Treatment of Poikiloderma of Civatte Using Intense Pulsed Light Source: 7 Years of Experience

BACKGROUND AND OBJECTIVE The treatment of choice of poikiloderma of Civatte should address both pigmented and vascular lesions at the same time. A broad-spectrum, noncoherent intense pulsed light (IPL) source can be used to obtain this effect. In this study, we investigated the clinical efficacy and side effects of treating this condition with IPL.
MATERIALS AND METHODS A total of 175 patients with poikiloderma of Civatte of the neck and chest were treated with IPL at various settings. The mean age of patients of various skin types (Fitzpatrick I to III) was 49 years. They were subjected to a treatment protocol including three sessions every 3 weeks. At follow-up visit, performed 3 months after the last treatment, clinical improvement was evaluated for all patients by comparing pre- and posttreatment photographs. The patients also scored their overall satisfaction.
RESULTS Clearance of more than 80% of vascular and pigmented components of poikiloderma of Civatte was observed. Minimal and transient side effects occurred in 5% of the patients. No scarring or pigment disturbances were noted after the treatments.
CONCLUSIONS The IPL source can be considered a safe and effective therapeutic option for poikiloderma of Civatte, allowing a marked improvement of vascular and pigmented lesions with minimal side effects.     

IPL technology: a review

BACKGROUND AND OBJECTIVES: Intense pulsed light (IPL) systems are high-intensity light sources, which emit polychromatic light. Unlike laser systems, these flashlamps work with noncoherent light in a broad wavelength spectrum of 515-1,200 nm. These properties allow for great variability in selecting individual treatment parameters and adapting to different types of skin types and indications. The purpose of this article was to critically review international medical publications of the many indication in which IPL technology can be used, including our own evaluations and experiences. STUDY DESIGN/MATERIALS AND METHODS: The range of therapeutic uses for high-intensity flashlamps was reviewed, ranging from benign cavernous hemangiomas, benign venous malformations, essential telangiectasias, leg telangiectasias, poikiloderma of Civatte, and port-wine stains to pigmented lesions, cosmetically undesired hypertrichosis, and facial rhydids. The relative benefits and risks were discussed in detail and compared with other laser systems. RESULTS: Because of the wide spectrum of potential combinations of wavelengths, pulse durations, pulse frequency, and fluences, a great deal of experience is required when using IPL technology. Proper patient selection and critical diagnostics serve to keep the adverse effects of the treatment to a minimum. CONCLUSIONS: The distinctive technical conditions involved combine to make IPL technology an alternative and auxiliary treatment option to existing laser systems and conventional therapies.     

强脉冲光联合射频治疗面部皮肤光老化的临床体会

目的：探讨强脉冲光（IPL）联合射频（RF）治疗面部皮肤光老化的临床应用及其与单一使用IPL或RF方法的效果比较。方法：451例患者,其中134例行单一IPL治疗,138例行单一RF治疗,179例行IPL联合RF治疗。比较治疗前后患者面部毛细血管血管扩张、色素沉着、皮肤质地的改善情况,评估各方法的有效率及患者的满意程度。结果：单一行IPL组,单一行RF组以及IPL联合RF治疗组治疗毛细血管扩张有效率分别为84.33%、14.49%、88.27%,治疗色素沉着有效率分别为57.46%,12.32%,62.01%,改善皮肤质地有效率分别为57.71%、83.82%、85.29%,三种方法患者的满意度分别为73.13%,68.12%,88.27%。结论：IPL治疗面部毛细血管扩张、祛除色斑效果较好,RF治疗皮肤干纹,改善皮肤松弛效果明显,两者联合使用可相互促进达到优于两者单独治疗的效果。     

Rejuvenation of Photoaged Skin: 5 Years Results with Intense Pulsed Light of the Face, Neck, and Chest

