Possible unwanted effects of IPL

[Mistica]

Has anyone come across any literature on the possible long term effects of IPL?

I just found the attached article, which many of you might have already read.
It holds interest for me, due to the texture/tissue damage I have got due to IPL.
I have noted a few others who have been left with similar problems, but after only one or two treatments.

I consulted a plastic surgeon and he told me that IPL is a relatively new technology and while initial effects are beneficial, and a God send for Rosacea patients, in reality, no one knows what the long term effects might be.
He looked at the damaged areas of my skin and his comments were that it appeared that the sebaceous glands might be damaged, as the skin was chronically dry with crinkled/orange peel texture. One area was slightly depressed. I remember the term 'rete pegs' were also mentioned.
In addition, he felt I had undergone more IPL treatments than anyone else in history and perhaps this is an indication of what might happen with long term use? Currently there is scant medical literature on it.

He also suggested that my IPL doctor over treated me in those areas? ( which I am sure he did).
Or, some of the treatments were too close together?
Or, all of the above?

It is a huge concern for me though, as since consulting that plastic surgeon, I have gone on to develop damage on my nose.
My rosacea has become so severe though, I have to do something to get relief. Every time I get an improvement and get excited, it all sails downhill again.
I am sure there are many others in this position.

Anyway, here is the article.

http://dermatology.jwatch.org/cgi/co...ull/2007/413/1

I would be very interested to know if anyone else has heard anything about this.

[snuffleupagus]

How many IPLs did you have?

[alyfpet]

Yuck, that was no fun reading. A bit scary that the study was conducted using 9 J and they still found these effects. I know my last IPL was 30 J.

I too have had bad results from IPL. I only had two, but my face and skin has not been the same since. It woresened my redness significantly, making it permanent, and caused edema that has yet to resolve after 4 months. I had 2 vbeams since then to try to bring some of the swelling down and correct the redness. I think the first one helped a bit but another derm has since diagnosed me with dermatits to explain the constant redness, so now I'm on long-term antibiotics. I had none of these issues until I had my IPL. I only had minor redness that would come and go under my nose and occasional flushing.

I guess IPL is not for everyone, that's for sure. Alyssa

[Mistica]

EK1,

Since October 2000 I have probably had over 100 IPL's. Many of which I shouldn't have had to have.
I was always going to need more than the average amount as my condition was severe. However, due to many medical mistakes, such as two treatments which caused 'burns' ( terrible grazing), I ended up having to have lots.
Additionally, I have melasma, which was very bad initially and you can't therapeutically treat rosacea while melasma is dark. It results in burns. We had to keep the rosacea at bay, while fading the melasma with topical drugs. Rosacea causes inflammation and inflammation causes more melasma.

My treatments were done in batches over a period of 2 years. All was wonderful after that. No sign of rosacea at all. My results far exceeded those of everyone, doctor included.
When I had touch ups, it should have been a quick job. Which it was in some ways, but, at that point I had been on the same oral antibiotics for 4 years and they started to cause problems. Lots of outbreaks. Each time this happened, I would develop more and more redness, which my doctor tried to treat with IPL. Outbreaks causes more pigment too, which in turn makes it difficult to treat with IPL.
He wouldn't change the antibiotics though and stupidly, I didn't pursue this until much, much later. If I had done so immediately, I would have been put in remission quickly and carried on with my life. ( If only I could turn back time
Instead of this though, I followed the advice I was given and ended up having numerous IPL treatments which weren't really affective due to the damage done by the bad outbreaks. The outer cheeks were the problem. It was a vicious cycle.

I didn't have the full face treated each time. Mostly it was the outer cheeks alone, or outer, inner and nose.
I should have insisted the doctor didn't treat the inner cheeks and nose, as they had long ceased to be a problem, but he just didn't seem to think about possible consequences.
Those being, it is possible to become resistant to some or all forms of IPL. And of course, texture damage.
IPL is touted as being good for collagen stimulation, so in all fairness, perhaps doctors don't consider the opposite can happen if a patient is exposed to too much IPL? After all, there is little literature on it at the current time and when random cases occur, most doctors are quick to stamp out the suggestion that IPL might not be as safe as they advertise.
Having said that, I feel my doctor should have only treated the areas which needed it. Then I might not have become resistant and in the mess I am.

Now, my inner cheeks and nose are my worse areas. Last week I thought all was finally settling, but suddenly, all has deteriorated terribly again. Worse than I have been in 6 weeks. I could cry.

