Skin Deep: IPL 101

“Skin is in” is one of my favorite AbFab lines. AF predicted the irony of skin being fashionable 2 decades before lightening made it possible to actually change your skin tone and retexturizing methods went from abrasive to clinical. I’m obsessively diligent about mine, having being classically Irish freckled redhead – or as my friend Jennifer Sullivan and I used to joke, “Cheap Irish skin.” Meaning it crinkles like a paper bag if you’re not careful. I was the beach kid with a hat under the umbrella while the others ran wild. When I pretended I could stand the sun, I’d burn, blister, and suffer.  My childhood dream of being Malibu Barbie faded as I got older as I started to appreciate my non-wrinkled skin from years of  hats, sunblock, and New England/New York/English weather.  My dad had melanoma, which has a strong possibility to run in families. I have physical sunblock (hats and clothing) along with liquid, spray, and creams everywhere, which I’ll do a later column on. While good and problematic skin, along with the rest of you, has mostly your genes to thank (or curse!), there are many more options to help your DNA along, inside and out.

While we all know about smoking, dehydration, lack of sleep and general skin neglect, the most damaging thing are those UV rays which you cannot avoid unless you’ve never been outside. Dracula, this means you. Everyone else, no matter what skin color, has the same mortal enemy that causes us to look bad and get cancer. And of course, we love it. The sun good for us in small doses (Vitamin D) and boosts serotonin. I speak from experience – I moved here for the weather! I also spend a lot of time in the high desert.  All of this will give those wonderful gifts of unevenness, splotches, sunspots – no matter how sunblock-diligent you are. I had tried a peel some years ago but it was far too reminiscent of the bad childhood sunburns, and walking around with peeling skin is not something I want to repeat.  My general skin-care routine consists of alpha and beta-hydroxy acids, topical antioxidants, retinol, and well as a Clarisonic, so I was in fairly good condition to start with. At least I like to think so. I’ve had other derms want to burn marks off of my skin, but I’m hesitant, especially because that can leave an obvious white spot. Just a small removal of skin from my calf for a biopsy (negative) left me with a permanent scar. I tried fillers, but pretty much every dermatologist and skin-care practitioner all said the same thing: a laser would get rid of those fine lines, wipe out damage, and best of all, stimulate collagen. “That will just wipe all of that damage away and make your skin condition so much better,” my dermatologist, Dr. Rebecca Fitzgerald, opined. I trust Dr Fitz – if your doctor has a suspiciously augmented face, well, you know the rest.

Regular skin screens are important, (there are occasional free screenings on the ASDS website – click here.)  Find out if your doctor uses UV to see what your skin really looks like. On the surface, damage shows up as pigmentary changes (blotches or spots), difference in texture (those little crinkles along with big wrinkles), spider veins, redness, and enlarged pores. While skin cancer metabolizes differently than surface damage, I look at removal of these as a preventative measure. Working at home made this option more appealing.

Pale skin reacts very well to IPL, whereas a heaver laser, like Fraxel, would be too intense. I can’t tolerate Retin-A and I’ve had allergic reactions to Clinique products but there are options for “gentle” laser: IPL Intense Pulsed Light Photofacial  and the Clear and Brilliant Gentle Laser are two.

Whatever you choose, go pro.  I wouldn’t recommend coupon deals for several reasons, the main reason being burns.  Alternatively, the IPL a spa uses may not be strong enough as the dermatologist and you’re throwing your money away. It’s your face and all treatments should be tailored to skin type, condition, and other factors, one being tanning. The laser sees tanned skin as damaged skin (read on.) You wouldn’t do a bargain deal for a cardiologist, would you?

At Dr. Fitzgerald’s office, I spent some time talking with Angela Sarff, RN, who performs these procedures. You know you’re in the right hands (oh, bad pun) when the people you trust your skin to have gorgeous, glowing skin that looks natural and fresh. We went over some points about the IPL, which is what I did first.