BACKGROUND: Photorejuvenation involves the use of lasers or light sources to reverse signs of photoaging. Multiple devices have been shown to be effective over the short-term. OBJECTIVE: To investigate the long-term clinical results on the face, neck and chest at 4 years using filtered flashlamp intense pulsed light (IPL) for treatment of photoaging changes of telangiectasias, dyspigmentation, and rough skin texture. METHODS: A chart review of 80 randomly selected patients with skin types I-IV who were treated by IPL during 1996 and 1997 was performed. Photos and patient self-assessment were graded for features of textural smoothness, telangiectasia severity, and blotchy pigmentation into four categories of worse, no change, slightly better (less than 50% improvement) and much better (greater than 50% improvement). RESULTS: At 4 years following initial treatment, skin textural improvement was noted in 83% of the subjects. Telangiectasias were improved in 82% of subjects, while pigmentation remained improved in 79%. The median number of treatments was 3. The face responded slightly better than the chest or neck. Most common side-effects included temporary mild crusting (19%), erythema (15%) and purpura (6%). CONCLUSION: Signs of photoaging including telangiectasias and mottled pigmentation of the face, neck, and chest, can be improved by IPL with a long-lasting result. Minimal or no downtime with minimal adverse effects can be achieved with the settings reported. Skin textural smoothing, although not easily quantified, is an additional benefit observed long-term.     

Split treatment of photodamaged skin with KTP 532 nm laser with 10 mm handpiece versus IPL: a cheek-to-cheek comparison

BACKGROUND AND OBJECTIVES: The treatment of photodamaged skin with potassium-titanyl-phosphate (KTP) laser and intense pulsed light (IPL) has been reported in several studies. Each device has strengths and weaknesses; however, patient and device variability have made it difficult to ascertain the optimal device for photorejuvenation. The objective of this study was to obtain a head-to-head comparison of IPL and KTP laser for photorejuvenation. Each patient received one KTP laser treatment on one side of the face and one IPL treatment on the other side. STUDY DESIGN/MATERIALS AND METHODS: Seventeen patients with skin types I-IV were accepted into the study based on existence of dyschromias (pigmented and vascular) and/or discrete telangiectases. After performance of test spots on each patient to determine optimal settings for both devices, patients were treated with both devices in a split face manner. Evaluations and photographs were performed 1 week and 1 month after treatment. Patient and observer evaluations of results were recorded, as well as time to perform each treatment, and patient feedback with regard to pain and edema. No anesthesia was used in these treatments. Photographs were reviewed by a panel of blinded observers to assess changes in red and brown dyschromias. RESULTS: One month average improvement (evaluator) for IPL side was (mean) 38.16%/35.08% for vascular/pigment lesions versus 41.99%/30.21% for KTP side. Patient self-evaluated global improvement at 1 month was (mean) 65.59% for IPL side versus 60.88% for KTP side. A majority of patients found the KTP to be slightly more painful with a mean pain rating of 5.27 of 10 versus 4.4 of 10 for IPL. A majority of patients experienced subjectively greater post-procedure swelling on the KTP side. Time to conduct treatment was an average of 10.0 minutes for IPL, 8.7 minutes for KTP. CONCLUSIONS: Both large spot KTP and IPL achieved marked improvement in vascular and pigmented lesions in one session. The KTP laser caused slightly more discomfort and edema than the IPL. On the other hand, the KTP laser was faster, and more ergonomically flexible.     

强脉冲光美容效果的评价

目的观察强脉冲光对皮肤表浅色素性和血管性疾病、寻常痤疮的疗效;评价其嫩肤美容及脱毛的疗效。方法采用GP666型强脉冲比（IPL）治疗仪对皮肤老化、面部色沉性皮损、皮肤毛细血管扩张、寻常痤疮及多毛症各20例共100例进行治疗,光子嫩肤每3周治疗1次,5次为1个疗程;脱毛每月治疗1次。结果经5次治疗,色素痫和血管痫有效率为90％,痤疮疗效为75%,美容效果为100％,脱毛效果为90％。无小可逆不良反膻发牛。结论IPL能有效治疗皮肤浅表色素沉着性皮损和毛细血管扩张;有较好的关容效果;脱毛效果肯定。     

