Before and after picture of Photofacial anti-aging skin rejuvenation treatments for the neck and decolletage or chest area (Palomar.)

Photofacial or IPL is not a laser and is a new non-surgical anti-aging skin care treatment method. Photofacial uses a flash of visible light to remove aging changes from the facial, neck, hand and décolletage skin. Anti-aging Photofacial skin care treatments do not require a topical anesthetic, are quick, and effective. Photofacial skin care treatments do not require the down time or recovery time associated with laser skin resurfacing or surgical anti-aging skin care methods such as the aggressive laser skin resurfacing skin rejuvenation method.

Photofacial anti-aging skin care treatments or IPL treatments can freshen aging and sun damaged skin to a clear uniform appearance without age spots, brown spots and broken blood vessels. See the before and after pictures of photofacial skin care treatment of the face below:

Before and after pictures of photofacial anti-aging skin rejuvenation treatments of the face (Palomar.)

What Causes Age Spots, Sun Spots, Red Blotches and Broken Blood Vessels on the Face Neck and Décolletage?

Browns spots and broken blood vessels around the nose, chin, cheeks, neck, hands and Décolletage are classic signs of sun damage and aging of the skin. Brown spots, often called age spots are caused by pigment that is produced by the skin to protect the skin from the harmful ultraviolet (UV) rays of the sun. New blood vessels grow into the skin in response to skin injury by the sun. This process of new blood vessel growth is called inflammation.

The new blood vessels bring blood into the facial skin first to wash out damaged skin cell debris and later to bring in skin healing factors.

As our skin ages, the brown spots and broken blood vessels are left behind on the skin after the inflammation or skin injury has passed. These pigmented and red vascular spots create an aged variegated appearance to the facial skin which is called dyschromia, which is a sign of facial aging.

Photofacial skin care treatments or IPL treatments are the non-surgical anti-aging skin care treatment of choice for benign facial skin pigmentation, age spots, brown spots and broken blood vessels, the small red spots called telangiectasia, on the face, hands, neck and Décolletage. Photofacial treatments are now preferred over laser treatments for these specific pigment and vascular lesions.

How Do Photofacial or Intense Pulsed Light Non-surgical anti-aging Skin Care Treatments Work?

Photofacial or IPL anti-aging skin care treatments use a bright flash of visible light, like the light of a camera flash to remove pigment and blood vessels non-surgically from the skin. This pulsed or flashed light is very different from a laser and in most instances, less powerful and less dangerous that laser light.

I use a Photofacial IPL machine called the LuxGreen IPL made by Palomar Medical Laser Company in Burlington, Massachusetts. Palomar Medical is the premier manufacturer of Aesthetic Laser and Light therapy machines in the world. The LuxGreen Photofacial is the best Photofacial technology I have ever used. The LuxGreen Photofacial IPL machine is very effective and is the most comfortable for you the patient of any IPL device available.

Photofacial skin rejuvenation works by passing a flash of bright light through a filter that only allows a specific color of light in the flash to pass through the filter and hit the skin. In the case of the LuxGreen Photofacial, only light with a wavelength of 550nm (nm=nanometers or one millionth of a meter and is the measure of the green light wavelength in the visible light spectrum) to pass through the IPL filter and hit the skin.

The LuxGreen Photofacial 550nm light is selectively absorbed or taken up by the brown pigment in an age spot or the dark reddish brown color of blood in a blood vessel. When the Photofacial light energy is absorbed by the pigment or blood vessel, the heat from the Photofacial or IPL light destroys the pigment or blood vessel by heating it.

This process is called Target Specific Photothermolysis. A specific target, that is a color, is heated (thermo) with a light (photo) beam and dissolved or destroyed (lysis).

Using color filters placed in front of the Photofacial light beam, a wide variety of colors can be allowed through to treat many different skin conditions including hair removal (LuxRed), acne (LuxViolet), and others.

