Burned by IPL....will it heal??

[minibbb]

I have just had my second IPL treatment for what I believe to be KPRF facial redness (as opposed to rosacea)

My first IPL was at 30J using a 560 filter. My second was exactly a month later and at 31J using a 560 filter again. On both ocassions the Dr did a second pass using either a double or triple pulse, im unsure of the energy though.

I noticed the left side of my face was far more painful throughout the treatment, it also swelled up a fair bit more. Later than night i felt raised bumps on the left side of my cheek and blisters appeared!!

I dutifully popped these with a clean needle and treated with Savlon (hopefully the right thing to do!!) but have been left with scabbing as shown in the pictures.

I had the IPL thurs, today is tuesday. Are these likely to heal OK without scarring? Any idea why they were caused, I didnt think the Dr rose the energy levels too high!

Also, how long after IPL can I expect my face to calm down, it seems redder than normal at the moment? At my wits end with this now! The Dr reckons I will be virtually cured of my facial redness after six treatments, had two so far and the results aren't encouraging. Its worth noting that my Dr is a GP, running the aesthetics clinic in addititon to his surgery. The IPL machine is made by Vasculight IIRC. Im considering calling it a day and tracking down a Vbeam practitioner.

Anyway, thoughts on my pictures would be much appreciated!

[TheMediumDog]

Don't worry.

I too experienced blistering from a couple of my IPL treatments. They healed fully, and the skin beneath them was perfectly normal - no scarring or anything.

The time taken to heal obviously depends on the size + depth. One of mine was pretty big (a bit larger than yours) and also in a difficult place where it was constantly disturbed (at the side of my nose - every time I smiled it kind of cracked the scab that had formed). It took 3 weeks to heal. But others I had took a shorter time - like a week and a half.

Obviously, you should try to leave it alone as much as possible. Don't pick at it. Let it scab over. When you wash, try not to disturb the scab that forms. And so on.

As to why it happened on this occasion - I would not get too hung up on the Joules used. I think it has more to do with the technique of the surgeon. My biggest blister, for example, was caused when I had two shots successively in the same place (this was on a different, stronger machine not intended for triple-pass).
Still, I think you have to accept that it is just one of the unavoidable dangers of IPL.

You don't mention how soon this second session was after your first session. This might have an effect, but only if it was very soon after.

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As for the greater pain during the session, and the possibly greater swelling post-treatment (which will go down. Again, don't worry, its not unusual), my feeling would be: there are just going to be some differences in your reaction each time, which have no single simple cause. (Again, though, time between sessions is important).

For me, for example, my blisters came in sessions 3 and 5. And on a couple of occasions, I thought the procedure hurt more. Why? It could be anything - that I had unaccountably been washing my skin just a little bit harder in the week prior; that my skin had caught a bit of sun; that the doctor left slightly less space between individual shots. You know, its all imponderable

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As for IPL v Vbeam, I have no experience. I would say that my improvement from IPL was gradual, and that it was not before about the 3rd or 4th session that the reduction it had made was really appreciable. Is your doctor taking photos to record your progress?

[phlika29]

Medium Dog has given you some good advice, just try to leave them alone and they will heal.

I got a few small blisters the last time I had pdl and they just sort of disappeared after a few days. I didn't pop them (great advice from boyandhisdog) and for future reference I think it would be perhaps better to just leave them be. If they appear to get infected then go to the doctor and ask for Flamazine or something similar.

Dont worry though it should heal just fine.

[pretty_boy]

I personally am against the use of the 560nm filter. I know alot of people who have had the same problem(sounds like your operator is inexperienced) for a start 30joules is not a mild setting especially for your first pass and or treatment. a test patch should have been done first and foremost, I know alot of doctors who use the 590nm instead. it does the same job as the 560nm and more,most doctors regard it as their favourite filter to use.you have to understand that the lower the filter used then the more heat of the ipl is dispersed into your skin,meaning when you use 30joules with a 695filter it is alot safer as the light that penetrates is alot narrower and goes deep witin the skin whereas the shallow filters have alot more risks with burning and blistering as the light is alot closer to the surface of the skin where problems like purpura,blistering and crusting can take place and when this happens you have just wasted your money on that treatment because when the skin gets damaged it immediately produced angioneogenesis(regrowth of blood vessels) because this is how the skin reacts when damaged which is exactly what your trying not to do, so best to use milder settings,the operator should have started around 26joules especially with that filter.

