Underestimated Variable in Success of Laser/IPL TX

[drnase]

Group,

A nice article should hit the stands soon in Lasers in Surgery and Medicine on a variable that has never been taken into account that may limit the effectiveness of laser or IPL treatments.

***Pressure applied to the superficial blood vessels when physician is trying to keep good contact with laser device and patient's skin.


This pressure can actually push blood forwards and backwards so that there is NO BLOOD (and thus no target for laser) directly under the laser tip or crystal head. This results in ineffective treeatment.

This is especially important when using gobs of topicals such as anesthetic or contact gel which makes it harder to know how much pressure you are actually applying to the skin and thus not know how much you are squooshing the blood out of the superficial hair pin loops. You can also show this phenomenon with gentle pressure by glass slides used in the laboratory.

Another problem is based on the area, especially the nose. Most doctors move the tip of the nose to get a flat surface. That in itself can cut off blood supply temporarily to the site under treatment. Also, as indicated in the article, most physicians naturally press down harder on most areas of the nose.

An interesting factor never taken into account. In conclusion, the patient should never feel anything other than the lightest touch of the laser/IPL in contact with the skin.

[Warren]

I have already read about this somewhere because I added it to the [wiki]IPL[/wiki] article a long time ago. I think it was from http://www.ellipse.org but I can not seem to find it again.

The site also mentions some things like that blood pressure can affect the depth the IPL is effective to, any pre numbing cream should be kept at room temperature and that

A correct response is that the vessel will coagulate i.e. turn bluish in colour immediately after the “shot”. This endpoint is applicable for all vessels regardless of anatomical site. If the vessel turns into a greyish colour, the energy is too high. If you are treating vascular malformations (Port-wine stains), you have to see slight purpura as you are treating the area

[Mermaid]

Hello Dr Nase and Warren,

Your post was extremely interesting to me Dr Nase. I haven't really mentioned this before but my IPL practitioner agrees wholeheartedly with this notion that you describe about applying too much pressure and as a result pushing the blood backwards.

As a result, he has devised a method of administering PhotoLaser therapy from a distance, applying no gel to the skin or cooling device. He has called his method 'Distant IPL'. He believes that using PhotoLaser energy with a certain frequency applied gently and from a distance stimulates the formation of new, healthy blood vessels while shutting down the abnormal pathological ones. He believes that this method delivers more oxygen and provides better nutritional support to the skin at a cellular level. He believes that this coupled with the immediate anti inflammatory reaction, is the key issue in PhotoLaser therapy.

I never feel any pressure at all although I know that the device is extremely close to my skin and as I said I have not mentioned this 'Distant IPL' because it was something that no one had ever mentioned and I was reticent to bring it up.

All I know is that considering how crippling and devestated my skin was when I first visted Dr Georghy, perhaps that is the reason that I have received such fantastic IPL results.

Anyway, just thought I'd share this with you.

Mermaid.