heat will either shut down the vessel, in the case of dilated capillaries, or alter the hemoglobin molecule. The body recognizes that the hemoglobin molecule is no longer normal and cleans it up.

OK, so IPL is a great treatment but I have to tell you that people who are prone to melasma, a familial predisposition to developing brown pigmentation on the cheeks, upper lip, forehead and nose, can actually become darker with an IPL treatment. These people need to be on good skincare, usually including retinoids and skin lighteners. IPL can be done only after the tendency to darken the pigment has been suppressed with skin lighteners.


golphr said...

In January '08 I had cataracts removed from both eyes. Shortly after surgery (4-6 weeks) I began complaining about unusual sensations in my eyes (IE. sand under my lid, chronic red eye as well as chronic dry eye). My ophthalmologist casually mentioned that I have and have had Rosacea which was causing these ocular symptoms. This condition was incurable and I will, essentially, just have to live with it. Interestingly enough, no one at the clinic ever mentioned anything about any pre-existing conditions before surgery.

I am looking for suggestions as to mitigating the chronic redness I have in both eyes. I don't drink but my eyes look like I always have a hangover. Any suggestions or suggested sources of information will be sincerely appreciated. I have researched these symptoms on the Internet without success.

Thanks for your help.


Dr. Rose Jeans said...

Hi Steve,

Here are the general principles for managing ocular rosacea but you should be under the care of an ophthalmologist to have the treatment customized to you:

- use of lubricants and good lid hygiene to decrease irritation to the eye
- use of topical anti-inflammatories (drops or ointment) to calm the eyes
- use of anti-inflammatory pills
- use of antibiotic pills (usually doxycycline)

This rosacea support website has lots of up-to-date info:

Best of luck,

Dr. Rose

golphr said...

Thanks so much for the information. Considering your suggestions I am curious as to your thoughts about using a vassal constrictor like Visine (Tetrahydrozoline ophthalmic)?

Dr. Rose Jeans said...

The eye drops won't hurt you but they are not addressing the underlying problem.

I strongly recommend that you see an ophthalmologist or dermatologist with an interest in ocular rosacea.

You may be better off with eye drops that replace your tears and lubricate your eyes rather than just address the redness.

The redness is a symptom rather than the disease and you need to have treatments that deal with the disease itself.

Marilyn Barnicke Belleghem M.Ed. said...

I too have the problem with inflamed eyelids and redness. I really appreciate your specific suggestions Dr. Jeans.

My Ophthalmologist has prescribed Zaditor. Is this for Rosachea? That's not what she called it but I can't remember what it was she did say it is.


Dr. Rose Jeans said...

Hi Marilyn,

Zaditor is an antihistamine compound that is prescribed for allergic conjunctivitis.

If your eyes are improving with Zaditor then the redness has an allergic component. If they're not improving, I would ask your ophthalmologist whether she thinks you have ocular rosacea.

All the best,

Dr. Rose

golphr said...

Update...After being diagnosed by my Opthamologist with Rosacea as an explanation for the chronic redness and dryness in my eyes I sought out a second opinion. The second opthamologist said that it appeared that I had an infection causing the ducts in my eyelids to become blocked resulting in the dryness which contributed to the redness.

He then prescribed TOBRADEX OPHTH OINT 3.5GM and TOBRADEX OPHTH SUSP 5ML. He also suggested that I wash my eyelids (where the eyelashes meet the eyelids) with a Q-Tip and baby shampoo. The results were almost immediate and unexpected. My eyes, for the first time in memory, felt truly refreshed and the redness began to fade. As of today the redness and dryness of my eyes has been significantly reduced, if not totally eliminated.

Hooray for second opinions!

Dr. Rose Jeans said...

Hi Steve,

This is great news! I'm glad to hear that you have found a solution to your sore eyes.

Your experience highlights for me the importance of having a face-to-face assessment rather than relying on generic advice from the internet.

Also, it shows the importance of getting a second opinion.

All the best,

Dr. Rose

mtr320 said...

I have a question about IPL.

5 days agoI had this procedure done where the doctor colored on me with a clear stick, then i sat for an hour and then had the ipl. my face is not becoming extra red or dry and flaking off at all. im concerned nothing is happening as the pigmentation and brown spots are still there as ever.

how long does it typically take to see results from a treatment?

its great that ive had no adverse reactions but it seems to me that ive had NO reaction

Dr. Rose Jeans said...

Hi mtr320,

It sounds like you had photodynamic therapy, where the IPL treatment is intensified by having Levulan applied first.