What Will My Skin Look Like Immediately After a Photofacial Skin Care Treatment?

Unlike lasers, which can cause the skin to peel and possibly leave scars, the Lux Green Photofacial treatments are very gentle on the skin. The pigment in the brown spot or age spot will darken very slightly, and the treated blood vessel will also darken a bit. However the skin will be intact. The treated areas may also be slightly pink for a few hours.

We place ice or a cool pack on the treated area immediately and this also may make the skin pink. However, the pinkness may be covered with makeup immediately. You may return to work. And your skin will be nearly normal the next day.

Does A Photofacial Skin Care Treatment Hurt?

There is minimal discomfort during a Photofacial skin care treatment. Anesthesia or numbing medicine is not required. When the Photofacial or IPL flash hits the skin you will feel a small snap or sting, but this is easily tolerated by all of my patients.

How Many Photofacial Skin care treatments will I Need?

Usually 3 Photofacial skin care treatments are required spaced 4-5 weeks apart for the best results. Multiple treatments are the price for gentle treatments that are not painful and do not injure the skin.

Technically enough power can be used to remove the brown spot or blood vessel in one treatment, but this energy level would be painful, blister the skin and possibly leave a scar. This is what happened with old time laser treatments, and the new Photofacial is designed to remove pigment and blood vessels painlessly and with no trace or scar left behind. To accomplish this we need to stage the removal in 2-3 treatments 4-5 weeks apart. The results are well worth the wait.

How Soon after My Photofacial Skin Care Treatment Will I See a Result?

Generally you will see the results of your Photofacial skin care treatment at 4-5 weeks. The brown spot will be lighter or gone and the red spot or blood vessel will be much smaller. Some patients with thin skin and very light pigment or small broken blood vessels will see complete removal after one treatment.

However most people see definite improvement 5 weeks after the Photofacial IPL treatment and require 2 more treatments for complete removal.

Who Should I Consult For My Photofacial or Intense Pulsed Light (IPL) Skin Care Treatment?

The best Photofacial or IPL machines are found in a physician’s office. Less powerful Photofacial machines are allowed to be used in Spas, but results are not as effective with these downgraded machines. In my experience patients do not get the results that they want in a spa, and often come to my practice for repeat treatments with the LuxGreen Photofacial after having already spent money for IPL in a spa.

The other benefit of having your Photofacial treatment in a physician’s office is that you will be examined by a doctor who can properly diagnose your skin condition. Some brown lesions are dangerous and require medical evaluation and should not be treated with IPL. If you have Rosacea or larger blood vessels on your face, a different therapy is required. These are medical treatments and should be done in a doctor’s office. Your skin will be evaluated for more serious skin conditions, and you will receive more effective Photofacial skin care treatments.

How Do I Find a Good Doctor to Do My Photofacial Skin Care Treatment?

Light based and laser non-surgical skin rejuvenation treatments are best done by a doctor who is well trained and specializes in anti-aging skin care. Your safest bet is to seek consultation with a board certified plastic surgeon or dermatologist who has experience in laser and light based therapies such as Photofacial or Intense Pulsed Light.

I am of course prejudiced because I am a board certified plastic surgeon. However, a plastic surgeon is trained and capable of providing the full range of non-surgical and surgical skin anti-aging procedures and can customize your skin care treatments to your unique face. Doctors who cannot provide all treatments are tempted to “fit your unique face” into the particular skin care treatment they offer, and that is not the best situation for you.

Good sources of honest objective information about choosing a physician are available at the following links:

American Society of Plastic surgeons

American Society of Aesthetic Plastic Surgeons

American Board of Plastic Surgery

American Society of lasers in Medicine and Surgery

Read our free newsletter to learn more about non-surgical facial rejuvenation. read Save Your Face to learn how to prevent skin aging.

