Is IPL Treatments Safe When Pregnant?

Pregnancy causes skin alteration in unpredicted ways. IPL has not been tested in pregnant women and as such we cannot say with certainty that it would affect you adversely.IPL is not recommended once you find out you're pregnant. The worse case scenario is you run into complications post IPL and you're unable to take the proper antibiotics because of the pregnancy.It is best to wait until several months after delivery to get laser or IPL treatments. Hormonal changes during pregnancy change skin pigmentation and the way skin responds. Also, laser and IPL treatments have not been tested for safety in pregnant women, so such data is not available.It would be difficult to imagine why an intense light on your face would put your baby at risk. That being said, the laser companies will let you know that using any laser during pregnancy is contraindicated.

Pregnancy is a contraindication for IPL and BBL (Broad Band Light) treatments. The effect on the fetus is unknown and the hormonal shifts of pregnancy make the response of pigmented lesions very unpredictable.Although there is no scientific evidence relating to potential damage to the fetus, it is recommended that you forego any laser treatment while pregnant or lactating. This is purely a precautionary measure.Because very few treatments of any sort have been studied in pregnant or lactating women, most dermatologists would advise waiting till after the pregnancy.

Acne

Acne vulgaris (or acne) is a common human skin disease, characterized by areas of skin with seborrhea (scaly red skin), comedones (blackheads and whiteheads), papules (pinheads), pustules (pimples), nodules (large papules) and possibly scarring. Acne affects mostly skin with the densest population of sebaceous follicles; these areas include the face, the upper part of the chest, and the back. Severe acne is inflammatory, but acne can also manifest in noninflammatory forms. The lesions are caused by changes in pilosebaceous units, skin structures consisting of a hair follicle and its associated sebaceous gland, changes that require androgen stimulation.

Acne occurs most commonly during adolescence, and often continues into adulthood. In adolescence, acne is usually caused by an increase in male sex hormones, which people of both genders accrue during puberty. For most people, acne diminishes over time and tends to disappear — or at the very least decrease — after one reaches one's early twenties. There is, however, no way to predict how long it will take to disappear entirely, and some individuals will carry this condition well into their thirties, forties, and beyond.

Some of the large nodules were previously called "cysts" and the term nodulocystic has been used to describe severe cases of inflammatory acne. The "cysts," or boils that accompany cystic acne, can appear on the buttocks, groin, and armpit area, and anywhere else where sweat collects in hair follicles and perspiration ducts. Cystic acne affects deeper skin tissue than does common acne.

Aside from scarring, its main effects are psychological, such as reduced self-esteem[8] and, according to at least one study, depression or suicide.[9] Acne usually appears during adolescence, when people already tend to be most socially insecure[citation needed]. Early and aggressive treatment is therefore advocated by some to lessen the overall impact to individuals.

Signs and symptoms"

Typical features of acne include: seborrhea (scaly red skin), comedones (blackheads and whiteheads), papules (pinheads), pustules (pimples), nodules (large papules) and, possibly scarring. It presents somewhat differently in people with dark skin.

Scars:

Acne scars are the result of inflammation within the dermis brought on by acne. The scar is created by the wound trying to heal itself resulting in too much collagen in one spot.

Physical acne scars are often referred to as "Icepick" scars. This is because the scars tend to cause an indentation in the skin's surface. There are a range of treatments available. Although quite rare, the medical condition Atrophia Maculosa Varioliformis Cutis also results in "acne-like" depressed scars on the face.

Ice pick scars: Deep pits, that are the most common and a classic sign of acne scarring.

Box car scars: Angular scars that usually occur on the temple and cheeks, and can be either superficial or deep, these are similar to chickenpox scars.

Rolling scars: Scars that give the skin a wave-like appearance.

Hypertrophic scars: Thickened, or keloid scars.

