Clinic of Dermatology

These laser systems represent a new field in dermatology, which introduces laser technologies for the treatment of various dermatological conditions while it is extremely safe for the patients – with minimum side effects and does not hinder routine lifestyle or prevent public activities.

IPL technology has established itself as an extremely effective laser system in the recent years for management of the ageing skin alterations (non – ablative skin rejuvenation). It brings excellent clinical and histological results confirmed by numerous clinical studies and shows high patient satisfaction index (SI).

What is IPL technology?

The IPL system emits incoherent light with a wavelength in the ranges between 500 and 1200 nm of the electromagnetic spectrum. Filters that eliminate shortwave light rays are being utilized, thus concentrating the light energy and improving its penetration through the skin. The light is emitted in series of single, double or triple impulses with duration of 2 until 25 msec and 10 to 500 msec intervals between them. Shortwave light interacts easier with the epidermal melanin and the filters, which let it pass, are suitable for fair skin patients. The physician determines the most appropriate parameters (filter, wavelength respectively, pulse duration, pulse interval, etc.) in accordance with the dermatological issue to be solved, skin type ( from type 1– fair to type 5 – dark) and a variety of other factors.

What are the main indications for IPL?

Vascular lesions – teleangiectases (dilated capillaries), vascular spots, hemangiomas and other vascular malformations. The blood oxyhaemoglobin serves as a chromofore, which absorbs the light energy, transforms it in heat resulting in destruction of undesired blood vessels. Good therapeutic response is achieved through several consecutive procedures (3 – 5) and a combination with Nd: Yag laser can be performed by the decision of the physician. Smaller vascular lesions, for example vascular spots and facial teleangiectases are easily managed with fewer procedures.

Pigmented lesions – brownish spots, located predominantly in the facial region resulting from intense sun exposure, pregnancy, administration of certain medications or ageing skin alterations. The melanin of the skin is the pigment that absorbs light with subsequent desquamation of the spots within a few days. The pigmented lesions fade with each procedure until they completely disappear. These dermatological issues require several consecutive procedures (3 – 5) as well with an interval of 1 month between them.

Skin rejuvenation - management of ageing skin signs.

Before	After
Before	After

What are the alterations of ageing skin?

The skin changes with ageing, especially under systemic ultraviolet sun exposure. Fine lines, wrinkles, pigmented spots and dilated capillaries emerge while the skin looses its tone and elasticity, hardens and becomes flabby. These alterations originate from epidermal thinning, collagen and elastin fiber disorganization, reduction of collagen precursors and microfibers of the dermoepidermal border.

How are these changes managed?

ÈVarious treatment modalities for management of the ageing process are performed – topical substances like alpha-hydroxy acids vitamin C, E and tretinoin, etc. Plastic surgery methods, which are more aggressive are effective but require long recovery period and carry the risk of side effects – pigmentations, infections and scarring.

What is the alternative?

Progress in laser technologies in the last two decades introduced non-ablative laser systems (IPL and Nd:Yag) in dermatology as an excellent alternative for visible rejuvenation of the skin – the so-called photorejuvenation.

What is the principle of IPL and Nd:Yag action during photorejuvenation?

Light absorption from skin pigments like melanin, oxyhaemoglobin, etc. and its transformation in heat energy leads to thermally induced changes in the treated area. The changes can be superficial resulting in pigmented spots and dilated capillaries management, and deep – they bring alterations in the collagen molecule, stimulation of the skin’s natural regeneration processes and as a result – gradual flattening of the fine lines and wrinkles. Three to five procedures with an interval of one month between them are usually required.

Before	After
Before	After

What are the major advantages of the method?

1. The skin of the face, neck and neckline flattens – wrinkles and fine lines are reduced, pigmentations and dilated capillaries disappear, the skin colour becomes even; that leads to the visible effects of rejuvenation.
2. The procedures are safe, no recovery period is required, therefore routine lifestyle and public activities of the patient are not disturbed.
3. The results are durable – confirmed by clinical studies that find out, including histologically that stimulation of collagen synthesis continues after the 6-th month of therapy end.

How are the procedures performed?

The initial dermatological examination is obligatory. Therapeutic plan regarding the most appropriate treatment for a certain problem and a period for its performance is determined. The procedures are usually held during autumn and winter, because there is no risk of skin pigmentation. The patient must apply sun protection cream during the period of laser therapy.

What are the possible side effects?

Almost all patients respond with temporary redness of the skin after the procedure and sometimes – minor swelling, especially around the eyes. These phenomena fade away within a few hours or 1 – 2 days after the treatment and are considered a normal skin reaction towards the light, which does not require management. Pigmented spots treatment may result in slight scaling, which fades away in 3–5 days.

What are the contraindications for undergoing a procedure?

• Pregnancy
• Skin infections in the treated region (herpes, etc.).
• Concomitant administration of photosensitive substances that increase the skin sensitivity towards sunlight.
• Very dark skin or tanned skin as a result of sun exposure.;
• Increased predisposition of the individual to form solid and elevated scars.