Dr. Seckel
Concord, Massachusetts
Boston, Massachusetts

Photo facial rejuvenation is usually used to refer to IPL treatments for non-surgical facial rejuvenation. Technically all laser and IPL therapy is Phototherapy because they use light waves or photo energy to treat the skin. But common usage of Photo facial rejuvenation usually refers to IPL.

I am not familiar with FotofacialRF. But if the RF refers to Radiofrequency it is not a photo facial treatment because radiofrequency (RF) uses radiofrequency waves not light or photic waves to treat the skin. Actually foto refers to photography and should not be used to refer to light therapy on the face.

Photodynamic therapy refers to the use of IPL on the skin after the application of a photo sensitizing agent to enhance the effect on the skin. Photodynamic therapy is very successful for treating acne bit I am unaware of the effect on enlarged pores.

For more information visit my Boston Plastic Surgery Practice, read Save Your Face or contact me.

Dr Seckel

Boston, Massachusetts

Peabody, Massachusetts

If the main problem you want to correct is enlarged skin pores I recommend a laser skin treatment called Lasergenesis®. It is very safe treatment that does not ablate or remove skin and there is no contact by the laser with the skin. Thus I feel it is safer for Asian skin. Since Lasergenesis is a gentle treatment you will need multiple treatments, perhaps 5-7 over the course of 3-4 months and you will not see results until 5-7 months have passed. This is because the treatments stimulate the skin to form new collagen in the deeper skin layers. The new collagen compresses the pores making them smaller. An added benefit of this treatment is improvement in skin texture and very fine wrinkles.

The IPL called Intense Pulsed Light or photo facial is actually not a laser. IPL or photo facial is a more aggressive treatment than Lasergenesis®. If you have brown spots and pigment, or small blood vessels or flushing on the skin, the IPL or photo facial is very effective. The IPL or photo facial is more powerful and is placed in direct contact with the skin. Improper usage can create skin injury so it is crucial that you find a board certified physician who is experienced in the use of IPL. You can check the Cutera® website to find a physician who has the Lasergenesis® machine. Often this machine also has an IPL

I would not use Microlaserpeel® or any ablative laser such as the CO@, Erbium, or Fraxil® to treat enlarged pores. These lasers are ablative-which means they remove skin, and removing skin could actually enlarge pores, initially at least.

I do not personally have experience with mesotherapy. It is gaining in popularity as an alternative to liposuction. If you do choose to have mesotherapy it is very important to find a board certified physician who is experienced in its use. Mesotherapy involves injecting a fat dissolving solution into the fat beneath the skin and waiting for the fat to dissolve.

One word of CAUTION-the fat deposits in the face surround very important facial nerves. If these nerves are injured as the needle is passed into the face, or if the fat dissolving solution injures the nerves the face could be paralyzed-a disastrous result. I have not heard of this happening but it is a concern of mine. If you are contemplating mesotherapy in your face I certainly would find an experienced board certified physician and ask him if this could happen to you.

For further information on facial rejuvenation and non-surgical facial rejuvenation visit my Boston Plastic Surgery Practice, read Save Your Face or contact me.
Dr Seckel

Boston, Massachusetts

Peabody, Massachusetts

Thank you for your very insightful question. Facial skin aging is caused by a number of factors of which the sun is a most important one. Ultraviolet radiation from the sun as you point out causes facial aging by direct damage to the collagen and elastin fibers in the dermis or deep layer of the skin. Healthy collagen keeps the skin plump and supple, and the elastin gives the skin elasticity, the ability to snap back when it is pulled away from the face. As the skin ages, after years of exposure to the sun the elastin fibers are broken up and collect in the deep layers of the dermis a condition called solar elastosis a classic sign of facial aging in the skin. Other factors contribute to facial aging including loss of facial fat which plumps the skin when we are younger, loss of facial bone density, elevated cortisol the stress hormone, free radicals released by toxins and bad diet, and intrinsic factors – our inherited genetic propensity for facial aging.

