The power of light is infinite. From targeting wrinkles, fine lines and scars to improving skin complexion and hyperpigmentation, lightbased therapies can treat a wide range of facial ageing concerns.
The healing power of light has been recognised and used for thousands of years, dating back to the Ancient Greeks and Romans. Over the millennia, our understanding and use of light-based therapies have continually evolved to optimise results, reduce downtime and treat a wide range of skin conditions and ageing concerns.
For cosmetic indications, light-based treatments can be broadly categorised as intense pulsed light (IPL) therapy, light-emitting diode (LED) therapy, photodynamic therapy and laser therapies.
Today’s light-based technologies can significantly diminish and even reverse many of the tell-tale signs of ageing – from early lines, uneven pigmentation and broken capillaries to deep wrinkles and severe sun damage.
They can reach much deeper levels and affect far more significant changes than would be possible with most other cosmetic treatments, and without needing to invest significant money.
Moreover, a procedure can often be performed in less than an hour and may require little or no downtime.
There is a dizzying array of choice – and much potential confusion for the consumer.
It’s always best, therefore, to seek the advice of a doctor or clinician who is fully qualified and experienced in using laser and light devices and who will be able to advise which treatment is best for different concerns.
While lasers may sound like magic wands, it is important to have realistic expectations. Some skin tightening is possible, but lasers cannot produce the same degree of lifting seen after a surgical facelift or eyelid lift. Wrinkles caused by constant muscle movement such as frown lines can be hard to treat with lasers alone; anti-wrinkle injections may be used in conjunction.
Laser skin rejuvenation cannot stop the skin from continuing to age; crow’s feet may reappear and new age spots can develop. Lasers and other light therapies have fewer side effects than more traditional skin resurfacing procedures such as chemical peeling and dermabrasion, but there are still risks. The most common is unwanted temporary darkening or lightening of the treated skin (hypo or hyper-pigmentation). There also is a relatively small risk of scarring.
As with any procedure, the success of treatment is highly dependent on the skill level and knowledge of the person performing it, so it is important to ‘do your homework’ before choosing a laser practitioner.
Intense pulsed light therapy
Intense pulsed light (IPL) in cosmetic therapy uses light wavelengths that safely target either melanin or haemoglobin in the skin. It can be used to permanently reduce unwanted hair growth, fade brown spots and cauterise enlarged or broken capillaries and port wine stain birthmarks. Some treatments have been developed specifically to treat rosacea.the lower abdomen, which can be hidden within the bikini line, and minimised with various scar therapies.
Unlike lasers, IPL devices produce a broad spectrum of light in a range of wavelengths. The emitted light is further adjustable through the use of filters, allowing any skin colour to be treated. The range of light is typically between 500- 1500nm, depending on the machine and filter used. This versatility allows the characteristics of the light energy to be adjusted according to each patient’s skin type, specific condition and location of the area to be treated.
Another difference is in the size of the area that can be treated in one session. Generally IPL treatment heads are up to eight times larger than the small spot size produced by lasers, so treatments are quicker but not as targeted as laser.
In terms of safety, the two types are similar, but with both IPL and laser facial rejuvenation treatments the practitioner and patient each need to use eye protection, and treatment needs to occur in a controlled area where people cannot wander in and be exposed to the light.
While lasers and IPL treat many of the same conditions, IPL is a single technology for a multitude of applications – from unsightly veins and birthmarks to ageing and sundamaged skin, unwanted hair and rosacea.
During the procedure pulses of intense light are red at the skin through varying filters which isolate specific wavelengths of light. Various targets (such as haemoglobin in the blood to remove vascular lesions, or melanin to treat hyperpigmentation) are preferentially absorbed, heated and selectively destroyed by certain light wavelengths (called selective photothermolysis) without damaging surrounding tissues.
IPL treatment cannot typically address extensive sun damage and skin discolourations but it can reduce surfaced capillaries and brown spots, as well as help revitalise and even out the overall complexion. Typically four to six treatments are required for optimal results.
The usual downtime with IPL modalities is minimal to none, depending on the intensity of treatment, however full recovery can take around two weeks in some cases. Immediately after IPL a slight burning sensation can occur for a few hours but there is generally little discomfort. Temporary discolouration can occur for around three to four days after the procedure and this skin will flake off slowly. Short-term side effects include reddening of the skin (erythema), temporary bruising and oedema (swelling). Reactions such as scabbing and blistering are possible, though rare. It’s important to protect skin from UV light with daily sunscreen application.
LED therapy
Treatment with light emitting diodes (LED) delivers light at certain wavelengths to stimulate cellular activity and collagen production in the dermis. This delivers an antiageing, rejuvenating effect, and LED treatment is often recommended before and after surgery, as well as a standalone skin revitalisation treatment.
It uses different wavelengths to increase blood ow to the skin, accelerate cellular turnover and address specific concerns such as acne or pigmentation.
