Intense pulsed light piqued the interest of many in the medical aesthetic community when it was first introduced 20 years ago. Its inclusion of multiple spectra of light delivered using laser-based technologies suggested the ability to treat multiple indications in one system. Unfortunately, the original Photoderm quickly fell out of favor.
“The device took a long time to warm up, and it was potentially hazardous, because it didn’t have a lot of safety features,” says Jeffrey Dover, MD, associate clinical professor of dermatology, Yale University School of Medicine, co-director of Skincare Physicians, Chestnut Hills, Massachusetts. “While it worked for vascular facial lesions and lentigines and for treating photoaging in general, frankly we never used our device. The basic concept of intense pulsed light as an alternative to laser made sense, but the results were unpredictable.”
Over the past 20 years, IPL engineers have remedied these problems through a variety of advances that make today’s IPLs more predictable and more effective at treating a range of indications like redness, photoaging and permanent hair removal. “The original Photoderm technology used Pulse Forming Network supplies to deliver the energy,” says Scott Davenport, senior director of product development at Cutera (www.cutera.com). “These produced a spiked pulse that can produce spectral variability. Because as the fluence is increased, the light spectrum also shifts, which affects the tissue response.”
Cutera chose a regulated rectangular power supply pulse combined with closed loop power control—via in-handpiece photodetectors—to keep the fluence steady in its LimeLight handpiece. “This makes the treatment more predictable and safer, especially for darker skin types,” says Davenport.
In an effort to create more uniform energy delivery in its BBL module, Sciton uses an over/under twin lamp delivery system. “It allows for high power without creating hot spots and without having areas that go untreated,” says Cheryl Deguara, Sciton BBL product manager at Sciton (www.sciton.com). “Not only is the energy delivered evenly, there is a feedback mechanism that allows us to pulse it in a way that keeps the fluence in a maximum therapeutic range.”
The ability to control fluence and pulse durations through user-friendly software improves patient safety and allows users to adapt treatment parameters for specific indications. “With CO2 lasers, they went from continuous wave to super pulse,” says Eric Fuller, president, Emvera (www.emvera.com). “We took that concept and brought it to our IPL.” The company’s “Variable Synchronized Pulse” control includes five to 12 sub-pulses within each pulse. In addition to controlling the number of sub-pulses, practitioners can stretch out pulse delay times to allow for more or less thermal relaxation time during treatment.
“This allows us to treat darker skin types, not skin type VI, but darker than you could previously treat with IPL,” says Fuller.
Palomar Medical developed what it refers to as “Smooth Pulse” technology for its MaxG handpiece. “If you choose a treatment pulse of 20ms, for instance, our pulse light handpiece has one continuous pulse over that 20ms, so the distribution of energy is very uniform,” says Richard Bankowski, field clinical director, Palomar Medical Technologies (www.palomarmedical.com).
Early IPLs gained a negative reputation due to high incidences of burning. The devices often left stamp-shaped burn marks on patients and caused long-term pigmentation problems. While many of these adverse events can be traced to poor training, innovations in cooling technologies are helping to decrease these risks.
Image copyright iStockPhoto.com.