This treatment is used to treat and prevent non-melanoma skin cancers, moderate-severe acne and aged skin.

I would expect you to see changes from the treatment within 24 hours, especially redness and darkening of sun spots.

The areas that absorb the most Levulan should appear sunburned, i.e. red and tender, after the treatment.

If you really are not seeing any changes, call the clinic and let them know. They may want to have a look at you to verify that there are no changes.

However, I would reserve final judgment on the treatment until 2 weeks after, when you should be able to see a difference if there is one.

Gina said...

I have a question. I am considering an IPL facial in this next week. My late 30s skin is fine..a little bit of faint freckling..age spots..undereye wrinkles a bit..really i am fine. The day I do the IPL facial..what should I expect? Will I get all red and look oddly? Will I peel or anything? I have an event to go to in a two weeks. thanks

Dr. Rose Jeans said...

Hi Gina,

You might be a little red immediately after the treatment just from having your skin handled but that should settle within the hour.

Immediately after the IPL, your freckles (anything brown) will start darkening and reach their darkest at the 24 hour mark. It takes between 10 and 14 days for the dark brown to disappear.

If the dark brown pigment is superficial, it might flake off as a thin scab. Otherwise it will look as if little bites are being taken out day by day.

I'm going to post a picture of our 10 Years Younger recipient, Catherine, to show the darkened pigment so if you go to, it should be up by the end of the day today.

If you have a lot of dark spots, you will probably absorb enough energy from the IPL to get some skin tightening. You will see that your face keeps looking better and better for weeks after your treatment.

Good luck with your treatment.

Dr. Rose

Gina said...

Hi Dr. Rose,
WEll, I did the IPL facial and it has been a week and really it did little specks of brown flaking, no difference. Can't even tell I did anything. I have not called Dr and told her this yet. Any thoughts? Thanks, G

Dr. Rose Jeans said...

Hi Gina,

If you had had the IPL at my clinic and came back and said that nothing happened, the first thing that I would do is re-photograph you and compare your before and after shots.

If I couldn't see a difference on your pictures then I would offer to redo the treatment or give you your money back.

If, for some reason, I do not have a before picture to compare with, I would give you the benefit of the doubt and offer to redo the treatment or give you your money back.

I hope everything works out for you. I love IPL and what the skin looks like when we erase sun damage and redness.

All the best,

Dr. Rose

Naomi said...


i was wondering how old you have to be for IPL?


Dr. Rose Jeans said...

Hi Naomi,

In general, I prefer to treat clients who are 18 years or older. However, IPL has been used in children to treat port-wine-stain birthmarks.

As far as using IPL for sun damage, the big concern is that the client is going to avoid sun afterwards. I personally find that a lot easier to do in my 40s than I did in my 20s but it really depends on the individual.

I hope that answers your question.

All the best,

Dr. Rose

Rosalina said...

Hi Dr. Rose,

I got, I believe a photodermatitis on my cheeks post Profractional & Microlaserpeel treatment. With that, I am taking doxycycline to hopefully control it down as well as the occasional active acnes (so that the lasered skin cells can be free from acne while producing collagen). In about 2 weeks, I have an IPL treatment scheduled to reduce the redness on lasered area. My questions are:
1. Given that I am taking doxyclicne and have the photodermatitis issue, how safe is it to do IPL as well?
2. Do you have any suggestions on how to stop the photodermatitis since it is bloody itchy and made my skin like a sand paper? I am also taking Benadryl and birth control pill (ortho). It has been 3 days and still flaring and itchy.

Desperate, basya.

Dr. Rose Jeans said...

Hi Rosalina,

I just have to reiterate here that any ideas or suggestions I give here are based on my best guesses, that I haven't seen you for myself.

It would help me to know how aggressive your treatment was and what skincare products you were using after the treatment. How long ago was the treatment?

The first question that comes to my mind when I read your story is what is really going on with your skin?

If you truly have a dermatitis, that is, inflammation without infection, I would recommend a topical steroid to calm it down.

Doxycycline is an antibiotic that also has anti-inflammatory effects so if things are not calming within 3 days, you need to be looked at again to see if the therapy should be changed.

Doxycycline also makes your skin more light-sensitive so I wouldn't do an IPL until you have been off the antibiotic for at least 4 or 5 days.

You may have infection rather than just pure inflammation. Is there any discharge from the treated area, and if so, what does it look like?

In general, I would not do another treatment on you until you had completely healed from this reaction so you may have to hold off on the IPL.