Carcinogenesis related to intense pulsed light and UV exposure: an experimental animal study

This study examines whether intense pulsed light (IPL) treatment has a carcinogenic potential itself or may influence ultraviolet (UV)-induced carcinogenesis. Secondly, it evaluates whether UV exposure may influence IPL-induced side effects. Hairless, lightly pigmented mice (n=144) received three IPL treatments at 2-week intervals. Simulated solar radiation was administered preoperatively [six standard erythema doses (SED) four times weekly for 11 weeks] as well as pre- and postoperatively (six SED four times weekly up to 26 weeks). Skin tumors were assessed weekly during a 12-month observation period. Side effects were evaluated clinically. No tumors appeared in untreated control mice or in just IPL-treated mice. Skin tumors developed in UV-exposed mice independently of IPL treatments. The time it took for 50% of the mice to first develop skin tumor ranged from 47 to 49 weeks in preoperative UV-exposed mice (p=0.94) and from 22 to 23 weeks in pre- and postoperative UV-exposed mice (p=0.11). IPL rejuvenation of lightly pigmented skin did not induce pigmentary changes (p=1.00). IPL rejuvenation of UV-pigmented skin resulted in an immediate increased skin pigmentation and a subsequent short-term reduced skin pigmentation (p<0.002). Postoperative UV radiation resulted in re-pigmentation of IPL-induced pigment reduction (p=0.12). No texture changes were observed. Postoperative edema and erythema were increased by preoperative UV exposure (p<0.002). IPL rejuvenation has no carcinogenic potential itself and does not influence UV-induced carcinogenesis. UV exposure influences the occurrence of side effects after IPL rejuvenation in an animal model.     

Intense Pulsed Light and Laser Treatment of Facial Telangiectasias and Dyspigmentation: Some Theoretical and Practical Comparisons

Background and Objective. A comparative overview is presented, both theoretical and clinical, for intense pulsed light (IPL) and laser treatment of facial telangiectasias and pigmented lesions.
Materials and Methods. A narrative approach describes light penetration into the epidermis, dermis, dermal-epidermal junction, and facial ectasias. Based on mathematical models, we examine some temperature profiles for monochromatic and broadband light sources. Specifically, temperature elevations of representative vascular targets are discussed. Also, clinical scenarios are reviewed for both IPL and laser. Although multiple monochromatic devices are reviewed, only the 532 and 595 nm wavelengths are emphasized.
Results. In theory, an IPL can be filtered to simulate 532 and 595 nm laser light in the treatment of telangiectasias and dyschromias. In comparing our experiences with the different devices, all three (IPL, 532 nm laser, and 595 nm laser) are capable of achieving a reduction in ectasias and hyperpigmented macules.
Conclusions. With an optimal set of parameters, IPLs and lasers are comparable in the treatment of vascular and pigmented lesions with respect to treatment efficiency and safety.     

A newly modified 595-nm pulsed dye laser with compression handpiece for the treatment of photodamaged skin

