Photofacial

Non-Ablative Skin Rejuvenation Using Intense Pulsed Light

The overall appearance of aging skin is primarily related to the quantitative effects of sun exposure with resultant UV damage of structural components such as collagen and elastic fibers. Appearance, however, is also affected by genetic factors) intrinsic factors, disease processes such as rosacea, and the overall loss of cutaneous elasticity associated with age. Many patients have exposed themselves to vast recreation, Along with thinning of the ozone and other factors; this has made visible signs of aging, damage and disease evident in younger and younger individuals. We are seeing patients in their twenties and thirties presenting with solar elastosis, telangiectasias, lentigines and rhytid information. In the older population and those individuals with extensive sun exposure, these changes are magnified.

In the past decade, a dramatic transformation of rejuvenation procedures has occurred. It began with dermabrasion and deep chemical peels progressing to deeper laser resurfacing. Although effectively dealing with some aspects of coetaneous photoaging, these were usually associated with significant downtime and side effects. While patients have benefited dramatically from ablative C02 and erbium resurfacing, as well as lasers for vascular and pigmented lesions, many of them cannot tolerate these procedures either because of associated pain, potential side effects, or prolonged downtime with loss of income.

Presently, there is pent-up demand for the new generation of non-ablative treatment that promises dramatic improvement for the visible signs of aging, photo damage and intrinsic disease with low risk and, perhaps most importantly, no "downtime".

PHOTO-REJUVENATION TECHNIQUES
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Photo-rejuvenation is a dynamic non-ablative process defined as the use of non-coherent, intense pulsed light (IPL) in a low fluence non-ablative manner to rejuvenate the skin. The treatment is generally administered in a series of four to six procedures in 3-week intervals. In most cases, the entire face is treated, rather than a limited affected area for a uniform and aesthetically pleasing result. The patient may return to all activities immediately after the procedure. Epidermal cooling or topical anesthetic may be used.

TYPE I PHOTO-REJUVENATION is used for treatment of Group A Skin Damage, such as changes involving the pigmentary effects of sun damage, hyper-pigmentation, mottled pigmentation, lentigines, and lesions and dyschromia of benign vascular origin, including telangiectasias, symptoms of rosacea, flushing, as well as erythema following laser resurfacing and other procedures.

Group A Skin Damage
Includes mottled pigmentation, lentigines, as well as vascular changes including telangiectasias and erythema that can be seen both as a result of early to moderate photo damage or intrinsic processes such as rosacea.

TYPE II PHOTO-REJUVENATION is used for Group B sin Damage, involving changes of collagenous and connective tissue origin, including pore size, elastosis and rhytides. Type II Photorejuvenation techniques may involve combined technologies, such as IPL treatments alternated with Nd: YAG laser treatments.

Group B Skin Damage
Includes dermal and epidermal structural changes, such as rhytides, large pores, as well as significant elastotic change manifested as a cobblestone, ruddy appearance.

The Photo-rejuvenation process can significantly improve skin damage of both Groups A and B in a single program of treatment, defining a standard for non-ablative therapy using intense pulsed light. These definitions are inclusive of types of intense pulsed light treatments for skin rejuvenation known by other nomenclature, such as FotoFacial, PhotoFacial, EpiFacial, FacialLight, and many others.

INTENSE PULSED LIGHT (IPL) and the PHOTO-REJUVENATION PROCESS While many forms of coherent laser light are currently being studied and used for their effects on specific aspects of photo damage, including resurfacing and rejuvenation, IPL technology, as utilized in the ESC Sharplan PhotoDerm, MultiLight, EpiLight, and new platforms under development, offers unique characteristics ideal for the Photorejuvenation process. IPL is filtered and multi-spectral; a filter limits its emitted wavelengths, raging from approximately 550 to 1200 nm, which selectively block and defines the lowest wavelength. While the shorter wavelengths are effective in removing unwanted vascular and pigmented lesions, the longer wavelength energy is available to rejuvenate the skin.

Clinical protocols suggest optimal outcomes require an average of four to six treatment sessions spaced approximately three weeks apart. Patients may be pretreated with topical anesthetic and may experience darkening of lentigines and hyper-pigmented areas for a short period of time. As the treatments progress, significant clinical improvement can be seen.

CONCLUSIONS

Type I and Type II Photo-rejuvenation using intense pulsed light holds the tremendous promise of allowing us to treat a large percentage of patients who present with Group A or Group B skin changes, a variety of conditions ranging from vascular and/or pigmentary abnormalities to the collagenous and connective tissue changes characterized by rhytides. Patients can see dramatic benefit after a series of treatments, which can be characterizes as not painful, truly non-ablative, and offering the very valuable lifestyle factor of "no downtime". The resulting procedure has been recognized for minimal adverse effects, excellent long-term results, and a very high measure of patient satisfaction.

TREATMENTS AVAILABLE FOR WRINKLES,
SUN SPOTS AND BLOTCHY SKIN
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BEFORE AND AFTER PICTURES

ROSACEA AFTER THREE TREATMENTS

SPIDER VEINS AFTER TWO TREATMENTS

BROWNSPOTS AFTER ONE TREATMENT

ROSACEA AFTER THREE TREATMENTS

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