I hope this helps.

All the best,

Dr. Rose

louise1980 said...

Hi Dr Rose,
I am considering having IPL to reduce the redness and broken capillaries in my cheeks and nose. I am quite scared. i'm also wondering how long- if it does work- the redness will stay away for. I have heard that IPL is not a permanent procedure and you need to keep going back every few years after the initial treatments. Also I dont really want my skin to tighten, I'm not worried about wrinkles, I dont have many, I am 27. Another concern of mine was if there is any risk of developing cancer from the procedure?
Thanks for your help.

Dr. Rose Jeans said...

Hi Louise1980,

IPL is a great way to get rid of redness and broken capillaries. Just so you know, it may take several treatments to get rid of broken capillaries.

How long the treatment lasts depends on what caused the problem in the first place.

If you got broken capillaries from being outdoors in the wind, sun and cold, and you continue to do that, they'll come back pretty fast. If you avoid that exposure and protect your skin, the results of the treatment will last longer.

IPL treatments have been done for years and there has never been evidence of an increased occurrence of cancer afterwards.

With the modern equipment for IPL the UV rays are completely filtered out so you're only being exposed to the safe wavelengths of light in the visible spectrum.

I'm excited for you to being having an IPL. It is such a good feeling to get rid of broken capillaries. You'll feel liberated from needing concealer and foundation.

Good luck with your treatment!
Dr. Rose

Laura Bowles said...

I'm currently scheduled for my first IPL treatment in September and I'm unsure whether to do IPL or the blue chemical peel treatment. I'm blonde blue eyed female with light skin and have a ton of sun damage at 27 years of age particularly on my left check. I even have a more significant frown line on the left check. more than ever I want the left check brown spots to go away. Which option would work better for me? Thanks.

Dr. Rose Jeans said...

Hi Laura,

The IPL specifically targets sun damage and redness. Apart from having very dark freckles for 10-14 days afterwards, the IPL has no downtime.

The Blue Peel is going to do a lot more for skin texture and tightening. You will have a swollen, raw face for several days afterwards.

At your age, I would be surprised if you need a Blue Peel and would think that the IPL would be more specific for your problem with no downtime.

Let me know what you decide and tell me how the treatment goes.

All the best,

Dr. Rose

Carryon said...

Hi Dr. Rose, just stumbled upon your page on a Google search. Anyway, my question is, would I, an 20 year old with what I consider minor burst capillaries on the nose (1 on the tip, a network on the upper part of my bridge, and a smallish red spot smack in the middle of my bridge) be a good candidate for IPL? I was kinda on and off about it for a while but this recent red dot on my nose has not gone away and it's driving me to consider the treatment. The best way I can describe what I have is through this anonymous patient's own capillaries.

What I DON'T have is on the left (before), that seems like an advanced case. What I DO have is somewhat similar to the right (after) pic, though my skin complexion is darker.

I would greatly appreciate a response, thanks!!!

Dr. Rose Jeans said...

Hi Carryon,

In general IPL is a good treatment for broken capillaries and the after picture could be improved with further treatments.

The question of whether you are a good candidate for the treatment really depends on how much darker your skin tone is.

IPL targets brown and red pigment and doesn't differentiate them. There are wavelengths of IPL that are safe and effective on darker skin tones.

If your skin is within a sort of Northern European range of tones, then I would feel comfortable going ahead with treatment, as long as you are not tanned.

If you are more Mediterranean or Asian in skin tone (or darker), I would probably want to do some test shots before proceeding.

The darker your skin tone, the lower the energy setting would be on the IPL and the more IPL treatments it would take to get rid of the broken capillaries.

I hope this helps.

BTW, that was a really clever way to give me an idea of your problem.

All the best,

Dr. Rose Jeans

Carryon said...

Thanks so much, it really helps to get some advice from a professional.

georgiea said...

I have adult acne. Does IPL help large pores too?

Dr. Rose Jeans said...

Hi georgiea,

IPL is good for adult acne but probably won't do a lot for your enlarged pores.

If you have a lot of target for the IPL (red and brown in skin), you will get some collagen formation in your skin that will tighten pores a bit. This is usually most apparent on the first treatment and decreases with subsequent treatments.

I also get enlarged pores. I shrink them with fractionated laser. I have a Pixel fractionated laser here but any of them work on same principle (Fraxel, ProFractional, etc.).

These treatments really stimulate collagen formation in the skin and new skin cell formation, giving you smoother, tighter and brighter skin.

