Evaluation of safety and efficacy of variable pulsed light in the treatment of unwanted hair in 77 volunteers

Background Several studies on hair removal with intense pulsed light (IPL) and various laser sources have been done, but adequate data on long‐term follow up are scarce. The present uncontrolled prospective pilot study evaluated safety and long‐term efficacy of variable pulsed light (VPL?) on hair removal in the face for medical and/or cosmetic indications. Study design/material and methods The VPL? system (Energist Ltd, UK) was used for the treatment of hypertrichosis in the face, mainly hirsutism, in 77 female volunteers. The minimum follow‐up time after the last treatment was 9 months (mean: 12.74 ± 2.87 months). Results Over 50% of hair clearance was observed in 68 (88.3%) of all cases. Erythema and leucotrichia were the most often associated side‐effects encountered. Transient pigmentary changes were not reported. Conclusion The VPL? System presents as a relatively efficient and safe treatment alternative for long‐term removal of unwanted hair. It seems to be particularly effective in fair‐skinned patients with dark hair (skin types II–III–IV). Adverse effects were minimal and transient and, in no patient, significant enough to interrupt treatment.     

A randomized double blind,vehicle controlled bilateral comparison study of the efficacy and safety of finasteride 0.5% solution in combination with intense pulsed light in the treatment of facial hirsutism*

Abstract

Objective: We sought to determine whether topical finasteride can enhance the efficacy of intense pulsed light hair removal. Materials and methods: An intense pulsed light (IPL) treatment with radiofrequency (RF) was performed every four weeks, resulting in up to three sessions, and again at the end of the study – 6 months after the start of the experiment. Each patient also applied either finasteride or placebo solution twice daily to each side of the chin in a double-blinded manner. Results: A total of 77 patients were included in the study. Mean hair density before treatment in finasteride side of the patient's chin was 19.7?±?11.7 and in placebo side was 19.1?±?11.3. After three sessions of IPL + RF treatment, combined with twice daily application of finasteride and placebo solutions, at the end of 6-month period mean hair density of 8?±?6.3 and 9?±?5.6 was achieved in finasteride and placebo side respectively. Statistically significant difference was found between finasteride and placebo solution. Conclusions: We have demonstrated that the addition of finasteride solution to IPL + RF hair removal may result in a more reduction of unwanted facial hair in women when the combination is used for up to 6 months.     

强脉冲光脱毛的疗效观察及分析

目的 观察强脉冲光脱毛的疗效和治疗时间，以及能量密度、毛发部位及皮肤类型对脱毛效果的影响。方法 574例患者，采用美国科医人公司生产的IPL Quantum HR仪器进行治疗。结果 574例患者中，57例患者自动放弃治疗（只治疗了1次未随访，未记入统计数据），517例患者取得了满意疗效，治疗毛发再生减少，再生时间延迟，再生毛发较前细小，色泽较前变淡。治疗早期，2例发生热损伤。结论 强脉冲光脱毛方便快捷，疗效满意，不良反应少．治疗效果在适当能量密度下与治疗次数呈正相关关系，亦与治疗部位有关。     

Photoepilation: a growing trend in laser-assisted cosmetic dermatology

Excess hair is an age-old condition plaguing both men and women alike, of all races. Conditions such as hirsutism or hypertrichosis, procedures that involve grafted donor sites, transsexual transformations from male to female, and genetics are all responsible for excess or unwanted hair. Previous options for people seeking to remove or lessen the presence of hair have either been painful or resulted in short-term hair removal. With the recent advent of laser technology, hair removal has been added to the many capabilities of the new generation nonablative lasers and light systems. Lasers are not yet a permanent solution for hair removal, but they are able to provide a safe, fast, and effective method of hair reduction.     

Objective and non‐invasive evaluation of photorejuvenation effect with intense pulsed light treatment in Asian skin

