Correspondence: Godfrey Town, University of Wales, Global Academy, Swansea Metropolitan University, Faculty of Applied Design & Engineering,Swansea, SA1 6ED, UK. Tel:
44-1444-484911. E-mail: firstname.lastname@example.org
(Received 8 September 2012 ; accepted 3 December 2012 )
Photo rejuvenation has become increasingly popularwith women and men seeking methods to counteractaging through enhancements to their appearance.Photo rejuvenation is a general term for a range of light based techniques to remove vascular blemishes,pigmented lesions, ﬁne lines and wrinkles and toimprove overall skin texture and elasticity. The exactmix of these characteristics depends upon age, sexand ethnic background. Pigmented lesions are acommon condition found in all skin types and maybe the result of intrinsic aging which affects the skinby slow, irreversible tissue degeneration or extrinsic-aging resulting from exposure to outdoor elementssuch as sun, wind, pollution etc. However, Asiansgenerally exhibit more pigmentary dischromiawhereas telangiectasia and diffuse redness arethe primary component of photo-aging amongstCaucasians. Pigmented blemishes can vary in colour,size and depth. Several different types of laser andintense pulsed light (IPL) devices have been usedsuccessfully to remove skin pigment (1 – 5) and it isassumed that the mode of action is coagulation orphoto-oxidation of groups of melanosomes in thetarget lesion under the inﬂuence of radiant energy.Because such lesions usually darken rapidly, crustand slough-off within a matter of days after treat-ment, it is often believed amongst clinicians that highenergy, short sub-pulse duration, ‘free discharge’ IPL systems are the best type of IPL device to eliminate
Journal of Cosmetic and Laser Therapy,
2013; Early Online: 1–10
ISSN 1476-4172 print/ISSN 1476-4180 online © 2013 Informa UK, Ltd.DOI: 10.3109/14764172.2012.758381
ORIGINAL RESEARCH REPORT
Pigmentation: selective photothermolysis or non-speciﬁc skinnecrosis using different intense pulsed light systems?
, CAERWYN ASH
, GODFREY TOWN
, KELVIN DONNE
& GWENAELLE DANIEL
Consultant Dermatologist, Hove Skin Clinic, Hove, UK,
Cyden Institute of Light Therapy, Institute of Life Sciences,Swansea University,UK,
University of Wales, Global Academy, Swansea Metropolitan University, Faculty of Applied Design & Engineering, Swansea, UK,
Swansea Metropolitan University, Faculty of Applied Design & Engineering,Swansea Metropolitan University, Swansea, UK, and
Department of Dermatology, Queens Square Medical Center,Yokohama, Japan
Background and objective:
This study considers end point tissue responses and side effects to determine whether ‘squarepulse’ IPL is more or less effective than the traditional IPL. Supporting histological data and computational modellingresults are provided. It provides guidance for IPL users unfamiliar with constant spectrum IPL devices and redirects atten-tion to treatment end points.
Materials and methods:
Twenty subjects of Fitzpatrick Skin Types I – III, presenting with variousepidermal pigmented lesions, were treated 1 – 3 times with two different IPLs. Coupling gel was used and ﬁrm pressure wasapplied to exclude blood from the treatment area. Immediate and post-treatment side effects, degree of discomfort andend results at fourteen and thirty days were evaluated by professional observation, digital photography and a patient ques-tionnaire.
Both IPLs showed a mean clearance of over 80% after 1 – 3 treatments but the free discharge IPL dem-onstrated a greater side effect proﬁle with a higher incidence of ulceration, crusting and erythema.
Clinicalobservation and mathematical modelling suggests that the square pulse, partial discharge IPL system may provide the IPL operator with greater control over the coagulation of pigment and is therefore the more efﬁcient device for effective pigmentlightening with fewer side effects.
coagulation , lasers and light sources (constant spectrum) , selective photothermolysis , tissue necrosis
J C o s m e t L a s e r T h e r D o w n l o a d e d f r o m i n f o r m a h e a l t h c a r e . c o m b y 2 . 5 . 1 5 2 . 1 7 7 o n 0 2 / 2 7 / 1 3 F o r p e r s o n a l u s e o n l y .