LED therapy is a shallower, gentler treatment than IPL, and is often used for collagen boosting and rejuvenating the skin.
LEDs are very small light bulbs that, in contrast to ordinary incandescent bulbs, don’t get especially hot and don’t burn out. LEDs have been found to trigger natural chemical processes inside the cells, boosting the body’s own production of collagen, which make them particularly useful for skin rejuvenation.
During treatment, certain light wavelengths are used to cause different reactions in the skin. Infrared light deeply penetrates the dermis and stimulates blood ow and collagen rebuilding in the skin’s deeper layers. Blue light, which is a shorter wavelength, doesn’t penetrate as deeply and is used for its anti-microbial effect, inhibiting the growth of acne-causing bacteria.
Photodynamic therapy (PDT)
Photodynamic therapy uses a chemical reaction activated by light energy to selectively destroy specific tissues and can be used to treat sunspots, certain types of skin cancer, rosacea, acne and sun-damaged skin.
A photosensitising medication is applied topically on the skin and a narrow band of light (red or blue light) is administered to cause a moderately deep exfoliation and target damaged tissue and sebaceous glands.
When skin is exposed to a light source of an appropriate wavelength, its photosensitiser molecules are activated to produce oxygen intermediates that destroy the targeted cells. Recovery time is around two weeks after each treatment and usually one to three sessions are required.
Laser therapy
Laser is an acronym for Light Amplification for the Stimulated Emission of Radiation. Laser light is different to normal light for many reasons: it travels in a synchronised fashion; retains its intensity over a long distance; is monochromatic (of the same wavelength or colour) and can be pulsed.
Laser therapies work by targeting tissue and can be used for a number of treatments, including pigmentation, scarring, unwanted hair, spider veins, sun-damaged skin, wrinkle reduction and overall complexion rejuvenation.
The principle behind lasers is light absorption. The same as a black car will be hotter than a white car because it absorbs more wavelengths of light, certain target tissues will absorb certain wavelengths of light more effectively.
As the laser light is mono-chromatic, the target tissue will take on maximum absorption while the surrounding tissues won’t. This allows the target to be isolated and treated. In other words, the laser emits a single frequency of light with all the light waves going in the same direction, allowing the target tissue to absorb the maximum amount of heat.
The target tissue is all-important when treating skin problems with a laser. For pigmentation it is melanin; for spider veins and other vascular conditions it is haemoglobin (blood); and for wrinkles it is water. Each of these target tissues absorbs a different wavelength of light, meaning a different laser is needed for each specific problem.
Recent advances in laser technology mean that laser skin resurfacing, once reserved for the treatment of severe conditions such as acne scarring due to the extensive downtime involved, has become an effective option for many people seeking reduction of lines and wrinkles and uneven skin colour, tone and texture.
Fractional laser therapy
The advent of fractionated laser, where microscopic columns of skin are treated while surrounding skin is left intact, has made it possible to achieve results comparable to traditional CO2 laser resurfacing with fewer side effects and profoundly less downtime.
Fractional skin resurfacing can utilise both non-ablative and ablative lasers – the breakthrough difference of this technology is the fractionated delivery system of light.
Fractional laser technologies break up light beams to allow columns of untreated tissue to activate healing mechanismsibeneath the skin’s surface, treating skin conditions ranging from scars and birthmarks to wrinkles.
These lasers work by creating microscopic thermal injuries that trigger collagen production, stimulating cell renewal and plumping out the tissues. In other words, the laser works by creating tiny holes, or ‘dots’, in the skin’s surface, penetrating deep into the dermis which triggers the body’s natural healing responses. It leaves the skin around each dot intact, enabling the surrounding tissue to heal these microscopic thermal injuries by stimulating the production of new collagen.
The anti-ageing benefits of fractional laser technology include improving evenness of skin tone and texture, reducing pore size and the appearance of lines and wrinkles, and helping to reverse the effects of sun damage. A more mild treatment may take several sessions, while one procedure is usually sufficient for a more aggressive treatment.
Because laser treatments use heat, a mild to moderate burning sensation is experienced during treatment and slight swelling, redness and bronzing afterwards. This can be covered with mineral makeup and normally subsides after a few days, however full healing can take several weeks, depending on the intensity of treatment and the areas targeted.
Results of light-based therapies vary, depending on the technique and experience of the practitioner, and the individual patient. Patients should always ask their practitioner how new the laser or IPL machine is and when it was purchased.
Recent models are far superior to earlier ones in terms of achieving predictable and precise results. With a wealth of medical, cosmetic and scienti c applications, research into laser and light-based technology is constantly evolving. What offers outstanding results today may one day be superseded by the next advance in laser-based therapies. One thing is certain, however: a wealth of conditions once untreatable can today be improved rapidly and with minimal discomfort thanks to laser and light-based technology. CBM
