What it is
Because it is unselective, the skin's own melanin competes with the target for the energy. That makes skin type, recent sun exposure and settings more decisive here than with almost any other device.
What this page covers
- Intense pulsed light photorejuvenation for lentigines, diffuse redness and photodamage on suitable skin types
- Broadband light (BBL) programs for redness, pigment and acne
- IPL hair reduction where hair is dark and skin is light
- Advice on home-use IPL and laser devices, and treatment of the burns and pigment marks they cause
- IPL for meibomian gland dysfunction, only in coordination with an ophthalmologist and with corneal shielding
Who it suits
- Someone at the lighter end of the range we see, who has been out of the sun for weeks, with discrete brown sun spots and a background redness she would rather treat together than one at a time
- Someone whose rosacea is already managed medically, who wants the standing redness and the visible vessels reduced alongside that plan rather than instead of it
- Someone who wants to be told plainly whether her own skin type suits broadband light at all, and who will accept a different device or a topical program as the answer. That answer is given here often
- Someone who bought a home light device and has been left with a burn, a pale patch or a dark mark from it. That is a consultation and treatment for the injury, not a reason to run the same light again
- Not you if what you want cleared is melasma: broadband light can darken it rather than lift it, and on skin like most of ours it is one of the readier routes to a wider problem — see melasma and pigmentation. Not you either if you are asking for hair reduction on deeper skin: an Nd:YAG laser wavelength suits that better, and we would rather say so than sell you the light
When we advise delaying or not treating
- Medicines that change how your skin answers light. Bring every box to the consultation, including what was never prescribed. Oral isotretinoin, the tetracycline antibiotics including doxycycline, and a number of other prescribed drugs — some water pills taken for blood pressure, some anti-inflammatory painkillers and some other antibiotics among them — leave the skin able to burn at a setting that would otherwise have been safe; so do St John's wort and several herbal products and lightening creams bought without a prescription, which patients frequently do not count as medication and so do not mention. The timing of a light session around isotretinoin is set by the doctor prescribing it, not decided at the door. And this is asked before every session rather than only the first, because prescriptions change in between
- Conditions that light provokes. Lupus, porphyria, and polymorphic light eruption — the itchy rash that comes up on exposed skin with the first strong sun — are reasons to postpone aiming broadband light at the skin, and in some cases reasons not to at all. A rash that appears where the sun reaches and spares what the clothing covers is diagnosed first; adding light to it is the wrong direction
- A recent tan, or sun in the days before. Recently tanned skin is a reason to postpone, not a reason to lower the settings. The same holds for an area threaded, waxed or sugared within the last few days — the surface layer has been stripped, so an ordinary setting becomes an injury — and for skin thinned by a topical steroid used over months, whether it was prescribed for something else or came hidden in an unlabeled lightening mixture: it is left to recover on a plain moisturizer and a gentle cleanser before any device touches it, and the steroid is withdrawn on a plan and by degrees, because stopping it all at once sets off a rebound flare
- An active infection or an open lesion in the treatment area. A cold sore, impetigo, an inflamed spot that is weeping, a fungal rash, or any break in the skin: the session is rebooked and the skin is treated first. Light over infected skin spreads the problem and leaves a mark where a short course of treatment would have left nothing
- Melasma, as a first move or as a shortcut. We decline. It is treated with photoprotection and topicals first and then reviewed, and a device is added only where it genuinely has a place — see melasma and pigmentation. Active post-inflammatory pigmentation, whether from an earlier session, a peel or a spot, gets the same answer: more light on top of it usually deepens it
- Hair reduction on deeper skin, asked for by name. Home-device advertising has made "IPL" a familiar word, but intense pulsed light is less selective than a laser, and at the darker end the risk of a burn and of a mark that outstays it is higher. We offer the appropriate wavelength instead — an Nd:YAG laser — rather than running the light at reduced settings
- Any brown spot that has not been examined, and any mole, tattoo or cosmetic tattoo inside the treatment area — microbladed brows, lip blush and eyeliner tattoo included. Read the box at the top of this page; on this page in particular it is not a detail, because this handpiece covers a wide footprint in a single pulse, so all of these fall inside its path without anyone aiming at them. A mole and a patch of ink both take a focal burn, and some cosmetic inks darken on the first pulse instead of fading, so they are found and shielded before the session rather than explained after it. Tell us about work done on your brows or lids even if it has faded and you no longer think of it as a tattoo
- Around the eye. Intense pulsed light for meibomian gland dysfunction is done only where an eye specialist has made that diagnosis, in coordination with them, and with internal corneal shields in place. It is not added to a facial session because dry eye came up in passing, and light is not aimed inside the orbital rim for a cosmetic reason at all. And if you have rosacea and your eyes are gritty, burning, watery, red, or crusting at the lid margin, say so — that is a question for an eye specialist and it is arranged rather than answered from here, because rosacea in the eye is common, is missed, and is not managed from a skin clinic alone
- Pregnancy, and the request with a date attached. Elective device work is postponed in pregnancy, and pigment in particular is reassessed after delivery, because pregnancy moves it on its own. And a request to clear a face of pigment before an occasion, within a set number of weeks, is answered honestly: on this skin, pushing a course toward a deadline is how a session that would have passed uneventfully becomes a mark that outlasts the occasion
Possible effects
Stated in full, because the decision is not sound without them. This is the least forgiving of the things offered on this page, and most of what goes wrong with it goes wrong in ways that can be anticipated before the session rather than explained after it.