Facial aging caused by the sun results after years of damage to the collagen and elastin, and aged facial skin has a damaged, lax, inelastic dermis which is deficient in healthy collagen and elastin.

The new “high tech” facial rejuvenation, anti-aging treatments attempt to restore or rejuvenate the facial skin and reverse facial aging changes by producing new healthy collagen and elastin and removing the old damaged collagen and elastin from the aged facial skin. This is a very sophisticated method which can best be described as “controlled scar formation”. Results can be beautiful.

The laser, IPL, radiofrequency wave or any other irritant such as a chemical peel is used to irritate the skin and damage the collagen and elastin in the dermis. When you irritate the dermis of the facial skin you initiate a process called inflammation. Inflammation is a healing or reparative process of the body. Where the collagen and elastin of the dermis is irritated or injured, white blood cells come into the area and remove the damaged collagen and elastin and some of the white blood cells convert to a cell called the fibroblast, a cell which can produce new collagen and elastin to replace the damaged collagen and elastin.

The key difference between skin sun damage to collagen and elastin and the skin damage caused by a laser or IPL is that the damage caused by the sun is chronic, that is it continues year after year and although the dermis tries to heal and produce new collagen and elastin the damage from the sun continues year after year and overwhelms the body’s natural inflammatory healing process. The damaged collagen and elastin atrophies or shrinks and dies and any new collagen or elastin which is formed is immediately damaged by further sun exposure.

Laser or IPL treatment called Photo facial skin rejuvenation is a very quick, very powerful event that damages a great deal of the aged collagen and elastin all at once and causes the aged skin to heal and regenerate a great deal of new collagen and elastin in a very short time. New collagen and elastin produced after a laser or IPL treatment during the first six months is probably more than would be produced in five or ten years in response to the sun, and of course ten years worth of sun damage is not daily hitting the new collagen and elastin so the dermis over a period of time after a number of treatments is plumped and the facial aging changes are lessened and non-surgical facial rejuvenation has occured. However, if sun block and good preventative skin care is not instituted after the laser or IPL treatment, the sun will damage the new collagen and elastin and facial aging will return.

The ability of laser and IPL to rejuvenate the face is dependent on many different factors. Visible wrinkle removal and skin tightening with one treatment requires ablative laser resurfacing with a CO2 or Erbium laser. This is called laser resurfacing and is a procedure which causes the face to be red and raw and requires 8-10 days of healing, followed by 6-8 weeks of facial redness requiring make up. This procedure produces dramatic immediate results.

The non-surgical facial rejuvenation procedures done with the IPL,. photo facial and non ablative lasers are very different. These are often called no down time facial rejuvenation procedures, meaning that you do not have the redness and healing time associated with the laser resurfacing procedure mentioned above. The no down time facial rejuvenation procedures done with the IPL and non ablative lasers take many treatments, five to seven sessions, over a period of six to seven months to see a result that often is only 20-30% as good as the result of the ablative laser resurfacing. The problem is that the no down time procedures only produce a small amount of inflammation and new collagen and elastin formation at each treatment, so they work much more slowly.

I often use a newer procedure called a microlaserpeel using the new erbium laser. In this procedure a very mild ablative laser peel is performed but only very superficially. The skin is red for only four to five days instead of 6 weeks, but more new collagen and elastin formation is produced and results are better than with the non ablative IPL, photo facial and laser treatments.

If you want to read a detailed discussion of exactly how the laser and IPL photo facial skin rejuvenation treatments produce inflammation and new collagen and elastin production in the drmis, read chapter 8 in my book Save Your Face – The Truth About Facial Aging, Its Prevention and Cure available on this website.

This is a very long answer to your excellent short question, but I hope it helps. For further information, visit my Boston Plastic Surgery Practice,  contact me or read Save Your Face.

Thank you,

Dr Seckel

Boston, Massachusetts

Peabody, Massachusetts