Intense pulsed light

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For other uses, see IPL (disambiguation).

Intense pulsed light, commonly abbreviated as IPL, is a technology used by beauty studios and medical practitioners to perform various skin treatments including hair removal and photorejuvenation. The technology utilises a broad spectrum lightsource, with a general spectral range of 515 to 1200 nm. Various cutoff filters are commonly used to filter out lower frequencies and narrow this spectrum to target specific structures and chromophores. Because of the broad spectrum of the IPL light source they are unique, as opposed to lasers, in the ability to filter the light spectrum to target various chromophores in the skin.[1]

Definition[edit]

Intense pulsed light describes the use of intense pulses of non-coherent light distributed over a range of wavelengths from 500 nm to 1200 nm, for removal of hair and other purposes.[2] A related but distinct technique is laser hair removal; the primary difference is that laser treatment uses laser-generated coherent and monochromatic light.

Regulations governing IPL and laser hair removal vary by jurisdiction.[3]

The two techniques are often confused. There are many names used for intense pulsed light treatments. IPL and equivalent treatments are referred to as I2PL, UPL, VPL, SPL, SPFT, SPTF, SIPL, PTF, CPL, AFT, E-Light, ELOS, M-Light, and other names. The name "Intense Pulse Light" is not known to be a registered trademark.

A distinction is sometimes made between beauty-grade and medical-grade machines. This distinction is mainly to get around regulations. Under the CE system no such distinction exists.

Hair removal[edit]

Permanence and efficiency[edit]

The first use of a specific IPL system developed for hair removal is reported in the literature in 1997.[4] Effectiveness, reported as hair count reduction, was found to be ~60%(12 weeks), 75%(1 year), 60%(2 year). The study utilized 31 patients.

A study by Fitzpatrick and Goldman reported that 5 treatments at 4 week intervals produced reductions of approximately 60%, 45%, and 40% at 4, 8, and 12 weeks following the final treatment. This study included 50 subjects.[5]

Smith et al. reported findings in 90 patients using four biweekly treatments. Effectiveness was reported as 81% reduction following the 3rd treatment, 63% at four months, and 48% at 6 months.[6]

Weiss et al., studied 23 patients using a single treatment and an additional 48 patients receiving 2 treatments 1 month apart. Patients showed hair reduction of 63% with one treatment (at 3 months). Two treatment patients showed 64% hair reduction directly after the second treatment, which declined to 33% at 6 months.[7]

Weir and Woo reported 42% reduction in skin types IV and 37% in skin types V at 15-months after a single treatment.[8]

Troilus and Troilus studied 10 patients using four treatment sessions at 1-month intervals. Reported hair reduction was 74.7% (4 months), and 80.2% (8 months).[9]

Schroeter et al. studied 40 patients receiving an average of 6 treatment sessions and found a hair reduction of 76.7%.[10]

Sadick et al. studied 67 patients and found hair reductions after one treatment of 61% at 3 months, 58% at 3–6 months, and 48% at 6 months or more. Multiple therapies (up to 7), showed hair reduction of 47% at 3 months, 56% at 3–6 months, and 64% at 6 months or more. In a subsequent report, 34 patients showed hair reduction of 76% after 4 treatments at 21.1 months.[11]

Bjerring et al. studied 31 patients using 3 treatments at 2 month intervals and found 49.3% hair reduction after 6 months.[12]

It is important to note that these studies utilized a variety of IPL devices on various skin areas, and used patients with varying hair and skin types. Thus the results are not directly comparable. In evaluating these results it is also important to remember that even a reduction of 75% indicates that 25% of the hair regrew after treatment. "Permanent hair removal" in these studies, as defined by the FDA, means the "long-term, stable reduction in the number of hairs regrowing after a treatment regime". The number of hairs regrowing must be stable over time greater than the duration of the complete growth cycle of hair follicles, which varies from four to twelve months according to body location.[13] No treatment to date has shown the ability to permanently eliminate all hair growth forever, however many patients experience a significant and permanent reduction in hair growth and are happy with their results.