My skin looks poreless after a Pixel.

And in the article about recovering from a Pixel that I put up, the model has adult acne. You can see that her spots are much better after the Pixel.

Here's the link:

If you don't have access to fractionated laser, I would use chemical peels. Approx. 6 peels give the same benefits as 1 laser.

Hope this helps.

All the best,

Dr. Rose Jeans

georgiea said...

Thank you for the advice on IPL.
For my pores I will do the 6 chemical peels. What do you think of the six every month for six months.

Will I need to so the chemical peels for touch up yearly. If so about how many.

georgiea said...

Dr. Rose sorry for the two consecutive post. I discovered that I might only be able to get a regular chemical peel and not the VI chemical peel or the pixel laser because I have dark eyes and medium to light skin. These other processes might lighten or darken my skin. Is that true?

My question from these two post is will 6 regular chemical peels work for a 54 year old with large, deep
pores on my nose and cheeks? If not what can I do?

I will also next year need 3 IPL on my face. I look forward to wearing no makeup.

Thank you for your response.

Dr. Rose Jeans said...

Hi georgiea,

When I saw the first of your 2 comments, I was going to answer that without seeing you or knowing your age, it would be hard to guess how often you would need peels for maintenance.

Thank you for answering my questions before I asked them :-)

I suspect that you will end up wanting to do the peels monthly for an indefinite period. That is the most common thing for women over 50 who are using peels to keep their skin looking young.

Having said that, once you have done your first series of 6, you will have a pretty good idea for yourself how much improvement you will get from 1 peel and how long your results last. So you may feel that maintenance peels every 2 or 3 months are sufficient.

The reason your clinic is concerned about your coloring, as far as having an aggressive peel or Pixel is concerned, is that they think you are at increased risk of hyperpigmentation (dark spots) after the treatment.

This most commonly occurs in people of Asian or African heritage, even if their skin is light.

The way I deal with this issue is to start my client on skincare to treat hyperpigmentation ahead of time for 6 weeks before doing a Pixel.

I use the SkinTx line in my clinic. You could also use the Obagi line.

The thing about these products is that they are going to improve the health of your skin and make it smoother, tighter, brighter and more tolerant (less likely to react to changes in the environment that might cause blemishes or discoloration). They will also make your skin look younger over time so using these products would be totally in keeping with what you are trying to achieve anyway.

The other thing you should be using is a topical retinoid such as Retin-A or Tazorac. This is a beauty secret that I think everyone should use every day forever to keep their skin looking younger.

You just have to remember to stop using your retinoid for 5 days before a Pixel or IPL treatment.

I have articles on this blog about SkinTx and retinoids (vitamin A derivatives).

I am so excited for you to be embarking on this journey of improving your skin and rejuvenating your face. You will feel so different about yourself when you see your younger face looking back at you in the mirror.

On the front page of this blog, I have an article about the changes in my sister face over 2 years. She is almost 51. She is so much more energetic and outgoing now that she has her face back. It really is wonderful.

All the best,

Dr. Rose Jeans

MindBody said...

Hi Dr Rose,

I have a few questions regarding IPL treatment...

Firstly i have the "slapped cheek effect" on my face but no noticeable thread veins, just overall redness. Is IPL treatment effective for general redness? I heard that the IPL setting has to be lower to target this problem, is this the case?

Also i am very physically active so wanted to know if i can exercise within 24-48hrs of treatment or is this likely to effect the healing process? (i flush and go extremely red when exercising)

Finally is there any way i can send you some pictures of my cheeks to give you an idea of my problem and whether in your medical opinion i would be a good candidate for the treatment.

Thank you, kind regards


zena said...

I use to have a few freckles on my face which i became increasingly consciouse of. I was advised to use lemon juice but much to my disappointment it made the matter much worse. I got an outbreak of freckles all over my face.

I then went to a clinic who advised me that i would really benefit from having a dermamelan treatment. This was not only extremly expensive but very time consuming. After 3months of treatment i saw absolutely no improvement.

I have now commenced IPL treatment but i have had 3 treatments and still i have not seen the freckles fading.

can you shed some light on this plz.


Pierce said...
This comment has been removed by a blog administrator.
Tish said...

I had IPL for small 'spider' type veins under my eyes, directly under the lower lid and lower (tear trough area I think?). I have had significant swelling for two weeks which is being handled with low dose prednisone but now I have large pink 'rings' under each eye. With your expertise, will this fade? I feel I have traded one problem for another. I'm afraid to do IPL again to treat this pinkness because the swelling was so severe. Could the IPL have burned my skin? Suggestions?