BACKGROUND AND OBJECTIVES: The pulsed dye laser set the standard of care for the treatment of vascular lesions, and recent modifications have enabled improved efficacy with fewer side effects. An investigational high energy, variable pulse duration pulsed dye laser has been modified to treat both vascular and pigmented lesions associated with photoaging. Each laser pulse is comprised of a sequence of eight uniform micropulses, which evenly distribute the pulse energy, effectively increasing the purpura threshold at any given fluence. Pigmented lesions are treated with a compression handpiece (CHP) that removes competing vascular target from the field, and helps to prevent purpura. This pilot study was undertaken to determine the optimum laser settings, and to investigate the ability of this device to improve vascular and pigmented lesions associated with photoaging. STUDY DESIGN/MATERIALS AND METHODS: Twenty-four patients with photoaged skin and phototype I-III were enrolled in the study. Thirteen received treatment for vascular and pigmented lesions, and 11 subjects were treated for pigmented lesions alone. Subjects received one to three treatments at 3-4 weeks intervals, and underwent 3- and 12-week follow-up evaluation. The degree of improvement was assessed by subject evaluation as well as comparison of standardized digital photographs by three independent dermatologists. Background erythema was treated with a 12-mm spot size, at a fluence of 7 J/cm(2), and a pulse width of 10 ms. The cryogen cooling was set at 30 mseconds with a 30 ms delay. Individual telangiectasias were treated with a 5- or 7-mm spot size at fluences of 9-14 J/cm(2) and pulse widths of 6-20 mseconds. Pigmented lesions were treated using a 5- or 7-mm spot size, with energy of 9-15 J/cm(2) and a pulse width of 1.5-10 ms without cooling. The CHP had a 7-mm spot size, and fluences of 9-16 J/cm(2), and pulse widths of 1.5 or 3 ms were used in the treatment of pigmented lesions. RESULTS: The treatment was well tolerated without the use of topical anesthetic. All subjects noted improvement in the both vascular and pigmented lesions, and were satisfied with their outcomes. Objectively, there was moderate improvement in background erythema, telangiectasia, and pigmented lesions. Three subjects who were treated with sun tans developed transient hypopigmentation and two subjects developed a transient textural change following pulse stacking for the treatment of pigmented lesions with the conventional handpiece. Purpura was noted in all patients treated for pigment with the conventional handpiece at pulsewidths less than 6 mseconds, as compared to only one that was treated with the CHP. Three patients treated in rapid succession for vascular, and then pigmented lesions with the CHP exhibited purpura, which was prevented in future treatments with 1-2 minutes of topical ice cooling between passes. CONCLUSIONS: This novel 595-nm pulsed dye laser, with a modified pulse sequence and CHP, now has the versatility to safely treat both pigment and vascular changes associated with photoaging.     

A prospective study of the safety and efficacy of a combined bipolar radiofrequency,intense pulsed light,and infrared diode laser treatment for global facial photoaging

The clinical features of photoaging include: skin texture changes, laxity, rhytides, pigmentary changes, and vascular changes such as erythema and telangiectasias. In order to meet patients’ increasing demands for improving all aspects of photoaging at one office visit, employing a multi-modality treatment for all aspects of photoaging has become increasingly desirable for the physician and patient alike. We examine a novel device that employs bipolar radiofrequency (RF), intense pulsed light (IPL), and infrared diode laser. These laser and light source treatments are performed sequentially. This study aims to evaluate the clinical efficacy and safety of this device (i.e., ELOS Triniti?). Twenty-six subjects received four ELOS Triniti? treatments at 1-month intervals. They were followed up 1, 3, and 6 months after completing the treatments. Two blinded dermatologists used a comprehensive grading scale to evaluate the degree of the photoaging in terms of rhytides, laxity, dyschromia, erythema, telangiectasias, and texture. Subjects used a 0–10 grading scale for self-assessment of photoaging. Additionally, we measured the Erythema Index (EI), Melanin Index (MI), transepidermal water loss scores (TEWL), stratum corneum moisture scores (SC), and dermis moisture scores (D) before treatment and 1, 3, and 6 months after treatment. There was a statistically significant improvement in all five aspects of the comprehensive grading scale. Overall, it had excellent efficacy for improving erythema, telangiectasias, and skin texture. It also had a relatively long effect on improving skin laxity; however, it had only a limited ability to improve rhytides and dyschromia. It can mildly to moderately improve the global photoaging. This global effect can be noted 1 month after treatment and becomes most clinically apparent 3 months after treatment. This is maintained at least 6 months after treatment. MI index and SC and D values increased while EI index and TEWL values decreased after the treatment. The subjects’ self-assessment improved by 2.7 ± 1.2 points. The overall satisfaction rate was 88%. The degree of pain measured 2.5 ± 1.9 points on average. There was no downtime and no severe side effects reported. The sequential implementation of bipolar radiofrequency based optical combination devices (IPL, IR, diode laser) is effective and safe for global facial photoaging.     