Instead of the vasculight IPL helping me now, mostly it causes severe redness and flushing. It is thought I have become resistant due to numerous treatements. My only hope is to try the Lumenis One, as I have mentioned in other posts, but there are negatives in that option. Travel for one. I have my doubts about it working anyway.

I must note here, that all my treatments have been with ONE pass only, which extends treatment time. Now-a-days the norm seems to be a triple pass. So to put my regime in perspective, it is necessary to divide the total by three.

Apart from being a place to vent and gain general tips of advice, this forum serves to make us as educated as possible.
I wish all this hadn't happened to me, as it has ruined my life, but I hope that by sharing my experiences, others can avoid the same pitfalls.

[snuffleupagus]

What antibiotics were you on while doing IPL treatments? Because from what i know, you're not supposed to be on any because of the possible damage it can cause. I wonder if this is what happened in your case? Every time i have an IPL session i have to stop my doxy for two weeks before.

[Mistica]

Hi,

Initially I was taking Erythromycin and since Xmas, I have been taking Clarithromycin. Both are macrolides.
I had an allergic reaction to Vibramycin, which caused pretty dramatic facial swelling, so I have been told I need to avoid all tetracyclines.
I am not 100% certain, but I have always been of the thought that it is the tetracyclines which cause sun sensitivity. ( Among other things).

For the past few months I have been trying Rosex, which is also known as Metrogel overseas.
That is metronizodole.
I know oral metronizodole makes the body photo sensitive, but I read that topical doesn't. I don't understand this.
Does anyone know if it is advisible to stop the topical prior to having IPL?

[alyfpet]

Hi Mistika. I'm so sorry you have had this experience. Besides the texture damage, is your rosacea under control at the present time? How long have you experienced the texture damage? Skin has a remarkable ability to heal itself, so don't lose hope! I'll be thinking of you and sending you well wishes! Alyssa

[Bradley]

Mistica could you explain in as much detail as possible what you mean by "texture/tissue damage". Does your skin have any indents, unevenness or depressions to it (apart from what you have already stated)? Have the pores become enlarged as a result of the IPL as well? And how does the damaged areas of the skin feel when you compare it to the tactility of normal parts, is there a big difference?

Originally Posted by Journal Watch Dermatology April 13, 2007

The implication of this study is that IPL treatment may not be without consequences. Although IPL irradiation did not affect thymine dimer production because the light source does not emit in the UV range, it did produce considerable amounts of lipid peroxides, an indicator of oxidative stress. Oxidative stress has been associated with a number of deleterious effects; beyond premature aging of the skin, it has been shown to promote skin cancer in experimental animal models.

Although these molecular studies do not necessarily mean that long-term adverse effects will ensue, the results point to our ignorance of IPL’s lasting effects. Many highly effective therapies have had adverse effects that were not fully identified until years after regulatory approval. Until IPL has been in active use for a while longer, continuing follow-up of patients remains important.

I think we should be giving this study as much attention and analysis as possible since this is highly concerning, especially for the many IPL users on here. Premature ageing AND skin cancer to name a few of the potential side-effects; this should be more than enough to encourage more research into this area. I don't want to find out that I have spent huge amounts of money on IPL for it to 'cure' my rosacea and replace it with skin cancer.

Thank you Mistica for posting this study. It would be great to also get the thoughts of Dr. Crouch, Dr. Pascoe and other doctors if possible.

[phlika29]

Someone may then want to post this article and question in the 'Ask the Doctor' section on the RSC:

http://rosacea-support.org/community...da88c16f67bae0

[Mistica]

Hi,

I can't take a photo, as my face is so damn red, and yet again, swollen in many areas, that it disguises the 'texture' problems I have developed. ( To a degree).

I do have a couple of photos, taken with makeup, which show a difference in texture across a large strip of skin. Maybe that might be slightly helpful.

I had thought I would draw the areas and add explanations, then scan them. However, I have no idea how to post the drawn image. If someone has the knowledge to do that and would be prepared to do it for me, then, perhaps that is the way to go?

Just a note, I have tried to discuss these problems with both Dr Crouch and Dr Soldo.
Regarding Dr Crouch, we had a long phone chat back in October, when my rosacea was deteriorating, but not quite at the arrival of my huge flare, from which I have never recovered. At that time, I explained to him about the 'texture' damage on my left cheek. He did not offer a strong opinion, as I don't think he had encountered anything quite like it before. I was using the Environ topical A cream at the time, to try and improve the appearance of the skin and he said that might help, but the 1064 laser, would probably help more. (there were also other reasons he recommended that laser). In addition he felt that some of my treatments were far too close together and that was likely part of the problem. I agreed with that.
Also, I have had so many, which shouldn't have been necessary.

