iPulse IPL

TRAINING COURSE

Acne

MILD TO MODERATE ACTIVE ACNE

• Acne Vulgaris is an inflammatory skin disease which affects the tiny pores that cover face, arms, back and chest and the oil glands attached to them.

• Under normal circumstance, sebum, the oily substance made by the sebaceous glands, travel up the hair follicule and out to the skin’s surface. Acne Vulgaris is caused by an excessive amount of oil producing glands and also due to a bacterium, Propionibacterium Acnes, which causes inflammation in the blocked glands. These three factors seem to work together to produce the red and yellow spots so characteristic of Acne.

• The iPulse can treat mild to moderate inflammatory acne (not Cystic Acne).

ACNE: STIMULATING BODY OWN IMMUNE SYSTEM

• Early inflammatory acne: the pilosebaceous duct is infected by Acnes bacterias. These bacteria spontaneously produce high concentrations of protoporphyrins (PpIX) which are light sensitive . They can absorb the light energy and transfer this energy to surrounding oxygen molecules and to toxic oxygen species (as free radicals). These chemicals can destroy the acne bacteria.

ACNE: STIMULATING BODY OWN IMMUNE SYSTEM

Significant absorption peaks of Pp9 at 508nm, 542nm, 577nm and 635nm to stimulate a beneficial response and ensure delivery of sufficient light to provide optimum effectiveness in stimulating the body’s own immune system response to fight the bacteria.

(deeper penetration than blue light).

Longer wavelengths have also been successful in the treatment of acne, achieving greater penetration depth in the pilosebaceous duct.

ACNE: Stimulating the Bodies Own Immune System

• These are the most important peaks as these longer wavelengths penetrate more deeply into the skin to reach the P.acnes bacteria which clog the sebaceous gland and sebaceous duct

• Note: If Acne Vulgaris is inflamed and sensitive, use a lower fluence. Usually 5-8 treatments are required at 2-3 week intervals to provide relief from mild to moderate inflammatory acne.

COMBINED iPulse+5-ALA TREATMENT OF ACNE VULGARIS

• Many cosmetic physicians now use 20% 5-ALA as a photosensitiser to enhance the effects of IPL treatment of acne vulgaris. DUSA Pharmaceuticals ‘Kerasticks’ and Metvix from Photocure, Norway are ALA products registered for sale now in many countries.

When using ALA in combination with iPulse, one re-treatment (one – two months following the first) should be undertaken if required.

• It should be remembered that ALA cream used in conjunction with IPL has been shown to be really successful in the hands of medical practitioners. The ALA cream is applied and occluded under kitchen cling-film for 45-60 minutes before using the iPulse. However, it is an off-label use of ALA and should only be given under medical supervision.

INFLAMMATORY ACNE VULGARIS

20 yr-old female, skin type III, before and after 2 iPulse treatments only, 16 J/cm2.

Female, 21 yrs, skin type III, before (left), after 1 day (center) and after 5 iPulse treatments only (right), 16 J/cm2.

INFLAMMATORY ACNE VULGARIS

Female, 21 yrs, skin type III, after 5 iPulse treatments only, 16 J/cm2.

INFLAMMATORY ACNE VULGARIS

ACNE TREATMENT

Facial acne: Male, 19 yrs, skin type III, before (left), 24 hrs post treatment (centre) and after 3 iPulse IPL treatments only, 16 J/cm2 showing reduction in inflammation and pustule shrinkage.

ACNE TREATMENT

Acne vulgaris: Male, 20 yrs. Single iPulse treatment, using 12 J/cm2 and cooling gel, no immediate redness post Tx, showing drying-up of condition 2 days after iPulse

treatment.

ACNE TREATMENT

Facial acne before treatment and 6 months after 5 IPL treatments

iPulse: Acne Treatment

iPulse: Acne Treatment

ACNE TREATMENT

Facial acne vulgaris: 26 yrs old female, skin type II, before, 4 months after and 13 months after 1 iPulse treatment with 20% 5-ALA.

ACNE TREATMENT

Facial acne before treatment and 3 months after 1 IPL+PDT treatment

ACNE TREATMENT

ACNE TREATMENT

• The Case Study on the previous photo using ALA was particularly severe so two treatments were needed. The patient suffered one set back a few months before the July 2006 photos were taken owing to use of an aggressive cosmeceutical product. When she stopped using it, most of the condition settled down again – as you can see in the last photo.

• positively treat any infected hair follicles (PFB)

iPulse: Acne TreatmentParameters

• Skin Types 1, 2 & 3: Program 9 @ 10 - 12 J/cm2 (Professional Mode)

• Skins Type 4 & 5: Program 9 or 15 @ 8 - 10 J/cm2 (Professional)

• Skin Type 6: Program 14 @ 7 - 8 J/cm2 (Professional)

• Treatment Protocol: 5 - 6 treatments at 2 week intervals• Intended for the treatment of inflammatory acne, not cystic acne• Mild to moderate redness may develop around the acne lesions

after treatment

ACNE SCARING?

Acne scaring will also respond to IPL treatmentat best improvement will be modest (<25%)

BEFORE AND AFTER 3 T WITH IPL

Managing the Patient

Managing the Patient

• Manage expectations• Always stay within the limitations of the technology• Most patients will require multiple treatments• Screening for suitability is as important as the treatment

itself• Ensure the patient follows the pre- and post-treatment

guidelines• Some drugs can effect the treatment—always survey

prior to starting a course of treatments• Always obtain a signed ‘informed consent’ form• Follow the approved treatment protocol

• Suggested accessories for skin diagnosis and treatment

ACCESSORIES

• Cooling gel• Gloves• Woods Lamp (Optional)

ADVICE

• Explain the technology in details to the patient.• Take a long time for the consultation.• Use professional terms then translate to the patient.• Use gloves, clean towels and antiseptic wipes.• Clean the glass block using antiseptic wipes in front of

the patient.• Use a very clean and professional treatment room for

iPulse.