- What is expected, and it looks worse before it looks better: redness and warmth for a day or so, and the treated brown spots darkening into fine dark flecks that crust and lift over the following days. They are not rubbed or picked off; more marks come from that than from the light itself
- Burns and blisters. Intense pulsed light is the device most often implicated in these, and they usually follow a short list of causes: a setting that suited a lighter skin than the one in the chair, recent sun, a home device, an area threaded or waxed a few days earlier, or skin thinned by a topical steroid, prescribed or hidden in an unlabeled mixture. A blister, spreading redness, increasing pain or any discharge is looked at the same day rather than held over to the next appointment
- Darkening afterward (post-inflammatory hyperpigmentation). The commonest complication in Fitzpatrick IV to VI, and the reason settings, cooling and a test spot are not extras. It is managed medically with device work paused rather than continued — light on top of active pigment usually deepens it. It fades slowly, and any date put on it is a guess
- Loss of color, and scarring. Less common, slower to change, and the skin may not come back as it was. This is the risk that argues for a test spot and conservative settings, not for a stronger session
- Melasma made worse. A described outcome of broadband light on this skin, not a rare surprise — see melasma and pigmentation
- Eye injury, which is the risk patients are told about least. Broadband light at or inside the orbital rim, without internal metal shields, can injure the iris — leaving light sensitivity, a pupil that no longer reacts as it did, glare, and inflammation inside the eye — and some of that does not recover. Appropriate protective eyewear is worn by everyone in the room for every pulse, including a quick touch-up, and internal shields are used for any work at the lid. Eye pain, light sensitivity, blurred or altered vision, or a change in the shape of the pupil after any session, wherever on the body the light was aimed, means an eye examination the same day — the nearest emergency department if it is out of hours — not watching and waiting
- New fine hair at the edge of a treated area (paradoxical hair growth). Reported most on the face and neck and more frequently in Middle Eastern skin, so it is not an oddity here. It changes the wavelength, the settings or the plan, and a hormonal cause is looked for before a course is simply carried on
- The result does not belong to the session. Sun spots return with further sun, and freckles in particular come back unless daily photoprotection becomes a habit. Anyone treating without saying so is selling the session, not the outcome
A note on darker skin
This is the page where skin type decides most of the answer. Intense pulsed light is unselective: the pigment spread through your own skin competes with the target for the same energy, so the setting that clears a sun spot on lighter skin can take the surface layer with it on Fitzpatrick IV to VI. That is why it is the device most often implicated in burns and in pigment change that lasts across this range, why it can push melasma the wrong way, and why a good number of the people who ask for it here are better served by a selective wavelength or a topical program instead. Where it is used on deeper skin, the safety lives in the preparation rather than in the machine: a recorded Fitzpatrick type, a documented medication and hair-removal history, a test spot reviewed after an interval before the full session is booked, reduced settings, longer intervals, cooling treated as part of the treatment rather than as an add-on, and daily photoprotection afterward. A test spot that looks fine lowers the risk without removing it — a pigment reaction can still appear after the test has passed — so the full session is approached as the next careful step rather than as something the test has cleared. And the honest part, which is the part usually left out: at the deeper end, lowering the settings is not always the safe version of this treatment — sometimes the safe version is declining it, and being told no here is a result of the examination, not a service withheld.Afterwards
- Cool the area as you were shown, and keep to a plain moisturizer and a gentle cleanser. Nothing active on the treated skin for the days you are given: no retinoid, no acids, no scrubs, no lightening cream
- The treated spots darken first and lift over days. Leave them. Do not pull them off, do not exfoliate them, and do not take a cloth to them in the shower; more marks come from that than from the session