Background Intense pulsed light (IPL) has been widely used for photorejuvenation. Although previous literature has shown clinical effectiveness of IPL treatments on cutaneous photoaging, the associated changes in the biophysical properties of the skin following IPL treatments have not been fully elucidated. Objective The aim of this study was to evaluate changes in skin biophysical properties in patients with photoaging after IPL treatments, using non‐invasive, objective skin measuring devices. Patients and methods A total of 26 Korean women with facial dyschromias underwent three sessions of IPL treatment at 4‐week intervals. Outcome assessments included standardized photography, global evaluation by blinded investigators, patients’ self‐assessment and objective measurements of colour (Mexameter MX18, Chromatometer), elasticity (Cutometer), roughness (Visiometer), sebum (Sebumeter) and skin hydration (Corneometer). Results Intense pulsed light treatments produced a 15% decrease in the size of representative pigmented lesions (P < 0.05). Patients’ self‐assessment revealed that 84% and 58% of subjects considered their pigmented lesions and wrinkles were improved respectively. Objective colorimetric measurement demonstrated significant improvements following IPL treatments that were most remarkable after one session of IPL. Moreover, skin elasticity showed significant improvements at the end of the study. Skin wrinkles as measured using Visiometer showed a mild improvement without statistical significance. Sebum secretion and water content of skin remained unchanged. Conclusions Intense pulsed light provided significant improvement in the appearance of facial pigmented lesions in Korean patients. These effects appeared to be more remarkable in improving pigmentation, skin tone and elasticity.     

Intense pulsed light in the treatment of non‐aesthetic facial and neck vascular lesions: report of 85 cases

Background Intense pulsed light (IPL) treatment is one of the most effective procedures for patients with non‐aesthetic vascular lesions in addition to signs of skin photoageing, and it has been reported as very successful in the treatment of telangiectasias, spider nevi, erythrosis, and above all, rosacea and poikiloderma. Its use is based on the principle of selective photothermolysis, which exploits the haemoglobin absorption peak among its range of wavelengths. Objective The aim of this study is to assess the efficacy and safety of intense pulsed light in treating non‐aesthetic vascular skin lesions, especially with regard to poikiloderma of Civatte and rosacea. Methods A total of eighty‐five patients, 64 women and 21 men, with 63 non‐aesthetic vascular lesions (28 Poikiloderma of Civatte and 35 rosacea), 22 pigmented lesions (UV‐related hyperpigmentation of solar lentigo‐type) and four precancerous lesions (actinic keratosis, AKs), were treated repeatedly with IPL for 2 years. The patients received a mean of five treatments (range 4–6) at 3‐weekly intervals. They were evaluated via clinical observations and professional photographs were taken before each treatment and after 2 weeks, 4 weeks, 3 months, 6 months and 12 months. The outcome of the IPL treatments was evaluated by four independent dermatologists, who were not informed about the study protocol, and who assessed the performance of IPL by dividing the results into four categories: no results, slight improvement, moderate improvement and marked improvement. Results All the patients showed improvements in their overall lesions: 72 lesions (80.9%) achieved a marked improvement, 14 lesions (15.7%) achieved a moderate improvement and three lesions (3.4%) achieved a slight improvement. The results of the 63 non‐aesthetic vascular lesions in Rosacea and Poikiloderma of Civatte were: 51 with a marked improvement, 10 with moderate improvement, whereas only two lesions achieved a slight improvement. The improvement of all four actinic keratoses was marked whereas the 22 pigmented lesions obtained a marked improvement in 17 cases, a moderate improvement in four cases and a slight improvement in one case. No undesirable effects were observed. Conclusions Our study confirms how by minimizing side‐effects, time and costs, IPL can be effective and safe for the treatment of non‐aesthetic facial and neck vascular lesions.     

新型强脉冲光治疗面部寻常痤疮的疗效观察

2005年7月至2007年8月,我科用具有优化脉冲技术的新型强脉冲光(intense pulsed light,IPL)治疗116例面部寻常痤疮患者,取得满意疗效. 一、临床资料 依据靳培英[1]标准,寻常痤疮严重程度分为轻(Ⅰ级)、中(Ⅱ级和Ⅲ级)、重(Ⅳ级),选择病情为Ⅱ～Ⅲ级的面部寻常痤疮患者116例,男46例,女70例;年龄18～42岁,平均(23.12±5.34)岁;病程2个月至13年,平均(2.76±1.58)年.其中Ⅱ级79例:有粉刺,伴有中等量的丘疹和脓疱,总数31～50个;Ⅲ级37例:有粉刺,伴有大量的丘疹和脓疱,偶见大的炎性损害,分布广泛,总数51～100个,有少数结节.排除标准:有光敏史者;1年内外用或口服光敏性药物者,如维A酸类药物;近期内服用其他药物(如糖皮质激素)者;正在使用其他方法治疗痤疮者;2周内经受日光曝晒者;妊娠及哺乳期患者;有精神疾患者.     

