Thank you for the question.
You are asking if IPL is safe for severe cystic acne.
Well, certainly it’s a very straight forward question but unfortunately acne is a complex
problem particularly when talking about cystic acne.
A little bit of background about myself, I’m a Board-certified cosmetic surgeon and Fellowship-trained
oculofacial plastic and reconstructive surgeon practicing in Manhattan and Long Island for
over 20 years.
Cosmetic dermatology is a very significant part of the services that we offer in our
practice and solving problems related to acne.
Although it is not focused on teenagers but more with adults, with acne, is something
we’ve been dealing with for this entire time and I can tell you that there are a lot
of ways to approach acne but we will address this question specifically.
First, it is actually relatively recent.
Let’s say in the past 5-10 years that the idea of light-based therapy for acne became
more popular and it was based on the idea of essentially trying to treat the bacteria
called propionibacterium acnes that is within what is called pilosebaceous unit.
That is a bacteria that is associated with the inflammation causing acne as well as other
modalities such as reducing the blood supply, the vessels that are contributing to the acne
as well as the inflammation.
So, when you think of IPL, IPL stands for Intense Pulsed Light.
Intense Pulsed Light means that there are many different wavelengths that are filtered
so that it is not like a laser where laser is a single wavelength.
IPL is multiple wavelengths and within that particular device, you can put on different
hand pieces which filter different wavelengths to help treat particular target tissues.
So IPL may be reasonably safe enough for cystic acne but the question is, is it the best light
energy based device for the treatment of acne and this is where a lot of doctors will conflict
about this type of situation.
To begin with, when you are dealing with cystic acne, you have to think about management from
a systemic level as well as the topical treatment level with an external device.
So generally, one would consider oral antibiotics drugs such as doxycycline as well as the use
of steroid injection which means to treat the acne directly, not to mention that in
some cases, you want to do incisional opening and manual expression of the keratin plug
within the acne lesions.
And then on top of that, if you want to think about light energy device, I’ll share with
you how I decided to choose the one I use in my practice.
I’ve had several different intense pulsed light machines over the many years.
This technology has been around and one of the challenges that I always dealt is controlling
the amount of heat that were being applied to the skin.
And even when I would use cooling gel and pre-cool, the skin with not only gel but then
with this cold packs and cold rollers to protect the superficial skin so that the therapeutic
energy will be delivered deeper.
The skin still has the tendency to get heated up so I decided ultimately to go with the
laser called the Nd:YAG laser.
And what essentially is it is a laser that allows me to treat the acne without having
to do this level of pre-cooling.
We still can cool the skin but the point is that I feel that it is more convenient for
the patient.
It is safer in terms of the amount of heat being delivered to the skin and in the end,
it is just much easier for the patient to tolerate and instead having to deal with some
redness afterwards and dealing with that issue if we can avoid it.
So In my practice I use an Nd:YAG laser, a very specific type of Nd:YAG laser with the
particular type of a method and treatment plan but I would say it is part of the treatment
plan.
It is not just the only thing we do.
So, the answer to your question is IPL safe for cystic acne?
It can be but you should meet with doctors who have experience using light based energy
devices.
Learn about why they choose their particular device and why they feel that’s the better
choice and see what works for you.
These decisions are made lot based on skin type, the age, the type of acne and many other
factors that are beyond just these simple questions.
Again meet with doctors, learn about your options and see where does this light energy
device fit for the treatment of your acne.
So I hope that was helpful, I wish you the best of luck and thank you for your question!