Laser and IPL Treatments

It is important that these treatments are carried out only on those pigmented blemishes which have a negligible risk of cancerous change and so you should ensure you are either treated by someone who is medically qualified and has the expertise to assess these blemishes, or that you have had an examination by an expert first. I am a Consultant Plastic Surgeon with a special expertise in melanoma and other skin cancers, working in partnership with Dermatologists and Oncologists in a regional centre for these cancers. I will always assess your skin clinically before considering any treatment.

Vascular skin blemishes such as Port Wine Stains; Thread Veins; Telangectasiae; Spider Naevi and Rosacea can be treated with either laser or IPL. I use a state-of-the-art system that allows me to treat you with either modality, and to switch between them as required.

The wavelength of the light used is chosen so as to be absorbed by haemaglobin in the cells within blood vessels travelling in the epidermis and dermis preferentially. Inside a vascular skin blemish, the blood vessels are overgrown or in higher concentrations than surrounding “normal skin”. When these blood vessels absorb the light, they heat up and are destroyed, whilst minimal collateral damage is caused to the surrounding skin. Following successful treatments, the damaged blood vessels are absorbed by the body, and little or no trace of the blemish remains.

Exactly the same principle applies to treatment with a laser. The laser can give a more powerful and selective treatment, but over a smaller surface area each time, and so is not usually my first choice because it will take me longer to achieve a finished result for you, involving you in more expense, time and treatments. I tend to use the laser therefore, on blemishes that are resistant to treatment with IPL or on people with darker skins because it is very gentle on dark skin types, so almost all skin types can be treated with the NdYAG laser.

First the skin being treated is cooled using a jet of refrigerated air. Then for IPL treatments, a thin layer of gel is applied to the skin prior to treatment, which both cools the skin further and optimises transmission of light from the applicator to the skin.
Your first treatment will occur at the end of your consultation, and will consist of several treatment ‘test patches’ which will allow me to assess the response of the blemish to the treatment and to ascertain at which power to treat your blemish subsequently. During treatment you must wear protective eye goggles.

In everyone, the outer layer of the skin, the epidermis, contains melanin which is a very good absorber of light, which is why it is utilised by our bodies as the skin’s natural defence against harmful ultraviolet radiation from the sun. The concentration of melanin in the skin is greater in darker skinned people and increases in light skinned people when the skin is exposed to UV light. The light emitted by the IPL system or Laser is absorbed to a certain extent by melanin in your skin as well as the blood vessels; and the portion of the light that is absorbed by melanin will produce unwanted, incidental heat in the skin. So the more melanin in the skin, the more heat will be produced, which could produce a burn. Therefore, it is not possible to treat very dark-skinned individuals with IPL (although they may be suitable for treatment with a Laser) or patients who have recently gained a sun tan (although they can subsequently be treated once their tan has faded).
If you have any areas of broken skin, treatment will be delayed until the area is healed completely.
Some vessels are not suitable for laser treatment: very large bore blood vessels and varicose veins cannot be treated. Some deep lying or blue veins can be treated, but will usually require more treatments than smaller red veins.

When light energy is absorbed in the skin, it heats it up, and creates a sharp sensation like a hot pinprick. Most patients describe the discomfort as moderate and acceptable. No anaesthesia is required, but to ease the discomfort I use a cold gel for IPL treatment in combination with a refrigerated air jet that you control during your treatment. For Laser treatments, the refrigerated air jet, followed by a cooling gel after treatment usually suffices.

Redness and a slight burning sensation in the skin are normal after treatment. A cooling pack will be applied to the skin to ease these symptoms. You may see a temporary grey colouration in the vessels. Some vessels disappear immediately, so you won’t see them again!

The visible light used in IPL is completely safe so no special precautions are needed apart from wearing protective glasses during treatment.
The skin of some patients becomes quite red immediately after treatment and in rare cases some bruising may be seen. However, most patients experience no side effects and any redness or bruising usually disappears over a period of hours to a few days. Very rarely the natural pigment in the skin may increase or decrease as a result of treatment, and this may be permanent. If you have been exposed to sun a day or so before treatment and have not yet developed a tan, you may still have enough extra melanin in your skin to burn, and then your skin will blister and scab after treatment and this may scar ultimately ‘ so avoidance of the sun and tanning before treatment is vital.

