Flashlamps/Intense Pulsed Light (IPL)
Basic facts
Some consumers have experienced permanent hair reduction, but
there is limited data on how much hair reduction is typical, and how
often hair reduction occurs.
Description
Full spectrum (non-coherent) light and low-range
infrared radiation are filtered to allow a specified range of
wavelengths.
This filtered light is delivered from a handpiece into
the skin, where it targets dark material such as the pigment in
hair.
This is intended to cause thermal and/or mechanical
damage to a hair follicle while sparing surrounding tissues.
Advantages
Some consumers have experienced long-lasting hair
removal or permanent hair reduction.
Considered safe if performed properly.
Useful for large areas such as backs or legs.
Regrowth can come back lighter in color or finer in
texture.
Light-skinned consumers with dark hair have the best
results.
Disadvantages
Long-term data on safety and effectiveness have not been
established.
Response rates have not been established.
Not as effective on unpigmented hairs and red or blonde
hair.
Must be used very cautiously on darker skin tones or on
consumers who tan themselves.
Improper treatment can cause burns, skin discoloration
lasting several months, or patchy/grid-like regrowth.
Requires eye protection.
Can be expensive.
Some find treatment painful.
Regulation varies by state, so inadequate controls exist
to ensure competent practitioners.
Some consumers do not respond to treatment.
Quack claims
"Painless" or "virtually painless"
While many clients tolerate flashlamp without requiring pain
relief, it's overpromise to state that treatment will be
painless for all consumers.
"Permanent hair removal" or "100% permanent" or
"permanent"
Some consumers experience permanent reduction of treated hair
over the course of treatment, but published studies have
observed that many consumers are not good candidates, and even
ideal candidates with light skin and dark hair do not always
respond to treatment.
"Guaranteed 0% regrowth"
There is no published clinical data to substantiate this sort
of overpromise.
"Beyond laser"
This marketing term suggests that flashlamp is better than
laser for consumers, but this is not always the
case.
Background
Also called IPL (intense pulsed light), ILS (intense light
source), full spectrum, non-coherent, and broadband light. The
primary differences between flashlamps and lasers used in hair
removal are:
Kind of light
As mentioned earlier, flash lamps do not use one wavelength
of light the way a laser does. Flashlamps emit every wavelength
of light in the visible spectrum, and a little into the band of
infrared radiation (up to about 1200 nm). Practitioners select a
cutoff filter to block out lower wavelengths.
Size and shape of the spot (beam)
Most flashlamps emit a beam that covers more area than a
laser. Most flashlamps also have a rectangular spot, rather than
the round type usually standard on
lasers.
History
Xenon is commonly used as a light source because of the
brilliant, full spectrum illumination it provides when exposed to
energy. Like laser, it can be designed to be extremely powerful and
has industrial applications like paint stripping. It is also used
for items such as the flashes in photographic equipment and in
surgical lighting equipment.
The xenon flashlamp, first developed as an energy source for
laser beams, was soon being used therapeutically with direct
applications of its energy. As with lasers, flash lamps began to be
used for medical purposes in the 1960's. The latter half of the
1960's saw published data on treating eye and skin disorders. [1, 2]
Early attempts in the 1970's to use xenon light energy delivered
via fiberoptic filament have not been demonstrated to be permanent.
Although these devices (see photoepilators) are still in use, they
should not be confused with the devices that became available 25
years later.
By the mid-1990's, researchers were exploring the use of
flashlamps for treating vascular lesions. In the year the first
flashlamp was cleared by FDA for use in treating vascular lesions,
[3] one study noted hair loss as a side effect of treatment. [4]
Other papers indicated promising results for some in the treatment
of leg veins, [5, 6] prompting one manufacturer to apply for and
receive FDA clearance for hair removal in 1997. [7] In 2000, FDA
began allowing some brands to claim permanent hair reduction in most
skin types. [8] The darkest skin type was not included.
Clinical data
There is limited clinical data and even less
with long-term follow-up for flashlamps. [9] Arguably the best overview is Tse. [10] Several brief discussions suggest usefulness without
detailing clinical data. [11, 12, 13, 14, 15]
The pilot study observed 60% reduction at 3
months [16] and 75% at 12 months.
[17] Another study observed 80% reduction
at 8 months. [18] One study with no
follow-up observed 77% reduction immediately after a 6th treatment.
[19]
Two articles reporting on overlapping patient
groups reported 54% to 64% reduction at 6 months. A later study by
the same authors observed 76% reduction immediately after a 4th
treatment. [20] The study observed 41% of
subjects had an average 83% reduction at 12 months or more.