Pigmentation:

Pigmented scars is a slightly misleading term, as it suggests a change in the skin's pigmentation and that they are true scars; however, neither is true. Pigmented scars are usually the result of nodular or cystic acne (the painful 'bumps' lying under the skin). They often leave behind an inflamed red mark. Often, the pigmentation scars can be avoided simply by avoiding aggravation of the nodule or cyst. When sufferers try to 'pop' cysts or nodules, pigmentation scarring becomes significantly worse[citation needed], and may even bruise the affected area. Pigmentation scars nearly always fade with time taking between three months to two years to do so, although rarely can persist.

Carbon Dioxide Laser (CO2 laser)

The carbon dioxide laser (CO2 laser) was one of the earliest gas lasers to be developed (invented by Kumar Patel of Bell Labs in 1964, and is still one of the most useful. Carbon dioxide lasers are the highest-power continuous wave lasers that are currently available. They are also quite efficient: the ratio of output power topump power can be as large as 20%.

The CO2 laser produces a beam of infrared light with the principal wavelength bands centering around 9.4 and 10.6 micrometers.

Amplification:

The active laser medium (laser gain/amplification medium) is a gas discharge which is air cooled (water cooled in higher power applications). The filling gas within the discharge tube consists primarily of:

Carbon dioxide (CO2) (around 10–20 %)

Nitrogen (N2) (around 10–20%)

Hydrogen (H2) and/or xenon (Xe) (a few percent; usually only used in a sealed tube.)

Helium (He) (The remainder of the gas mixture)

The specific proportions vary according to the particular laser.

The population inversion in the laser is achieved by the following sequence:

Electron impact excites vibrational motion of the nitrogen. Because nitrogen is a homonuclear molecule, it cannot lose this energy by photon emission, and its excited vibrational levels are therefore metastable and live for a long time.

Collisional energy transfer between the nitrogen and the carbon dioxide molecule causes vibrational excitation of the carbon dioxide, with sufficient efficiency to lead to the desired population inversion necessary for laser operation.

The nitrogen molecules are left in a lower excited state. Their transition to ground state takes place by collision with cold helium atoms. The resulting hot helium atoms must be cooled in order to sustain the ability to produce a population inversion in the carbon dioxide molecules. In sealed lasers, this takes place as the helium atoms strike the walls of the container. In flow-through lasers, a continuous stream of CO2 and nitrogen is excited by the plasma discharge and the hot gas mixture is exhausted from the resonator by pumps.

Contraction:

Because CO2 lasers operate in the infrared, special materials are necessary for their construction. Typically, the mirrors are silvered, while windows and lenses are made of eithergermanium or zinc selenide. For high power applications, gold mirrors and zinc selenide windows and lenses are preferred. There are also diamond windows and even lenses in use. Diamond windows are extremely expensive, but their high thermal conductivity and hardness make them useful in high-power applications and in dirty environments. Optical elements made of diamond can even be sand blasted without losing their optical properties. Historically, lenses and windows were made out of salt (either sodium chloride or potassium chloride). While the material was inexpensive, the lenses and windows degraded slowly with exposure to atmospheric moisture.

The most basic form of a CO2 laser consists of a gas discharge (with a mix close to that specified above) with a total reflector at one end, and an output coupler (usually a semi-reflective coated zinc selenide mirror) at the output end. The reflectivity of the output coupler is typically around 5-15%. The laser output may also be edge-coupled in higher power systems to reduce optical heating problems.

The CO2 laser can be constructed to have CW powers between milliwatts (mW) and hundreds of kilowatts (kW).It is also very easy to actively Q-switch a CO2 laser by means of a rotating mirror or an electro-optic switch, giving rise to Q-switched peak powers up to gigawatts (GW) of peak power.

Because the laser transitions are actually on vibration-rotation bands of a linear triatomic molecule, the rotational structure of the P and R bands can be selected by a tuning element in the laser cavity. Because transmissive materials in the infrared are rather lossy, the frequency tuning element is almost always a diffraction grating. By rotating the diffraction grating, a particular rotational line of the vibrational transition can be selected. The finest frequency selection may also be obtained through the use of an etalon. In practice, together with isotopic substitution, this means that a continuous comb of frequencies separated by around 1 cm−1 (30 GHz) can be used that extend from 880 to 1090 cm−1. Such "line-tuneable" carbon dioxide lasers are principally of interest in research applications.