Effectiveness of low-fluence and short-pulse intense pulsed light in the treatment of melasma: A randomized study

Background: Various treatment protocols for melasma have been suggested in the literature, but the efficacy and safety of treatment varies according to the report. Objective: To investigate the selective photothermolytic effect of fluence-dependent intense pulsed light (IPL) in the treatment of melasma. Methods: Twenty Korean adults with melasma were enrolled, randomly assigned to two groups and treated at fluences of 10 or 13 J/cm² of IPL weekly over 6 weeks. Subjects were evaluated at baseline and weekly during the 6 weeks of treatment and at 3 weeks following the final treatment. Melanin and erythema indices were scored using a spectrophotometer. Results: The modified Melasma Area Severity Index (MASI) score of 20 patients at inclusion was 11.6 (± 0.9). Both 10J and 13J IPL treatment groups had decreased modified MASI scores from 2 weeks onward at statistically significant levels. Both 10J and 13J IPL treatment groups showed decreased melanin indices with statistically significant differences from 3 weeks onward. The effect of IPL on melasma was slightly greater in patients treated with 13J of IPL than in those treated with 10J over the entire duration of the study. The erythema index was transiently increased in weeks 1–3, but after 4 weeks it decreased to sub-baseline levels. Conclusion: We suggest that a low-fluence IPL protocol could provide more effective treatment for melasma with minimal side effects in Asian skin.     

Hair removal with a novel,low fluence,home-use intense pulsed light device

Objective: To evaluate the reduction in unwanted body and facial hair at various body sites of Fitzpatrick skin types I–III and the efficacy, comfort and safety of this treatment intended for home-use by the general public. Methods: In this non-randomized study, 29 individuals were given three sequential weekly treatments on a total of 31 body and facial areas including the axilla, bikini area, abdomen, neck, chin and upper lip using a novel intense pulsed light device. All participants completed a simple self-assessment questionnaire, as well as an evaluation of pain/discomfort. Results: The mean reduction in terminal hair counts was 47% at 4 weeks' follow-up and 41% at 6 months' follow-up after completing three sequential weekly treatments. Overall, 84% of participants showed a significant percentage of hair reduction (p<0.01) at the 6-month follow-up, with a mean of 51% (range 25–86%). No treatment-related side effects were reported, with little or no discomfort reported during the treatment. Only mild erythema was noted immediately post-treatment. In total, 85% of the participants were either pleased or very pleased with the results 1 month after the third treatment. Conclusions: In simulated consumer use, this home-use IPL demonstrated a significant, quantifiable and sustainable reduction in unwanted body and facial hair with minimal side effects.     

Treatment of facial telangiectasia with narrow-band intense pulsed light in Chinese patients

Objective: To evaluate the efficacy and safety of narrow-band intense pulsed light (DPL) in treating facial telangiectasia. Method: Thirty patients with facial telangiectasia underwent five sessions of treatment with DPL (500 nm～600 nm) at 4-week interval. The erythema index (EI), temperature, transepidermal water loss (TEWL), and lightness of the skin (L) were measured before each treatment session and at each follow-up. Result: Thirty cases completed treatment and follow-ups. Twenty-seven cases (90%) got more than 50% clearance post-treatment and among them eight cases (27%) got more than 75% clearance. The average of the mean EI value decreased with the number of treatment sessions; the EI observed after two treatment sessions was significantly different from that observed before treatment (P = 0.012, P < 0.05). The decrease in skin temperature and TEWL values post-treatment was statistically significant (P = 0.000, P = 0.027, P < 0.05), while the L value increased significantly (P = 0.025, P < 0.05). Thirty percent cases had reccurence at 6-month follow-up. While burning sensation, erythema, and swelling were usually seen during the treatment, no severe side effects were observed during treatment and follow-ups. Conclusion: Narrow-band intense pulsed light DPL is effective and safe in treating facial telangiectasia.     

Treatment of facial port-wine stains with intense pulsed light: a prospective study

Background  Intense pulsed light (IPL) has been used for the treatment of port-wine stains for 10 years. There are many IPL systems that have different setting. Some of them have been reported in the treatment of fresh or laser-resistant port-wine stains localized in different body regions.
Objective  Our aim was to conduct a prospective trial to assess the effectiveness of Lynton (The Lumina Family of Medical Flashlamp Systems) of the IPL family in the treatment of fresh facial port-wine stains.
Material and methods  Twelve patients with facial and/or neck port-wine stains without previous treatment were enrolled in the trial. Patient demographics, treatment setting, outcome of clearing, and treatment complications were noted.
Results  The treatment intervals were 4 to 6 weeks for three to six treatment sessions. Moderate improvement (50–75%) was achieved in 47% of the patients. Complete clearing was seen in only one patient (8.3%) after four treatment sessions. Hypertrophic scar formation in two patients occurred after healing blister. Except for the side effects, long-term complications were not seen.
Conclusion  Moderate effectiveness was achieved with IPL treatment in the facial port-wine stains.     