Recently I emailed Dr Soldo regarding my full blown rosacea and my despair at becoming 'resistant' to IPL. At that time I had developed further damage to my nose. I had expressed my desire to have a phone chat with him, as I felt it was difficult to gain a full understanding in an email. I worried that important issues would be brushed over.
My fears were valid. I don't really think Dr Soldo fully appreciated my problem and thus suggested a course of PDT would help texture problems.
I took that to mean, less than perfect texture due to sun damage etc, which wasn't my problem.
Many will no doubt remember his response in the question and answer session, when the damage problem cropped up. He said he had never encountered it before.
I believe him.
However, I believe it does happen in other practices, but it is covered up.

Earlier in the year, I was in communication with another woman who had suffered far more damage than me.
She had depressions in her skin, in the shape of the crystal. Like me, she had previously undergone IPL treatments with no ill effects. In her case, about 5 to 8 sessions. Her rosacea symptoms had been greatly alleviated and she was very happy. After an additional treatment she developed depressions and also the orange peel effect that I also have.

I advised her to email Dr Crouch and ask for advice. She did and he called her. From memory I think he suggested the fluence might have been too high, although like me, there was no obvious signs of burning. He felt she could safely have additional IPL treatments to treat her rosacea, as long as the fluence was less. Meanwhile, I believe he suggested some other kind of laser treatment to try and improve the depressions.
I lost contact with the woman in question after this, so I don't know what happened to her.

I have found several accounts of similar problems on the internet. I am going to try and track them down again.

I have been examined by a plastic surgeon, who noted the problems, but said he had never encountered it before. And I have been examined recently by the chap who performed one Lumenis One treatment on me in May. He wasn't a doctor, although he did have a medical/science degree of some kind.
He had 7 or 8 years experience and had used various machines.
His thoughts were, that it was a very curious problem due to various technical reasons. Something about IPL not being thought capable of causing structural damage below the surface, while leaving the surface intact.
He said he had heard of a couple of cases, but I was the first one he had actually seen.
Intially he thought I had received IPL coupled with radio frequency, as that is known to cause such problems, but no, I have never had that and would never do so.
He felt that the way IPL worked and the consequences it might have, needs to be re-examined.

********************
My left cheek. An area of it, starting from hair line:
Texture/appearance of skin resembles orange peel. Amid this area, is crinkly, crepe paper type skin. Some of the latter has been alleviated to a degree, by use of topical retinyl palmitate 2000IU.
I have an area of pigmentation, which had lots of visible capillaries through it. The doctor over treated this in an effect to get the capillaries. This caused a slight grazing and left a very slight depression, but not in the full shape of the crystal. In addition, it looks as if someone got a pointed object and etched a moat out around the pigmented area and through it.
The whole area is leathery and has far less elasticity. Also, there seems to be very little oil production any more. This was another thing noted by the Lumenis One chap. I used to have really oily skin. Now it is much less and in that damaged area, it seems to be almost non existent.

We all know that IPL is said to shrink pores and make skin less oily. Perhaps there is a point where this lessening of oil becomes too much and thus detrimental to the health of the skin?
I don't know. Just trying to make educated guesses.
Of course, that doesn't explain other types of damage.

My nose:
I started to get slight indentations on the sides, where the bulb of the nose meets the straighter part.
Then, after a double pass on the top of the nose, it developed a finger print size area, of orange peel texture, and in the middle of that, a bit of crinkly skin. When this area is pressed, it doesn't have the resistance under it, that healthy areas of the nose have. It is really difficult to explain as you can see, hence my thoughts, that a drawn image would be much more helpful.

On my right cheek. The doctor didn't adjust the energy and did a shot which was far too high. I didn't burn, but developed a large welt. When they deflated, I was left with a small, triangular area of skin with the orange peel texture and loss of elasticity. This area is minor, and doesn't bother me too much. Not like the nose does.
The worry is, will it deteriorate further?
And, how the hell do I get my severe rosacea under control again?

Anyway, if someone is willing to post a drawn image by me, I would be happy to do that. I feel it would be far more revealing than my rambling attempts to explain the problem.