Applications:

Because of the high power levels available (combined with reasonable cost for the laser), CO2 lasers are frequently used in industrial applications for cutting and welding, while lower power level lasers are used for engraving. They are also very useful in surgical procedures because water (which makes up most biological tissue) absorbs this frequency of light very well. Some examples of medical uses are laser surgery, skin resurfacing ("laser facelifts") (which essentially consist of burning the skin to promote collagen formation), anddermabrasion. Also, it could be used to treat certain skin conditions such as hirsuties papillaris genitalis by removing embarrassing or annoying bumps, podules, etc. Researchers in Israel are experimenting with using CO2 lasers to weld human tissue, as an alternative to traditional sutures.

The common plastic Poly (methyl methacrylate) (PMMA) absorbs IR light in the 2.8–25 µm wavelength band, so CO2 lasers have been used in recent years for fabricating microfluidic devices from it, with channel widths of a few hundred micrometers.

Because the atmosphere is quite transparent to infrared light, CO2 lasers are also used for military rangefinding using LIDAR techniques.

Photorejuvenation

Photorejuvenation is a skin treatment that uses intense pulsed light or other thermal or chemical methods to treat some skin conditions and remove wrinkles arising from photoaging. The process induces controlled wounds on the skin, prompting it to heal itself by creating new cells. This process reverses the effects of photoaging to a certain extent by removing wrinkles.

Types:

There are three types of photorejuvenation:

1. Thermal photorejuvenation using a radio-frequency device to induce a thermal effect in the skin.

2. Chemical photorejuvenation with chemical peels.

3. Mechanical photorejuvenation with lasers.

Laser resurfacing:

Laser resurfacing is a technique used during laser surgery wherein molecular bonds are dissolved by laser. It is used for the treatment of wrinkles, solar lentigenes, sun damage, scars (see acne scar treatment), stretch marks, actinic keratosis and telangiectasias or "spider veins".

It can be combined with liposuction to remove excess fat from the chin and jaw area. The skin may be wrinkled after fat is removed and laser resurfacing can help tighten and smooth over the new contours.

Laser resurfacing is usually done with a 2940 nm Er:YAG laser or a 10,600 nm CO2 laser. Complete resurfacing was first done with a CO2 laser. More commonly now, laser resurfacing is done with a fractional laser. The term fractional pertains to the method in which the laser light is transferred. Tiny pinpoints of laser light are used to deliver the laser to the surface of the skin in only a fraction of the area. Several hundred or thousands of laser pinpoints may be used per square inch, leaving healthy skin in between the ablated areas, to allow more rapid healing and lower risk.

The newest types of laser resurfacing are radio frequency (Syneron Matrix RF) or EndyMed 3DEEP fractional skin resurfacing, erbium (Er:YAG), fractional (Palomar Medical Technologies Lux2940 or Sciton Profractional), and CO2 fractional lasers (DEKA Smartxide DOT). These were developed to remove skin more precisely, layer by layer, using very short pulsed light energy or continuous light beams that are delivered in a scanning pattern to remove thin layers of skin with minimal heat damage to the surrounding tissue structures.

Skin resurfacing can also be performed with a plasma-based device instead of a laser. At least one manufacturer of such a plasma device[who?] claims "It’s the only treatment proven to generate new skin, at the fundamental levels, for as long as a year after treatment". However these claims do not have supporting evidence published in a peer-reviewed medical journal, and have not been verified by any independently funded studies. Superiority to laser-based devices remains an open question.