[21]
One clinical report found “satisfactory”
results at 6 months in 2 transsexuals who received 13 and 41
treatments, respectively. [22] Another
clinical report observed one patient had successful removal of
transplanted scalp hair grafts with 1.5 year follow-up.
[23]
One study had findings which aligned more
closely with other reported light-based results, observing an
average 33% reduction at 6 months after 2 treatments.
[24]
Laser and flashlamp promoters sometimes suggest the devices are
very different in terms of effectiveness or side effects, but this
is not based on published comparative data.
References
- Verhagen AR. Light tests and pathogenetic wavelengths in chronic
polymorphous light dermatosis. Dermatologica.
1966;133(4):302-12.
- L'Esperance FA Jr. Clinical comparison of xenon-arc and laser
photocoagulation of retinal lesions. Archives of
Ophthalmology. 1966 Jan;75(1):61-7.
- FDA Docket K950493. August 7 1995.
- Hellwig S, Schonermark M, Raulin C.[Treatment of vascular malformations and pigment
disorders of the face and neck by pulsed dye laser, Photoderm VL
and Q-switched ruby laser].Laryngorhinootologie. 1995
Oct;74(10):635-41. German.
- Goldman MP, Eckhouse S. Photothermal sclerosis of leg veins. ESC Medical
Systems, LTD Photoderm VL Cooperative Study Group.
Dermatologic Surgery. 1996 Apr;22(4):323-30.
- Schroeter CA, Neumann HA. An intense light source. The photoderm VL-flashlamp
as a new treatment possibility for vascular skin lesions.
Dermatologic Surgery. 1998 Jul;24(7):743-8.
- FDA Docket K963249. July 7, 1997.
- FDA Docket K991935. January 27, 2000.
- Please see hairfacts.com for a list of the flashlamp medical literature.
- Tse Y. Hair removal using a
pulsed-intense light source.
Dermatologic Clinics. 1999 Apr;17(2):373-85, ix.
- Fitzpatrick RF Goldman MP Sriprachyaanut
S. Hair removal utilizing the ESC Epilight device. Lasers in
Surgery and Medicine (supplement) 9 36:1997.
- Smith SR, Tse Y, Adsit SK et. al.Long-term
results of hair photo-epilation. Lasers in Surgery and Medicine
(supplement) 43:1998.
- Gold MH. Hair removal with an intense
pulsed-light source. Lasers in Surgery and Medicine (supplement)
10 58:1998
- Weiss G, Cohen B. The efficacy of long-term
epilation of unwanted hair by noncoherent filtered
flashlamp. Lasers in Surgery and
Medicine. 2000;26(4):345.
- Weir VM, Woo TY. Photo-assisted epilation:
review and personal observations. Journal of Cutaneous Laser
Therapy. 1999;1:135-143. PMID not available.
- Gold MH, Bell MW, Foster TD, Street S.
Long-term epilation using the
EpiLight broad band, intense pulsed light hair removal
system. Dermatologic Surgery. 1997
Oct;23(10):909-13.
- Gold MH, Bell MW, Foster TD, Street S. One
year follow-up using an intense pulsed light source for long-term
hair removal. Journal of Cutaneous Laser Therapy.
1999;1:167-171. PMID not available.
- Trollius A, Troillus C. Hair removal with
a second-generation broad spectrum intense pulsed light source: a
long-term follow-up. Journal of Cutaneous Laser Therapy
1999;1:173-178. PMID not available.
- Schroeter CA,and others. Hair removal in 40 hirsute women
with an intense laser-like light source. European Journal of Dermatology. 1999
Jul-Aug;9(5):374-9.
- Sadick NS, and others. Available Long-term
photoepilation using a broad-spectrum intense pulsed light
source. Archives of Dermatology.
2000 Nov;136(11):1336-40. PMID 11074695
- Sadick NS, Shea CR, Burchette JL Jr,
Prieto VG. High-intensity flashlamp
photoepilation: a clinical, histological, and mechanistic study in
human skin. Archives of
Dermatology. 1999 Jun;135(6):668-76.
- Raulin C, Werner S, Hartschuh W,
Schonermark MP Effective treatment of
hypertrichosis with pulsed light: a report of two
cases. Annals of Plastic Surgery
1997 Aug;39(2):169-73 PMID 9262770
- Moreno-Arias GA, Navarra E, Vilalta A,
Ferrando J. Corrective photoepilation for
improper hairline placement after hair
transplantation. Dermatologic
Surgery. 2000 Aug;26(8):790-2; discussion 792.
- Weiss RA, Weiss MA, Marwaha S, Harrington
AC. Hair removal with a non-coherent
filtered flashlamp intense pulsed light source. Lasers in Surgery and Medicine. 1999;24(2):128-32.
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