You must avoid the sun, or using either a tanning salon or any fake tan for 6 weeks before, or during the entire treatment period to avoid burns from light absorption in the epidermis.
Also, immediately after the treatment, the skin is particularly sensitive to UV light, and strong sunlight should be avoided for 1-2 weeks.

The length of each treatment will depend on the type and size of lesion present, but a typical session for Rosacea might take 15 – 30 minutes.

The length and number of treatments will depend on the type and size of lesion present, but typically 1-5 treatments will be needed. Treatments should take place approximately every 4 to 6 weeks for IPL and every 6-8 weeks for laser.

In order to remove hair I will use either IPL at a wavelength of 650nM or a long-pulse NdYAG laser depending on how dark your skin is. Both methods are targeting melanin in your hair shaft in order to heat up and kill the hair follicle and neighbouring cells responsible for re-growth of the hair.

The skin will be cooled down prior to treatment, to prevent unwanted heating of the epidermis. The IPL or laser will be placed directly over the skin bearing the unwanted hair and fired. During treatment you must wear protective goggles.

Black hairs are most easily treated due to the large concentration of melanin in these hairs, which gives the most absorption and creates the most heat. Fair hair has less melanin and consequently less heat is produced with less certainty of permanent destruction of the hair follicles. Grey (white) hair has almost no melanin and cannot be treated effectively. The light emitted by Nd:YAG laser is especially gentle to dark skins, which means that it is the laser best suited for the treatment of Afro-Caribbean and the darker Asian skin types.

As the light energy is taken up by melanin, any discomfort depends upon the combined concentration of melanin in the epidermis and the hairs. No anaesthesia is required. Most patients describe the discomfort as moderate and acceptable, and liken it to a rubber band being flicked against the skin.

Hair should be shaved just before, or on the morning of treatment ‘ in many ways, it is easier to leave it for me to do just before treatment as that will allow me to see what needs treating! The guiding principle for successful treatment is that as many hair follicles as possible should contain a hair on the day of treatment in order to be destroyed by the light.

They don’t really, but they do appear to grow. The hairs are not always evaporated by this particular treatment in the way that some other light treatments do. Although the hair follicles are killed by the heat generated during the treatment, the hair shafts may remain in the follicles. They will fall out after 1-3 weeks as the epidermis is renewed. During this period it will seem that the hairs are growing because they are being pushed out of the epidermis.

After treatment the hairs are loose in the follicle and can sometimes be pulled out easily and painlessly with tweezers. A red ring around each follicle is often seen a few minutes after treatment, along with reddening of the skin. These end points indicate that sufficient heating of the follicles has taken place, however they are not always seen. Many patients have successful treatment results without these positive post-treatment signs.

The skin of some patients becomes quite red immediately after treatment. However, most patients experience no side effects and the described skin reactions usually disappear within hours to a few days. Rarely the natural pigment in the skin may increase or decrease as a result of treatment, and this may be permanent. Occasionally the treated skin may form blisters and then scab following treatment. These areas should be left alone to heal naturally. It is important to avoid scratching or picking scabs or blisters as this could result in scarring.

Of all the hairs on your body a variable number (10- 70%) are growing at any one time; the remainder are either resting or are about to fall out. Only hair that is growing when treatment occurs can be killed and removed permanently. Because the number of hairs in the growing phase varies, as does the length of the growth cycle of each hair, you will notice that a significant reduction in hair density occurs after the first treatment, but that not all of the hair in the area treated will have gone. More treatments will be needed to get the hairs that were resting or about to fall out last time. With each successive treatment, a smaller proportion remain and those that do tend to be finer. To achieve satisfactory results, treatment sessions are recommended every 4-6 weeks and the number of sessions needed varies, according to individual factors, but the usual number is 8-10

You must avoid the sun, sun lamps or the use of any fake tan 6 weeks ahead of and during the entire treatment period to avoid discomfort from light absorption in the epidermis and the risk of burns and permanent scarring.
Immediately after the treatment the skin is particularly sensitive to UV light, and strong sunlight should be avoided for 1-2 weeks

A facial treatment usually takes 15 minutes, whereas treating both legs or an entire back takes approximately 2 hours.

Currently-used technology is only a few years old, so we do not know definitively for how long these treatments are effective, but they seem to be lasting years.