Fractional photothermolysis (FP) is another form of laser treatment with several devices currently on the market including Matrix RF, EndyMed 3DEEP fractional skin resurfacing, Fraxel(R) Laser, Pixel, Palomar Medical Technologies Lux1540, DEKA Smartxide DOT and Cynosures SmartSkin CO2™. Some doctors claim FP provides similar results to CO2 laser resurfacing without risk of scarring or significant downtime. As of January 2008, there are a number of papers referenced on PubMed which mostly support those claims.[citation needed] Complications observed in a study of 961 treatments included acneiform eruptions (1.87%) and herpes simplex virus outbreaks (1.77%). Side effects and complications observed in this study were of a temporary nature. There have been, however, anecdotal negative accounts of bad scarring and hyperpigmentation without any findings of infection.

When compared to a chemical peel, dermabrasion or other forms of laser treatment, a laser allows the surgeon to customize the surgery not only for each patient but also to each area of the face.

CO2 laser resurfacing has been shown to have an increased risk of hypopigmentation and scarring when compared to the erbium lasers. This is due to the high degree of coagulation and thus heat production that occurs as a nature of the CO2 wavelength. Both Erbium and Co2 fractional systems have a better safety profile than lasers of the past.

Both Erbium and CO2 are used to treat deep rhytides, sun damage and age spots. Through the heating of the deep dermis, fibroblasts are stimulated to form new collagen and elastin helping to bring increased turgor and thickness to the skin.

Side Effects of IPL Usage in Mechanical Photorejuvenation:

Thermal injury causes DNA damage and lethality in unheated surrounding cells: active thermal bystander effect. Beginning in the late 1990s, a number of studies has been performed to evaluate the safety and effectiveness of IPL on wrinkle-removal and rejuvenation of the skin. One such study conducted by a group of 4 researchers from the Weill Cornell Medical College of Cornell University and published in the Journal of Drugs in Dermatology in 2004 found IPL to be a "non-invasive, non-ablative method for rejuvenating photoaged skin with minimal adverse events.

Intense Pulsed Light (IPL)

Intense pulsed light (IPL), is a technology aimed at producing light of high intensity during a very short period of time. It involves specific lamps together with capacitors whose rapid discharge provides the high energy required.

It is a method of hair removal from the body most commonly employed by medical practitioners and estheticians. It involves the use of a specially constructed xenon flash lamp and focusing optics.

The Intense Pulsed Light hair removal process has become very popular due to its cheaper and faster procedure compared to laser hair removal. The comparison of effectiveness between Intense Pulsed Light and Laser Epilation is debated by scientists, equipment manufacturers and practitioners, but results are generally accepted to be roughly equivalent. It is also used for the treatment of the skin in a process known as Photo Rejuvenation.

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 vaporized. The intense heat radiated by the hair also destroys the hair-producing papilla or the entire hair follicle. It is also claimed that direct light-heat conversion occurs directly in the darker colored capillaries that bring nourishing blood vessels to the follicle.

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

-Sun damage induced dyspigmentation and vascular changes

-Poikiloderma of Civatte

-Acne Rosacea

-Broken capillaries/telangiectases

-Vascular and pigmented birth marks

In terms of rosacea, IPL offers one of the few effective treatments to relieve the facial redness associated with the disorder. Such treatment may be administered by a dermatologist or other medical specialist with experience treating skin disorders. This new technology incorporates 'dual mode filtering' and other important advances which result in safer and more effective treatment than older systems designed for hair removal.

The pulses of light produced by IPL equipment are very short in duration, so discomfort and damage to non-target tissues is minor. Most people who undergo IPL epilation only experience slight irritation similar to that of a minor sunburn though under certain circumstances, blisters may occur. Men undergoing the procedure experience greater discomfort as male body hair is generally thicker than women's. Depending on the instrument settings and intensity, treating sensitive areas such as the chest and face can result in pain comparable to waxing the same areas; however this pain dissipates immediately. The light that emanates from the IPL wand is filtered to remove any ultraviolet components, eliminating the possibility of UV skin damage.

IPL's (Intense Pulsed Light) work more directly on the top layers of the skin and do not penetrate deep enough to damage hair germ cells, without potential damage to the epidermis.