Long-pulsed dye laser versus intense pulsed light for photodamaged skin: a randomized split-face trial with blinded response evaluation

OBJECTIVE: In a randomized controlled split-face trial to evaluate efficacy and adverse effects from rejuvenation with long-pulsed dye laser (LPDL) versus intense pulsed light (IPL). MATERIALS AND METHODS: Twenty female volunteers with Fitzpatrick skin types I-III, classes I-II rhytids, and symmetrical split-face photodamage were included in the study. Subjects received a series of three treatments at 3-week intervals with half-face LPDL (V-beam Perfecta, 595 nm, Candela Laser Corporation) and half-face IPL (Ellipse Flex, Danish Dermatologic Development); the interventions being randomly assigned to left and right sides. Primary end-points were telangiectasias, irregular pigmentation and preferred treatment. Secondary end-points were skin texture, rhytids, pain, and adverse effects. Efficacy was evaluated by patient self-assessments and by blinded clinical on-site and photographic evaluations at 1, 3, and 6 months postoperatively. Adverse effects were evaluated by blinded clinical on-site evaluations. RESULTS: Telangiectasia improved from LPDL and IPL treatments with superior vessel clearance from LPDL treatments (postoperative side-to-side evaluations, patient self-assessments, P相似文献   

Epidermal Cooling Crystal Collar Device for Improved Results and Reduced Side Effects on Leg Telangiectasias Using Intense Pulsed Light

BACKGROUND: Intense pulsed light (IPL), utilizing noncoherent yellow, red, and near-infrared wavelengths can be used to treat telangiectasias. In order to circumvent epidermal heating and allow greater fluence to be delivered safely, a new device that circulates water around the IPL crystal in contact with the skin to provide continuous cooling at 1 degrees C-4 degrees C range was developed. OBJECTIVE: To observe the effects of contact cooling on IPL treatment of leg telangiectasias. METHODS: A total of 25 patients were treated using two similar sites of matted telangiectasias on the leg, one site was treated without epidermal cooling and the other with the epidermal cooling crystal collar device. Results were evaluated by comparison with pretreatment photographs at 1 month. At one treatment center, a crossover was performed at the 1-month visit in which the non-E3C site was treated by cooling. Parameters consisted of a 570 nm filter, coupled pulses of 2-2.5 msec/6-7 msec with a 10-msec delay with fluences of 38-40 J. On the site receiving contact cooling the fluence was increased by 10% (4 J/mm2). Sites were graded worse, unchanged, or improved (RAW) or on a numerical scale of 1-4 (NSS). RESULTS: Compared to the contact cooling sites, uncooled sites showed 7 were improved, 5 were unchanged, and 3 were worsened, but cooled sites showed 10 were improved, 5 were unchanged, and none were worsened (P<.05). The grading scale on 10 patients revealed a mean improvement of 1.7 for noncooled sites and 2.7 for cooled sites (P<.001). For crossover treatment, eight noncooled sites (unchanged or worsened) were subsequently treated with cooling, demonstrating six improved (P<.001) and two with no change. Less erythema and edema was noted at all cooled sites. Furthermore, pain was significantly reduced with cooling (P<.003). Epidermal injury involving hyper- or hypopigmentation, crusting, or vesiculation was not observed in any of the cooled sites, but was recorded in three of the noncooled sites. CONCLUSIONS: These data indicate that continuous epidermal cooling with IPL allows delivery of higher fluences with less pain and fewer side effects. Efficacy is significantly improved using the coupled short pulse/long pulse protocol. An additional benefit is that IPL treatment becomes less operator dependent because the chilled crystal may be placed directly in contact with the skin.     