The basics: Getting rid of “age spots” and sun damage can take years off one’s face and it usually means spending less time applying makeup and concealer for uneven skin tone 🙂

Fair skin: IPLs work great for super fair and sensitive skin because this skin type is most prone to redness and sun damage. In addition, the light skin and darkness of the spots provides the highest contrast for the laser to target. In short, fair skin responds the best to IPLs and tends to need them more because of their propensity for redness and sun damage.

Go pro: IPL stands for intense pulsed light and is a powerful laser. For this reason it requires a specially trained Dermatologist to evaluate the patient’s skin type and determine the appropriate settings for the laser. At our office only the physician, registered nurse (RN), or physician’s assistant (PA) performs the laser treatment, and we have all had special training for these lasers. Our settings tend to be more aggressive, this is why IPLs in a salon setting do not usually work. (I knew it! – dl)

Prep:  The most important thing to consider before having an IPL is sun exposure. If the patient has ANY type of fresh sun exposure they can get burns and complications from the laser. This also includes self tanner. In Southern California this can be difficult because many patients lead active outdoor lifestyles. Dr. Fitzgerald uses the analogy of a microwave and asks “why is it that when you heat a bowl of soup up, the soup gets hot, but the bowl doesn’t?” In other words, “how does the laser only know to target the unwanted color?” This is the theory of selective photothermolysis, the laser targets the brown and red color with a specific wavelength of light and leaves the remainder of the skin intact.

If you are tan, the laser sees everything as target and will burn your skin. So, we prep our patients with an intense regimen of antioxidants and physical sunblocks for 1 month prior to the treatment and tell them to also avoid hiking and outdoor sports with low cut shirts.

Results: Most of our patients are extremely happy with the IPL laser and come back yearly for treatments and recommended it to their friends.

I most certainly would.  I opted for the IPL first. It’s not relaxing- although your face is numbed, it’s often described as a “snapping rubber band” feeling.  (Watch one of my favorite makeup artists, Wayne Goss, describe it here.) You may also have redness and swelling afterward, but I get that after an eyebrow wax, so I expected it.  Surprisingly, I didn’t have any. After the treatment, damaged spots (shattered melanin) rise to the surface and literally crumble off  so for the first few days I looked like Pippi Longstocking. I applied extra topical C, Embyrolisse, and sunscreen, along with my daily hat. Vitamin C can be irritating to some, so add to your products except sunblock, which is never something you want to dilute – always apply your C first.) Avoid retinoids for 1-2 weeks as well, which your doctor can advise you on. If you need a retinoid primer, here’s a good one.

Makeup easily covered the damage-removal process. But I shouldn’t have worried-  no one noticed. I just looked my regular freckled self had been to the beach.Surprise: deep damage on its way out.

Nearly a week later, most of the skin damage was gone and the deepest sun damage and broken capillaries faded fast. The texture was silky-smooth – much more than I expected.  After 10 days, something unexpected happened. A glowing pink blush appeared on my cheeks. I wondered if somehow I made up my face and forgotten (not likely!) I knew it wasn’t an accurately-placed burn. It’s a pink glow. Spots? Gone. Capillaries? Gone. Sun spots? Gone. Texture? Far softer than I imagined: like silk and velvet. A stranger stopped to tell me I had “really gorgeous skin.”

Selfie, no makeup and not enhanced.

My next session was with the Clear and Brilliant Gentle Laser. This procedure is similar to the IPL, with facial numbing, but much less painful (much less of the “rubber-band-snap”) and I was nice and relaxed. Angela applied some lightening cream and antioxidants as  their absorption is much more enhanced. You should follow the same post-care routine. “New skin (epithelium) will start to form within 24 hours but will remain covered by the old superficial layer of the skin (stratum corneum). This new skin formation usually lasts about 4 days, but can be longer for some skin types. During that time, the skin’s natural exfoliation process will reveal the newly repaired skin tissue. You can protect it by avoiding aggressive mechanical exfoliation and by applying moisturizers and sunscreen frequently.” (from Clear + Brilliant’s site.) If you don’t already, it’s a good way to jumpstart this skin habit.

Want more? Here are some doctor-submitted before and after IPL photos.