[SP1975]

One thing to remember though is that according to published studies on the effectiveness of ipl for treating subtype 1 rosacea, the 560nm filter is the one that has provided good results. A recently published study I looked at in a journal used the 560nm filter with impressive results, so the 560nm filter actually has real support to back it up. I have been getting treated with the sciton bbl 560nm filter, 12-13J now 4 times, and the base redness appears to be almost nonexistent, my skin looks normal now alot of the time. At this time the 560nm fitler still apears to be the best at treating the persistent redness, and maybe flushing.

[boyandhisdog]

Originally Posted by pretty_boy

I personally am against the use of the 560nm filter. I know alot of people who have had the same problem(sounds like your operator is inexperienced) for a start 30joules is not a mild setting especially for your first pass and or treatment. a test patch should have been done first and foremost, I know alot of doctors who use the 590nm instead. it does the same job as the 560nm and more,most doctors regard it as their favourite filter to use.you have to understand that the lower the filter used then the more heat of the ipl is dispersed into your skin,meaning when you use 30joules with a 695filter it is alot safer as the light that penetrates is alot narrower and goes deep witin the skin whereas the shallow filters have alot more risks with burning and blistering as the light is alot closer to the surface of the skin where problems like purpura,blistering and crusting can take place and when this happens you have just wasted your money on that treatment because when the skin gets damaged it immediately produced angioneogenesis(regrowth of blood vessels) because this is how the skin reacts when damaged which is exactly what your trying not to do, so best to use milder settings,the operator should have started around 26joules especially with that filter.

Pretty-
Hey, sounds like you know quite a bit about IPL so welcome to the forum.
I do have a couple of quick questions for you though.
How can you tell the operator was "inexperienced" when I have read a couple of studies (apparently the same one's that Jess read) that espouse the use of the 560? What is your rationale?
Second, you assert that purpura means you have "wasted your money" because the damage causes angiogenesis. I guess I have trouble with that statement in that I have read and can link studies that show more efficacy with purpuric levels of PDL treatments. I can also attest that from personal use, any treatment that is below the purpuric threshold for me, is completely useless.
I understand the theory that injury creates an envrironment for possible angiogenesis, but it is not absolute and I was under the impression the whole process is still poorly understood.
It is unfortunate the Dr. Crouch thread is closed or we could pose these questions to him, so I am very interested in your take.
Rob

[pretty_boy]

i agree with you on purpuric levels as i have read that if this happens it somehow yields really good results.for me personally i want to be treated with lumenis one as it is alot safer then the quantum that im getting treated with and has alot more efficacy at lower fluence,hence i would rather be safe then sorry and it is my personal belief only that when such sides occur you are risking such alot and as dr soldo mentions milder treatments are the way to go and are alot more effective then harsher treatments that create purpura because harsher treatments are a setback.ive read alot of horror stories where people have ended up coming out worse then before they had ipl and alot of these people were treated with older machines.As with the efficacy of the 560nano-meter and treating rosacea basically is all comes down to what type and how progressive the rosacea has gotten.for me i only have the flushing and erythema but the erythema seems to come and go so for me just because there is a few written articles stating the 560filter is good to treat wit,still isnt enough for me to personally risk that. im sure you have come accross alot of people as i have who have ended up worse with that filter.the 590 still iradicates the superficial vessels just like the 560 yet penetrates deeper.they are articles stating the dangers of using shallow filters with inexperienced operators because of the easyness of severe side effects.the reason i exclaimed the operator must have been inexperienced is because fluence should have been started alot lower it was not worth the risk now that dude is burnt. like i said this is only my own beliefs from what i have studied daily in the last 6months,i hope i answered your questions, if not i tried haha