Gross and Microscopic Findings in Patients Submitted to Nonablative Full-Face Resurfacing Using Intense Pulsed Light: A Preliminary Study

BACKGROUND: Intense pulsed light (IPL) is a noncoherent, nonlaser, filtered flashlamp emitting a broadband visible light that has been shown to be effective in photoepilation, as well as in a number of vascular and pigmented lesions of the skin. Their efficacy has also been reported recently in the treatment of photodamaged facial skin. In the last condition, however, there are few studies showing the clinical and microscopic changes produced by IPL. OBJECTIVE: To assess the gross and microscopic changes that occur in photodamaged skin submitted to nonablative full-face resurfacing (NAFFR) using IPL. METHODS: Five women were submitted to five NAFFR sessions using IPL, one every 2 weeks. Skin biopsies and photographs were taken on all of the patients before the first procedure and after the last one, as well as weekly clinical assessment. Data concerning skin features (wrinkles, oiliness, thickness, dilated pores, and general appearance) were all assessed. Microscopic improvement of the aging features in the epidermis and dermis were all assessed. For the statistical analysis a t test for small samples was used. RESULTS: All the patients showed clinical and microscopic improvement in every one of the parameters assessed. The t test for small samples showed a statistically significant difference (P < 0.01) in epidermal thickness. CONCLUSION: Facial photodamage was clinically and microscopically improved using IPL. Use of IPL as a rejuvenating method seems to be promising, with minimal side effects, a wide safety margin, and minimal downtime.     

Ablative versus non-ablative treatment of perioral rhytides. A randomized controlled trial with long-term blinded clinical evaluations and non-invasive measurements

BACKGROUND AND OBJECTIVE: To compare efficacy and side effects of CO(2) laser resurfacing and intense pulsed light (IPL) rejuvenation for treatment of perioral rhytides. METHODS: Twenty-seven female subjects with perioral rhytides (class I-III) were randomly treated with either CO(2) laser or IPL (three monthly treatments). Efficacy was evaluated by patient self-assessments and blinded photographs up to 12 months postoperatively. Side effects were assessed clinically. Non-invasive measurements included: trans epidermal water loss (TEWL), skin reflectance, skin elasticity, and ultrasound. RESULTS: CO(2) laser resurfacing resulted in higher degrees of patient satisfaction and clinical rhytide reduction compared to IPL rejuvenation up to 12 months postoperatively (patient evaluations, P < 0.05) (observer evaluations, P < 0.008). Laser-induced side effects included erythema, dyspigmentation, and milia whereas no side effects were observed after IPL rejuvenation. Non-invasive measurements showed a significant higher reduction of the subepidermal low-echogenic band in CO(2) laser treated areas versus IPL treated areas (12 months postoperatively, P < 0.001). Skin elasticity (expressed as Young's modulus) increased in both groups (P = ns). One month postoperatively a significant increase in TEWL values (P < 0.009) and skin redness% (P < 0.02) was found in CO(2) laser treated patients versus IPL treated patients. No significant differences were seen in skin pigmentation% during the observation period. CONCLUSION: CO(2) laser resurfacing induces a significantly higher degree of clinical rhytide reduction followed by considerably more side effects compared to IPL rejuvenation in a homogeneous group of patients.     

Evaluation of a novel flash lamp system (FLS) incorporating optimal spectral filtration for the treatment of photoaging