Clinical Comparison of Effectiveness[edit]

A 2006 review article in the journal "Lasers in Medical Science" compared IPL and both alexandrite and diode lasers. The review found no statistical difference in effectiveness, but a higher incidence of side effects with diode laser based treatment. Hair reduction after 6 months was reported as 68.75% for alexandrite lasers, 71.71% for diode lasers, and 66.96% for IPL. Side effects were reported as 9.5% for alexandrite lasers, 28.9% for diode lasers, and 15.3% for IPL. All side effects were found to be temporary and even pigmentation changes returned to normal within 6 months.[14]

The hair growth cycle[edit]

The focused, broad-spectrum light is applied to the surface of the skin by way of either a hand-held wand or an articulated arm. This light travels through the skin until it strikes the hair shafts or the bulb (root) of the hair. The bulb is usually where the highest concentration of melanin is located, as opposed to the rest of the hair shaft. As the light is converted to heat energy, the bulb and most of the hair shaft are instantly heated.[citation needed]

The intense heat radiated by the hair also destroys the hair-producing papilla. It is also claimed that direct light-heat conversion occurs directly in the darker colored capillaries that bring nourishing blood vessels to the follicle. Contrary to what is often claimed, photoepilation is not a permanent hair removal method but a permanent hair reduction method. This means that although IPL treatments with these devices will permanently reduce the total number of body hairs, they will not result in a permanent removal of all hair.[15] The argument of permanent hair removal against permanent hair reductions is only of relevance in the USA because of the wording on the FDA certificate.

At any one time, not all hair follicles are ‘active’, and only active hair follicles can be affected by the treatment. ‘Inactive’ hair follicles can be treated as they become ‘active’ over time. For IPL treatments an average of 8–10 treatments are required to remove most visible hair.[citation needed]

Contra-indications[edit]

Certain skin conditions, health irregularities, and medications can impact whether it is safe for a person to receive a light based hair removal treatment. This list applies to both IPL and conventional laser treatments.[16][unreliable source?]

  • Recent use of depilatory creams or sprays
  • Recent waxing, tweezing, or sugaring
  • Contagious skin diseases: not always contraindicated but requires special preparation
  • Herpes I and II in the area to be treated: not always contraindicated but requires special preparation
  • Skin trauma, lesions, sores or open wounds
  • Keloid or hypertrophic scarring
  • Moles or skin cancer: treatment can blanch skin marks, making melanoma difficult to detect
  • Sunburn
  • Suntan, real or fake: hyperstimulates melanin in skin which provides a confusing target for light
  • Epilepsy or other seizures potentially caused by flashing light
  • Polycystic Ovarian Syndrome (PCOS): condition needs to be normalised with medication before treatment
  • Hyperthyroidism: condition needs to be normalised with medication before treatment
  • Breastfeeding and pregnancy: increased hormone levels greatly decrease treatment efficacy[citation needed]
  • Hirsutism: not contraindicated but will require a greater number of treatments[citation needed]
  • Tattoos or permanent makeup in area to be treated
  • Photo-sensitising topical creams or medication: Tetracycline, Minomycin, Doxycycline, St John's Wort, any citrus essential oils
  • Black garments: can singe or combust if struck directly by the light flash
  • Pain during treatment: if a person feels more than mild[citation needed] discomfort during treatment, the machine settings are wrong
  • According to Remington, manufacturer of an IPL hair remover, all IPL and laser devices should only be used on light to medium skin tones, and work best on darker hair.[17]

Treatment protocol[edit]

No common treatment protocol exist and it depends on the equipment used and skin type of the patient/client. Commonly the treatment area needs to be clean, shaved and free of sunburn. Treatment sessions are usually 4 to 6 weeks apart for treatments at a beauty salon.