For removing tattoos I use a Q switched NdYAG laser which will remove most tattoo pigments effectively except green.

The short answer is that it doesn’t – the laser allows the body to remove the tattoo. Tattoos are made of ink contained in layers throughout the skin. The ink particles are recognised by the body as foreign material, but they are too large for the cells that digest foreign material to tackle, so instead, the body encapsulates the tattoo ink in a collagen protein coating to wall it off. The laser works by breaking down the collagen wall and fragmenting the ink particles till they reach a small enough size for the body’s defence cells to digest and excrete them.

Many variables will determine this and I never make a prediction; I just give you the facts and you can see for yourselves that your individual circumstances may mean a shorter or longer treatment span:

The number of treatments required to remove a tattoo will depend on:

Generally you can expect a gradual fading after each treatment as the body digests the shattered ink particles at its own speed until, after enough treatments, no ink remains. It is not possible to assess exactly the depth and density of a tattoo prior to treatment and therefore any estimate of the number of treatments required will always only be an educated guess.

The treatment of colours other than blue and black can be difficult. The colour that is hardest to treat is green and I do not have a laser that will treat green ink.
Certain new types of fluorescent tattoos do not respond to laser treatment and will be left behind after the rest of the tattoo is removed and this is not predictable before we start treatment! Moreover, some modern pigments may change colour after treatment and again, this is impossible to predict. But as a rule of thumb, if a tattoo is particularly dense or brightly coloured it is likely that some pigment will remain after the course of treatment is complete.

Tattoo removal is a medical process relying in part on your body’s cellular defence mechanisms, so it is essential that you advise me of all relevant information regarding both your tattoo and any other medical conditions from which you suffer.

During the healing process, the treated area might feel itchy, but you must resist scratching because it may lead to infection and scarring of the treated area.

The normal interval between treatments is 8 weeks to allow sufficient time for the skin to heal and the treatment to be most effective.

I recommend that you use a moisturising cream on the treated area between treatments.

Suitable eye protection is essential so that your eyes are kept safe from the laser.

The possibility of scarring is increased in areas where the tattoo ink is particularly dense. There is a risk that the natural pigment in the skin may increase or decrease as a result of treatment, and this may be permanent, but equally, increased or decreased pigmentation may resolve after six months but cannot be guaranteed and sometimes a “ghost” of your tattoo may remain on the skin, because the skin where the tattoo once was remains paler than the skin surrounding it.

IPL of a suitable wavelength for absorption by the melanin contained within freckles and sun (also called liver) spots, can be used to decrease or remove these skin blemishes. IPL uses heat energy to damage the blemishes whilst causing minimal damage to the surrounding skin. Following treatment, the damaged lesions turn darker first, and may crust, and then over a period of weeks they will gradually flake away from the skin leaving little trace of the original mark.

A thin layer of gel is applied to the skin being treated after first cooling it with a stream of refrigerated air. This helps to cool the skin, as well as ensuring optimal transmission of light from the applicator to the skin.
Your first treatment will occur at the end of your consultation, and will consist of several treatment “test patches” which will allow me to assess the response of the blemish to the treatment and to ascertain at which power to treat your blemish subsequently. During treatment you must wear protective eye goggles.

Almost everyone can be treated, apart from very dark skinned or tanned individuals.

Not all pigmented lesions can be treated. Large, dark moles should not be treated, nor should lesions covering a large part of the body. The pigmented marks that respond the best are superficial lesions such as those caused by sun damage (sun spots) and freckles.

It is important that these treatments are carried out only on pigmented blemishes which have a negligible risk of cancerous change and so you should ensure that you are either treated by someone who is medically qualified and has the expertise to assess these blemishes, or that you have had an examination by an expert first. I am a Consultant Plastic Surgeon with a special expertise in melanoma and other skin cancers, working in partnership with Dermatologists and Oncologists in a regional centre for these cancers. I will always assess your skin clinically before considering any treatment.

As the light energy is absorbed in the skin, it heats it up, and creates a sharp sensation like a hot pinprick. Most patients describe the discomfort as moderate and acceptable. No anaesthesia is required, but to ease the discomfort I use a cold gel for IPL treatment in combination with a refrigerated air jet that you control during your treatment.