BACKGROUND AND OBJECTIVES: Improvement in photoaging using laser and Intense Pulsed Light (IPL) modalities is well documented in the literature. We report a prospective study evaluating the safety and efficacy of a novel flash lamp IPL system incorporating a spectral filtration system designed to maximize improvement of facial dyschromias, telangiectases, and skin texture. The device was a prototype xenon flashlamp pulsed light. The novel features of this IPL device are the extended pulse duration and smooth temporal pulse profile. STUDY DESIGN/MATERIALS AND METHODS: We enrolled 23 patients (22 female, 1 male) of Fitzpatrick skin type I-IV with evidence of photoaging (lentigenes, ephelides, telangiectases, rhytides). Each patient underwent test sites on their back to establish safe treatment parameters. Using treatment fluences of 20-37 J/cm(2), each patient was given 2-4 full-face treatments separated by 3-4 weeks. RESULTS: Test sites revealed that shorter wavelength filters and shorter pulse durations increased the risk of epidermal injury. Objective assessment by evaluation of pre and post treatment photographs of the face showed an average improvement of 53% in hyperpigmentation, 39% in telangiectases, and 8% in wrinkles. There were no significant adverse effects. CONCLUSIONS: The novel flash lamp IPL system in this study was safe and effective in reducing vascular and pigment dyschromias in patients with skin types I through IV.     

Noninvasive Rejuvenation of Photodamaged Skin Using Serial, Full-Face Intense Pulsed Light Treatments

BACKGROUND: Photodamaged skin is characterized not only by rhytides, but also by epidermal and dermal atrophy, rough skin texture, irregular pigmentation, telangiectasias, laxity, and enlarged pores. There is growing interest in the development of noninvasive methods to treat photodamaged skin. Skin photorejuvenation is the visible improvement of photodamaged skin using a laser or other light source. A noncoherent, broadband, pulsed light source is effective in the treatment of vascular and pigmented lesions of the skin. This study evaluates the role of intense pulsed light in the rejuvenation of photo aged skin. OBJECTIVE: The purpose of this study was to evaluate and quantify the degree of visible improvement in photodamaged skin following a series of full-face, intense pulsed light treatments. METHODS: Forty-nine subjects with varying degrees of photo-damage were treated with a series of four or more full-face treatments at 3-week intervals using a nonablative, nonlaser intense pulsed visible light source. Fluences varied from 30 to 50 J/cm2. Subject evaluation and skin biopsies were used to assess treatment results. RESULTS: All aspects of photodamage including wrinkling, skin coarseness, irregular pigmentation, pore size, and telangiectasias showed visible improvement in more than 90% of subjects with minimal downtime and no scarring. Eighty-eight percent of subjects were satisfied with the overall results of their treatments. CONCLUSION: Treatment of photodamaged facial skin using a series of full-face treatments with intense pulsed light is a new and effective noninvasive method of skin rejuvenation with minimal risk and no patient downtime.     

Split-Face Treatment of Facial Dyschromia: Pulsed Dye Laser with a Compression Handpiece versus Intense Pulsed Light

BACKGROUND Many visible light lasers and intense pulsed light (IPL) devices are available to treat photodamaged skin.
OBJECTIVES The objective was to perform a multiple-treatment split-face comparison evaluating a pulsed dye laser (PDL) with a compression handpiece versus IPL for photorejuvenation.
METHODS Ten subjects were treated three times at 3- to 4-week intervals. One side of the face was treated with the PDL with compression handpiece, and the other with IPL. One month after final treatment, blinded evaluation assessed for improvements in dyschromias and texture. Patients provided self-assessment of improvement in dyschromias and texture. Time to complete final treatments and pain during all treatments were recorded for each device.
RESULTS Improvement of the PDL was (mean) 86.5, 65, 85, 38, and 40% for dark lentigines, light lentigines, vessels <0.6 mm, vessels >0.6 mm, and texture, respectively, versus 82, 62.5, 78.5, 32.5, and 32%, respectively, for the IPL side. Patient-evaluated difference in improvement for vascular lesions significantly favored the PDL ( p =.011). Mean third treatment times were 7.7 minutes for PDL versus 4.6 minutes for the IPL ( p =.005). Mean pain ratings were 5.8 for the PDL and 3.1 for the IPL ( p =.007). Purpura-free procedures depended on proper technical use of the compression handpiece when treating lentigines with the PDL.
CONCLUSIONS The PDL with compression handpiece and IPL are highly effective for photorejuvenation.     