Comparative efficacy of short-pulsed intense pulsed light and pulsed dye laser to treat rosacea

Background: Laser and light-based therapies have often been used successfully to treat rosacea. Recently, short-pulsed intense pulsed light (IPL) that emitted pulse durations down to 0.5 ms was found to be effective for rosacea treatment.

Objective: This study evaluated the efficacy of short-pulsed IPL in the treatment of rosacea compared with pulsed dye laser (PDL) using same pulse duration and fluence.

Materials and Methods: Nine patients with rosacea were enrolled in a randomized, split-face trial. Each treatment consisted of four sessions at three-week intervals and followed up until three weeks after the last treatment. Efficacy was assessed by erythema, melanin index, physician’s subjective evaluation, and patient’s satisfaction.

Results: The mean change in erythema index was ?4.93 ± 1.59 for the short-pulsed IPL group and ?4.27 ± 1.23 for the PDL group. The mean change in melanin index was ?2.52 ± 2.45 for the short-pulsed IPL group and ?1.95 ± 1.41 for the PDL group. There was no significant difference in either melanin or erythema index between short-pulsed IPL and PDL treatments, and there were no noticeable adverse events.

Conclusions: There was no significant difference between PDL and short-pulsed IPL treatment using the same energies and pulse. Both PDL and short-pulsed IPL were satisfactory and safe for rosacea treatment.     

Comparative efficacy of intense pulsed light for different erythema associated with rosacea

Abstract

Objective: To compare the efficacy of intense pulsed light (IPL) (540–950nm) in treating different erythema associated with rosacea. Methods: Thirty-two patients with erythematotelangiectatic rosacea (ETR) (n = 16) and papulopustular rosacea (PPR, n = 16) were recruited. Three treatments of IPL (540–950nm) were administered on the face at 3-week intervals. Clinical improvement in erythema was independently assessed by two dermatologists using a quartile grading scale [0, ≤ 25% improvement (poor); 1, 26–50% improvement (fair); 2, 51–75% improvement (good); and 3, 76–100% improvement (excellent)]. Patient satisfaction was evaluated using a 10-point visual analog scale (VAS: 0, lowest; and 10, highest). Results: Thirty patients were involved in this study. All patients showed improvement in erythema after three sessions of IPL (540–950nm) treatment. Based on physician's assessment, the overall clinical improvement in PPR group was significantly higher (mean ± SD of PPR group, 2.167 ± 0.748 vs. ETR group, 1.400 ± 0.541; P = 0.003) and patient satisfaction was also higher in PPR group (mean ± SD of PPR group, 6.867 ± 1.457 vs. ETR group, 5.600 ± 1.502; P = 0.026). The proportion of patients showing > 75% clinical improvement among PPR group was also higher than that among ETR group (5/15 and 0/15, respectively; P = 0.021). Side effects were minimal and transient (erythema and/or edema) for patients. Conclusions: IPL (540–950nm) is a safe and effective treatment for rosacea-associated erythema, especially for perilesional erythema.     

Intense pulsed light vs. pulsed‐dye laser in the treatment of facial acne: a randomized split‐face trial

Background Various laser and light therapy have been increasingly used for the treatment of acne vulgaris. Patients and methods Twenty patients with facial acne were treated using intense pulsed light (IPL) on one side of the face and pulsed dye laser (PDL) on the other to compare the efficacy and safety of IPL and PDL. Treatment was performed 4 times at 2‐week intervals. Treatment effectiveness was determined using lesion counts, acne severity, patient subjective self‐assessments of improvement, and histopathological examinations, which included immunohistochemical staining for transforming growth factor‐β (TGF‐β). Results Numbers of total acne lesions decreased following both treatments. For inflammatory lesions such as papules, pustules and nodules, IPL‐treated sides showed an earlier and more profound improvement than PDL‐treated sides. However, at 8 weeks after the 4th treatment, a rebound aggravation of acne was observed on IPL‐treated sides. On the contrary, PDL produced gradual improvements during the treatment sessions and these improvements lasted 8 weeks after the 4th treatment. Non‐inflammatory lesions as open and closed comedones also showed improvement following both treatments and PDL‐treated sides showed better improvement as the study proceeded. Histopathological examinations showed amelioration in inflammatory reactions and an increase in TGF‐β expression after both treatments, which were more prominent for PDL‐treated sides. Conclusion Both PDL and IPL were found to treat acne effectively, but PDL showed a more sustained effect. TGF‐β might play a key role in the resolution of inflammatory acne lesions.     