Other uses[edit]

IPL technology is employed in the treatment of medical disorders of the skin including:

See also[edit]

References[edit]

  1. ^ Gold, Michael H. (September–October 2007). "Lasers and light sources for the removal of unwanted hair". Clinics in Dermatology 25 (5): 443–453. doi:10.1016/j.clindermatol.2007.05.017. PMID 17870522. 
  2. ^ "Intense Pulsed Light Systems". HMP Communications. Retrieved 2 August 2012. 
  3. ^ "Laser Information". Florida Department of Health. Retrieved 2 August 2012. 
  4. ^ Gold, Michael H.; Bell, Michael W.; Foster, Teresa D.; Street, Sherri (October 1997). "Long-term epilation using the EpiLight broad band, intense pulsed light Hair Removal System". Dermatologic Surgery 23 (10): 909–913. doi:10.1111/j.1524-4725.1997.tb00746.x. PMID 9357500. 
  5. ^ Fitzpatrick, R.E.; M.P. Goldman, S. Sripsa Chaya-Anunt (1997). "Hair removal utilizing the ESC EpiLight device". Lasers Surg Med: 36. 
  6. ^ Smith, S.R.; Y. Tse, S.K. Adsit et al. et al. (1998). "Long-term results of hair photo-epilation". Lasers Surg Med: 43. 
  7. ^ Weiss, R.A.; Weiss, S. Marwaha, A.C. Harrington (1999). "Hair removal with a non-coherent filtered flashlamp intense pulsed light source". Lasers Surg Med: 128–132. 
  8. ^ Weir, V.M.; T.Y. Woo (1999). "Photo-assisted epilation—review and personal observations". J Cutan Laser Ther: 135–143. 
  9. ^ Troilus, A.; C. Troilus (1999). "Hair removal with a second generation broad spectrum intense pulsed light source—a long term follow-up". J Cutan Laser Ther: 173–178. 
  10. ^ Schroeter, C.A.; C. Raulin, W. Thuerlimann et al. et al. (1999). "Hair removal in 40hirsute women with an intense pulsed light source". Eur J Dermatol: 374–379. 
  11. ^ Sadick, N.S.; R.A. Weiss, C.R. Shea, H. Nagal et al. et al. (2000). "Long term photoepilation using a broad-spectrum intense pulsed light source". Arch Dermatol: 1336–1340. 
  12. ^ Bjerring, P.; M. Cramers, H. Egivist et al. et al. (2000). "Hair reduction using a new intense pulsed light irradiator and a normal mode ruby laser". J Cutan Laser Ther: 63–71. 
  13. ^ . FDA http://www.fda.gov/radiation-emittingproducts/resourcesforyouradiationemittingproducts/ucm252761.htm#1. Retrieved 23 September 2014.  |first1= missing |last1= in Authors list (help); Missing or empty |title= (help)
  14. ^ Toosi, Parviz; Sadighha, Afshin; Sharifian, Ali; Razavi, Gita Meshkat (3/1/2006). "A comparison study of the efficacy and side effects of different light sources in hair removal". Lasers in medical science 21 (1): 1–4. doi:10.1007/s10103-006-0373-2. PMID 16583183.  Check date values in: |date= (help)
  15. ^ Klein, A.; Steinert, S.; Baeumler, W.; Landthaler, M.; Babilas, P.; Baeumler, W.; Landthaler, M.; Babilas, P. (1 December 2012). "Photoepilation with a diode laser vs. intense pulsed light (IPL): a randomized, intra-patient left-to-right trial". British Journal of Dermatology 168 (6): 1287. doi:10.1111/bjd.12182. PMID 23278132. 
  16. ^ "Contraindications for Laser and Pulsed Light Hair Removal". A J Thompson. Retrieved 20 June 2012. 
  17. ^ Remington Web site: i-Light Pro: Ask the expert

External links[edit]