Intense Pulsed Light as a Nonablative Approach to Photoaging

Background and Objective. To describe the introduction and use of intense pulsed light (IPL) to treat vascular and pigmented lesions comprising photorejuvenation and its use in photodynamic therapy.
Methods. Review of the medical literature and the authors' experience with IPL.
Results and Conclusions. IPL is an excellent treatment modality for vascular and pigmented manifestations of photoaging and can be combined with photodynamic therapy for the treatment of early forms of skin cancer.     

595nm可调脉宽染料激光与强脉冲光治疗毛细血管扩张

目的：评价595nm可调脉宽染料激光与强脉冲光（IPL）治疗毛细血管扩张的疗效和不良反应。方法：用595nm可调脉宽脉冲染料激光仪与强脉冲光分组治疗毛细血管扩张共326例,按照就诊时间随机单盲将患者分为两组,A组：164例,应用595nm可调脉宽染料激光治疗;B组：162例,应用强脉冲光治疗。根据血管的粗细适当选择脉宽及能量密度,照射病变部位,观察局部治疗皮肤反应,即以照射部位皮肤变为紫灰色,扩张血管消失为适度。每月治疗1次,共治疗1～3次,分析两组患者的疗效和不良反应。结果：164例毛细血管扩张患者,经过595nm可调脉宽V-beam激光1～3次治疗后,85例痊愈,63例显效,总有效率90.2%;IPL组的总有效率在第1、2、3次治疗后分别为3.1%、21.6%和43.2%。与IPL组比较,595nm可调脉宽V-beam激光组的疗效要明显优于IPL组,两者的差异性有明显统计学差异（P〈0.01）。同一类型皮肤与IPL组比较,595nm可调脉宽V-beam激光组的疗效要明显优于IPL组,两者的差异性有明显统计学差异（P〈0.05）。两组治疗后皮肤反应轻微,595nm激光组治疗后会暂时出现局部水肿和紫癜,两组术后色素改变发生率无显著性差异（P〈0.05）。结论：595nm可调脉宽脉冲染料激光治疗毛细血管扩张疗效明显优于强脉冲光,且皮肤反应轻微,疗效确切,临床效果满意。     

Utilization of intense pulsed light in the treatment of face and neck erythrosis

Erythrosis is a clinical manifestation characterized by parossistic vasodilatations followed by fixed superficial venular dilatations localized at the face, neck, décolleté and pinnas. To date, a variety of lasers have been used for treating vascular skin lesions. This study will describe the response on these vascular lesions using the intense pulsed light (IPL) source. Twenty-two female patients and twelve men, aged between 19 and 65, had a phototype ranging from 2 to 4 on the Fitzpatrick scale. The technique is based on a pulsed light of high intensity obtained with a vascular filter of 560 nm. They underwent five treatments of twenty minutes each, at intervals of twenty-one days, with a variable fluency between 9-12 J/cm2 and impulse time of 10-20 ms. The sheaf used is a rectangular spot of 2 cm x 5 cm. In twenty-four patients we obtained a total regression of the cutaneous manifestation after 5 applications, whilst another two patients showed only an attenuation of the erythema. In five cases with erythrosis the erythema persisted after the end of the treatment, although the patients were satisfied with the evident benefits. In two patients affected by Civatte's poikiloderma of the neck we obtained differing results: In the first case an evident positive response of the clinical picture was perceived after only two application of the IPL; in the second case, the benefits were evident after 3-4 applications of IPL at a higher fluency of up to 14 J/ cm2. One patient in treatment with oral antibiotics showed good results from the first application with regression of the erythema up to its disappearance. Collateral effects are not reported, although there was a long-standing (more than 48 hours) post-treatment erythema in only one case. The IPL system, with its broad range of technical variables, is an effective tool in achieving meaningful and lasting clearance of erythrosis.