Redness and a slight burning sensation are normal after treatment. A cooling pack will be applied to the skin to ease these symptoms. The lesions will darken after treatment and may appear more obvious at first, but gradually the marks will flake away. However, if you expose yourself to sunlight you may get a recurrence of the original mark, so you should always wear a sunscreen with a SPF of 15 or higher.

The visible light used in IPL is completely safe so no special precautions are needed apart from wearing protective glasses during treatment.
The skin of some patients becomes quite red immediately after treatment and in rare cases some bruising may be seen. However, most patients experience no side effects and any redness or bruising usually disappears over a period of hours to a few days. Very rarely the natural pigment in the skin may increase or decrease as a result of treatment, and this may be permanent. If you have been exposed to sun, a day or so before treatment and have not yet developed a tan, you may still have enough extra melanin in your skin to burn, and then your skin will blister and scab after treatment and this may scar ultimately ‘ so avoidance of the sun and tanning before treatment is vital.

You must avoid the sun, or using either a tanning salon or any fake tan for 6 weeks before or during the entire treatment period to avoid burns from light absorption in the epidermis.

Also, immediately after the treatment, the skin is particularly sensitive to UV light, and strong sunlight should be avoided for 1-2 weeks.

The length of each treatment will depend on the type and size of lesion present, but a typical session for Rosacea might take 15 – 30 minutes.

The length and number of treatments will depend on the type and size of lesion present, but typically 1-5 treatments will be needed. Treatments should take place approximately every 4 – 6 weeks.

IPL treats acne using yellow, green and red light. The yellow light destroys the bacteria that live in the skin and cause acne, while the red light targets the overactive sebaceous glands directly so lessening outbreaks of pustules.

A thin layer of gel is applied to the skin being treated after first cooling it with a stream of refrigerated air. This helps to cool the skin, as well as ensuring optimal transmission of light from the applicator to the skin.
Your first treatment will occur at the end of your consultation, and will consist of several treatment “test patches” which will allow me to assess the response of the blemish to the treatment and to ascertain at which power to treat your blemish subsequently. During treatment you must wear protective eye goggles.

Almost everyone can be treated, apart from very dark skinned or tanned individuals.
People with mild to severe acne should see an improvement.
Pregnant women or people taking the acne treatment Roaccutane should not be treated.

As the light energy is absorbed in the skin, it heats it up, and creates a sharp sensation like a hot pinprick. Most patients describe the discomfort as moderate and acceptable. No anaesthesia is required, but to ease the discomfort I use a cold gel for IPL treatment in combination with a refrigerated air jet that you control during your treatment.

Redness and a slight burning sensation are normal after treatment ‘ this generally dies down within 30 minutes, but some people remain red for up to 24 hours. A cooling pack will be applied to the skin to ease these symptoms. The lesions will darken after treatment and may appear more obvious at first, but gradually the marks will flake away. However, you should avoid sun exposure and wear a sunscreen with a SPF of 15 or higher for 2 weeks after treatment.

The visible light used in IPL is completely safe so no special precautions are needed apart from wearing protective glasses during treatment.
The skin of some patients becomes quite red immediately after treatment and in rare cases some bruising may be seen. However, most patients experience no side effects and any redness or bruising usually disappears over a period of hours to a few days. Very rarely the natural pigment in the skin may increase or decrease as a result of treatment, and this may be permanent. If you have been exposed to sun a day or so before treatment and have not yet developed a tan, you may still have enough extra melanin in your skin to burn, and then your skin will blister and scab after treatment and this may scar ultimately ‘ so avoidance of the sun and tanning before treatment is vital.
It is possible that some hair loss will occur, and it could be permanent, so men should consider this possibility before agreeing to treatment of their beard area.
There are some positive side effects as well as acne reduction, many people find that their skin texture and tone improve dramatically.

You must avoid the sun, or using either a tanning salon or any fake tan for 6 weeks before or during the entire treatment period to avoid burns from light absorption in the epidermis.
Also, immediately after the treatment, the skin is particularly sensitive to UV light, and strong sunlight should be avoided for 2-3 weeks.

A typical treatment session will last 15 – 45 minutes

The number of treatments necessary varies from person to person, but typically 1-5 treatments will be needed to get a lasting result, and each treatment should have an interval between it and the next of 2 – 4 weeks.