A prospective study of safety and efficacy of combination therapy with bipolar radiofrequency-based intense pulsed light,infrared light,and diode laser in Chinese subjects with photoaged skin

Objective: To further evaluate the safety and effectiveness of bipolar RF-based optical therapy combining intense pulsed light (IPL), infrared light, and diode laser in the treatment of photoaged skin in Chinese subjects. Methods: Twenty-seven subjects received five treatments at 3-week intervals. Triple therapy was applied in one session to the face. Images and data were obtained 30 and 180 days after the last treatment. Objective measurements (including photometric analysis of skin pigmentation, texture and wrinkles, ultrasonic measurement of dermal thickness and dermal echo intensity, and public and self-assessment of apparent age), clinical assessment, and safety were evaluated. Results: Objective measurements of pigmentation, texture, wrinkles, and dermal echo intensity improved significantly, regardless of age. Self-assessment of apparent age at 30 and 180 days was reduced by an average of 2.7 and 2.2 years, respectively, and public assessment of apparent age was reduced by an average of 3.14 years and 2.95 years, respectively. Global scores for photoaging were improved in all patients. Adverse events were generally transient and mild. Conclusion: Sequential combination treatment reported here could significantly reduce skin pigmentation, texture and wrinkles, improve dermal intensity, and reduce the self and publicly perceived age. This therapy is safe and well tolerated.     

Efficacy and safety of intense pulsed light in the treatment of inflammatory acne vulgaris with a novel filter

Acne vulgaris is one of the most common skin diseases affecting young people. Intense pulsed light (IPL) has become a well-recognized method in the treatment of acne vulgaris. We aim evaluate the clinical efficacy and safety of a novel IPL filter at wavelength of 400–600 nm and 800–1,200 nm in the treatment of inflammatory acne lesions. Twenty-one patients with Pillsbury I–III facial acne vulgaris between July 2017 and January 2018 were enrolled in this prospective clinical study. Five sessions of IPL treatment were administered to the subjects at 4-week interval. Final assessment was performed 1 month after the final treatment. One month posttreatment, over 75% subjects exhibited excellent or good response. Of the Pillsbury I–II patients, the effective rate reached 88.24%. The inflammatory lesions were dramatically decreased (25.23 ± 2.76 versus 14.01 ± 1.98) and statistically evident (P = .031). According to Hayashi assessment of acne severity, there was a significant improvement at follow-up visit (P = .022). Moreover, patients reported significant improvements in self-evaluation. The novel IPL filter at wavelength of 400–600 nm and 800–1,200 nm provides an effective option to treatment of inflammatory acne lesions, especially for Pillsbury I–II acne patients, with minimal reversible side effects, such as transient post-inflammatory pigmentation.     

New insight in the treatment of refractory melasma: Laser Q‐switched Nd: YAG non‐ablative fractionated followed by intense pulsed light

The purpose of our study was to verify the results of the association of Q‐switched Nd: YAG non‐ablative fractionated with intense pulsed light, in order to treat patients with refractory melasma. The combination of these two devices seems to be the best treatment to combat hyperpigmentation produced by melasma, with low occurrence of side effects, which may be justified by the selective photothermolysis at subcellular level.     

Treatment of facial telangiectasia with a small spot of intense pulsed light: A case series of three patients

Intense pulsed light (IPL) technology has long been used in the treatment of facial telangiectasia. While the large spot size of traditional IPL devices offers rapid coverage, it has limitations in terms of visibility and uniform contact with the skin in contoured areas of the face. The novel IPL used in this study had a small spot size (6.35 mm) and shorter wavelength (500–635 nm), allowing the use of high fluence without burning the normal epidermal tissue surrounding the lesion, thus providing better efficacy. Treatment of facial telangiectasia using small‐spot IPL is effective with a low risk of dermatological damage, and its uses for medical care are expected to diversify.