The IPL photo facial: more pain than gain?
It's the must-have anti-ageing treatment for the Hollywood A-list. At 37, Charlotte Cripps couldn't wait to try it. But less than an hour later, she was covered in burns. Here, she recounts a cautionary tale
Tuesday 25 November 2008
I'm lying in a dimly lit room while a woman wearing a white coat puts her goggles on. She is ready to come at me with a little flash lamp, which will release pulsed light into my face, via a small hand-piece, that is placed against my skin. I'm not sure quite what to expect, although it's not exactly painful, I'm told – a bit like an elastic band lightly snapping on your cheek.
I'd heard about Intense Pulsed Light (IPL) photo facial treatments from friends in Los Angeles who swear by them for a permanently fresh and youthful complexion – as do models and A-listers. If you've ever wondered why celebrity women of a certain age have such uncannily baby-smooth skin, wonder no more. Along with the other latest treatments such as Fraxel laser, this is a fast and effective way of removing the visible ravages of time without surgery.
Apparently, it will relieve my skin of sun damage, rejuvenate my skin by boosting collagen production, reverse the signs of ageing and give me a youthful glow, as well as removing fine lines.
I was amazed when I saw the change in one friend who'd had a course of IPL. Years had been knocked off her face. Without hesitation, I booked my first IPL treatment at a top London spa.
At the age of 37, my skin had become grey and dull and lacked that youthful glow that I had always taken for granted. I used sun beds a lot in my teens and continued to sunbathe at any opportunity. As a result, I had slight patches of brown pigmentation on my forehead, where I had forgotten to cover my face evenly with sun cream and my skin now looked tired and lifeless. I dreaded the day I'd wake up with leathery crocodile skin and wished I'd taken sun protection more seriously.
As I lay there, I felt as if I was in safe hands because the spa was at the top end of the market. I asked the therapist to treat my neck, chest and hands, as well as my face, as these areas are often exposed to the sun the most. After cooling gel was applied, I felt the first zap of the IPL on my face.
What exactly is IPL and how does it work? IPL is an intense, pulsed low-fluence (or density) light used in a non-abrasive way to rejuvenate the skin. During treatment that takes about 30 minutes, light pulses are directed evenly over the skin. The light passes through the epidermis and penetrates deeper into the dermis where the pulsed light energy stimulates cells called fibroblasts to produce fresh collagen. Over several treatments, this new collagen smooths and softens the appearance of wrinkles, pores and textural irregularities. It also treats sun-damaged skin with pigmentation abnormalities, spider veins and rosacea, which absorb the light and are damaged until they fade from view.
The technician told me she would use a strong setting to get better results. As she passed the handpiece across my face the feeling grew hotter and hotter. By the time the device reached my neck, I could barely imagine continuing with the burning sensation. When she started on my chest the pain was intolerable and I had to ask her to stop repeatedly before continuing with what felt like torture. I'd thought of "no pain, no gain" and I soldiered on.
I got dressed, with a burning hot chest and a face that looked as if I'd been pulled out of a forest fire.
I was scheduled to return in two weeks for the next IPL treatment, in a course of six that costs £1,200. I went to a make-up shop and was dusted with a mineral powder, suggested by the spa, to camouflage the redness of my face.
A woman at the same counter asked me what the hell I'd had done. When I proudly informed her I'd had an IPL photo facial – she looked at me with total horror. "I don't mean to worry you, but I've had a course and it never looked like that." I largely shrugged off her words of warning. Why would I question the skill of a technician at the high end of the market? It's not as if I'd taken a chance and visited a high-street beauty parlour.
When I got home and looked in the mirror at my chest for the first time since the treatment - only an hour later – I was horrified. Angry red rectangular burns covered my chest in a random grid. Little did I know when I'd set off that morning that I would return after my first exciting treatment scorched and traumatised. What made no sense to me was that the treatment had not been done uniformly which was more obvious on my chest where I looked like I'd been branded with a hot iron.
The next day, on the advice of a friend, I called a top dermatologist – Dr Nick Lowe – known as the god of dermatology. He is also the man the rich and famous depend on when they need to be fixed, without resorting to the knife.
Dr Lowe saw me as a medical emergency the following morning. He works at the Cranley Clinic, off Harley Street, London, has a private practice in Santa Monica, California, and is clinical professor of dermatology at the UCLA School of Medicine, Los Angeles. He has his own skin care range and is the author of many books, including, most recently, The Wrinkle Revolution.
He was horrified by what he saw and concerned that no doctor was present at the IPL treatment – but it didn't surprise him. Along with other doctors, he is lobbying to get these types of treatments regulated in the UK. He believes treatments including Botox, line fillers, laser and light should only be conducted by doctors or administered under a doctor's supervision.