Transa said...

I had ipl done and it's been HELL. I am disappointed that so many doctors haven't been up front and posted that IPL comes with serious risks, and dangers. It can leave squares, etching marks, ice & pin prick marks, indentations, discolouration of the skin, amongst other things that never were there before the procedure. The internet is buzzing with people who have been severly damaged by IPL. The stories of people who have suffered extreme FAT LOSS, the woman who passed away indirectly from Fraxel. (Angela Walker)RIP.

It's disconcerting that MDs are discreet about the cons but will gladly boast about IPL. IT's inhumane to knowingly harm people's faces and not acknowledge the risks associated with this particular procedure. All I see are a lot of medial doctors wanting to make as much money as they can. Their day will come!

khaki said...

Hello...i am 26 yrs old South Asian woman..i had acne all my life, face and body..i have huge pores on my nose and acne scars scattered all over my there anything that i can do to get rid rid of these two problems and get clearer skin...? and my skin is dull and lifeless..any suggestions please..

David said...

If you truly have a dermatitis, that is, inflammation without infection, I would recommend a topical steroid to calm it down.

Doxycycline is an antibiotic that also has anti-inflammatory effects so if things are not calming within 3 days, you need to be looked at again to see if the therapy should be changed.

Doxycycline also makes your skin more light-sensitive so I wouldn't do an IPL until you have been off the antibiotic for at least 4 or 5 days.

Others with the skin lightening for african americans also have the same issue chronic red eye as well as chronic dry eye). My ophthalmologist casually mentioned that I have and have had Rosacea which was causing these ocular symptoms

zz said...

Hi Doctor,
I just had a few questions on the ipl and was hoping you could help?
- Once ipl is used on freckling and the freckles are removed will they come back?
- Does the ipl on the face kill hairs like laser hair removal?

I have just finished my second session and I have noticed that the doctor singed some of my left brow. Also my first session did nothing so this time the doctor turned iy up i now have some dark freckling. Do you know is there a certain type of machine to look for also how many treatments are usually required?

Larry Williams said...
This comment has been removed by the author.
Laverne Gentry said...

Dr Rose
I am 74 years old. I am going to get a IPL. I have nice skin but about the size of a nickle broken veins. My husband says I have to get old sometime. Am I being foolish to keep doing things for my skin. Should I just give up?

Dr. Rose Jeans said...

Ruth, your comment brings up so many issues for me! I could write volumes.
In the first place, I don't think broken veins are an age issue. I had the experience when I was an intern, aged 25, of doing a dermatology clinic and the dermatologist I was working with turned to the patient and said "See -- Dr. Jeans already has broken capillaries!"
As if the broken veins shouldn't bother the patient because I had them too!
Well, they bothered me but this was 1990 and no treatment was offered at that time to get rid of them.
It's so easy to get rid of them now with IPL. I think if something bothers you, you should go ahead and get it treated. You will find that you feel much better about your appearance and that will give you more energy and self-confidence.

rockdove said...

HI Dr. Rose,

I am 35 years old and have some very minor melasma on my upper lip due to pregnancy (I am now 8 weeks post partum).

Would you recommend IPL? Or would I be better to try a cream or something first?


Larry Williams said...
This comment has been removed by the author.
Steph said...

Dr. Rose, I'm a 43 y/o female. Fair to medium skin. I don't have facial wrinkles, a few fine lines around the eyes. However, I'm beginning to experience some wrinkling/slight sag in my neck. I'm on the slender side and have been same wt for at least 15 yrs. I'm wondering if there may be a laser or other treatment that may help.

Liz15 said...

Dr. Rose,
What is the average cost of IPL treatments?

Taneka Fiorenza said...

when I was pregnant at 29 I got brown pigmentation all over my face and my son now 13 months and still a light brown splotches so I had ipl done for my pigmentation 4 days ago and have been reading that there was meant to be a gel put on my skin before she did it but didnt and then after doing half my face asked how it hurt and i said less then getting the hair one done so she upped the settings and redid it, I have only had a few black dots fall off and now and a little scabbing on my chin but now my whole face is dark brown splotches. when will it start to go away? I have been wearing %)plus suncream only but should I be using something else? she said just to use aloevera but leaves my face itchy and dry as for some reason TIA

Hiedi Clayton said...

Hi hiediclayton
I am very happy to get information

What you can do about rosacea