"The UK is one of the few countries in Europe that does not have sound legislation. It is much more regulated in France, Spain and Italy where only trained doctors can administer these treatments. The UK has failed totally to protect the public in this arena," says Dr Lowe.
This week, the Chartered Institute of Environmental Health warned that many treatments, including anti-ageing procedures, waxing and body piercing, are not carried out properly and called for more regulation to protect the public.
Dr Lowe tells me that I shouldn't have had IPL on my chest because I had a tan. He asks me whether the therapist had performed a patch test in this area – which she hadn't. He confirmed that no area, including the face, had been done uniformly and that too high an energy setting had been used on my chest and I was burnt.
"What you got was very irregular areas of burn from the pulse light. It looks as if large areas have been skipped. If these areas hadn't been missed, then certainly the pulse light needs checking because it's putting out huge amounts of variable energy," says Dr Lowe. "I see reactions like this quite often, but more commonly when people have been to a beauty parlour to have IPL or laser treatments for hair removal."
The first priority was to reduce the redness on the burn areas to minimise skin damage. By this point I had blistering, too, and although the redness would fade over the next few months, Dr Lowe couldn't say whether the damage was permanent. I was prescribed hydrocortisone cream for the chest and neck wounds and was told to keep the whole area covered and out of the sun.
All in all, I felt naive as I was confronted with the prospect of permanent skin damage – but luckily Dr Lowe agreed to finish the course of IPL on my face, as the skin texture was left uneven where parts had been skipped. He said he thought I had never needed to have the other areas treated in the first place.
I had four treatments at three-week intervals, costing £1,600 – while Dr Lowe also treated my chest with Airol cream (retin-A) which has the active ingredient tretinoin which reduces pigmentation. In addition, I was given Dr Lowe's Cell Renew Dermabrasion Peel as well as his Brightening Radiance Cream, which he said would help blend the colour changes. Over the next month the red patches faded to light pink.
Recalling the pain of my last treatment, I braced myself for the IPL as I lay down, with a pipe of freezing air in my hand, that I could direct to the treated areas. After the first zap by Dr Lowe, I relaxed as the sensation was, indeed, nothing more than a mild snap of an elastic band. When I left, my face was a little red but I didn't need any make-up.
The second IPL was a bit stronger, but still nothing like before in terms of pain. Dr Lowe even went right under my eyes and double pulsed over certain areas, especially spider veins. "Double/triple pulsing is better than overdoing it in one go," he says. The targeted spider veins on my cheeks and around my nose have now disappeared. "The yellow part of the light spectrum in the IPL is absorbed by the red in the spider veins. It heats and damages the spider veins in a controlled way and narrows them down. It must be done at the right energy otherwise it leaves a general injury as you had on your chest."
There was no downtime and within two days of each IPL treatment – even after the first one – my skin glowed. After the third IPL treatment, friends and acquaintances who had no idea I'd been having treatments commented on the fact that I looked younger and more radiant.
The only problem now is that I have been left with tiny white spots across my chest, caused by a loss of pigmentation after my chest was burnt.
And while the original spa couldn't explain the damage I had suffered and said it was not a common reaction at all, this was no consolation. It pointed out that I had signed a consent form, which had warned me against adverse reactions. I was left angry at the lack of regulation of these treatments in the UK.
Dr Lowe suggested using micro-dermabrasion and beta peels, as well as the creams, to deal with the patchy colour of my chest. "But if the white spots where the skin is not re-pigmenting have not gone in two months, the damage may be permanent," he says.
The good news is that my youthful and smooth looking skin can last several years. "Just as long as you use a daily protective cream that contains an SPF 15 with a UVA protection, even on cloudy days, and a sunblock and a sun hat if you sunbathe," says Dr Lowe.
To learn more about Dr Nick Lowe, his range and his skincare guidance visit www.drnicklowe.com
Cosmetic skin treatments: Dr Lowe's advice
* A growing number of non-physicians give cosmetic advice and treatment, creating a potential minefield of insufficiently expert practice. Some of the technicians have only been trained by the companies that sell the equipment.
* Intense Pulsed Light (IPL) and laser treatments, including hair removal, should only be done or directly supervised by dermatologists, GPs and plastic surgeons, who have undertaken additional training in these cosmetic procedures.
* Make sure you are examined by the doctor in one of those specialties on the day you start the IPL photo facial treatment.
* A medical aesthetician with full training in lasers and light treatments should only administer treatments under the supervision of a doctor. They do not have sufficient training in skin disease and dermatology and should consult the doctor about laser/IPL energy levels for a patient.
* Always ask for a test patch to be carried out first.
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