- Sunscreen every morning and reapplied, with shade and a hat where you can. A fresh tan on skin treated last week is what turns a good session into a pigment problem
- No threading, waxing or sugaring on the treated area, and no hot water, sauna, steam room, gym or pool — each for the period you were given. Heat counts here on its own, not only the sun: it drives redness, and on pigment-prone skin it is one of the things that keeps a mark going
- Photograph anything that surprises you on the day it appears, and bring the photograph
- Tell us the same day, without waiting for the next appointment: a blister; spreading redness, increasing pain, or any discharge; a burn. Leave a blister covered and intact rather than opening it. And if it is out of hours and the redness is spreading quickly, or you have a fever or feel unwell with it, go to the nearest emergency department rather than waiting for the clinic to open
- And after any session, wherever it was on the body: eye pain, light sensitivity, blurred or altered vision, or a change in the shape of the pupil — the eye is examined by a specialist that same day, and at the nearest emergency department if it is out of hours
- Weeks later, tell us if the darkening is spreading beyond the spots that were treated instead of fading. That is not a reason to bring the next session forward; it is the reason to postpone it
- Come to the review with your medicine list brought up to date, including anything started since the last session. A new antibiotic between sessions changes what can safely be run
Honestly
IPL is the device most often implicated in burns and lasting pigment change in Fitzpatrick IV–VI and it can make melasma worse, so many patients here are better served by a selective laser or by topical treatment, and it is not used on recently tanned skin, on skin threaded or waxed in the last few days, or over steroid-thinned skin.
Common questions
Is IPL a laser or not?
It is not a laser. A laser is a single wavelength going after one target; intense pulsed light is broad light, filtered, reaching several targets at once. That is the whole of it: because it is unselective, the pigment in your skin competes with the spot for the energy, which is why your skin type decides more here than the name of the machine does.
My skin is dark — can I have IPL?
The honest answer, in a good many cases, is no. Broadband light is the device most often implicated in burns and pigment change on Fitzpatrick IV to VI, and a selective laser or a topical program will often suit you better. Where it is suitable, we begin with a test spot reviewed after an interval before the full session is booked, with conservative settings and longer intervals. A test spot that looks fine lowers the risk without removing it. And sometimes the safety is in declining rather than in going gently.
I have melasma and my friend had IPL and it came out nicely for her
Her skin is not your skin, and what she has may not be melasma at all. Broadband light can darken melasma, and melasma is a condition that is controlled and followed rather than finished in a session. We start with sun protection and topical treatment and review, and a device is added only where it has a place. The detail is on the melasma and pigmentation page.
I take isotretinoin, or an antibiotic for my spots — does it matter?
It matters a great deal, and it is among the most important things asked before any light session. Isotretinoin and the tetracycline antibiotics — doxycycline among them — leave the skin able to burn at a setting that would otherwise have been safe, and so do some water pills taken for blood pressure, some anti-inflammatory painkillers, some other antibiotics, St John's wort, and a number of herbal products and lightening creams bought without a prescription. The timing of a session around isotretinoin is set by the doctor prescribing it. Bring all your boxes, including what was never prescribed, and expect the question before every session rather than only the first.
I bought a home IPL device — should I use it?
Ask us about it at your visit and we will go through what your device can actually do for your skin type and your hair type; some are not suitable for deeper skin at all. What reaches us in clinic from these devices is burns and pigment marks, most of them from a setting built for lighter skin. If you do use one: cover moles and tattoos the way they are covered in clinic, do not use it on recently tanned skin, and do not use it on an area threaded or waxed in the last few days.
Do I really have to wear the goggles? The session is nowhere near my eyes
Yes, for every pulse, including a quick touch-up, and everyone in the room wears them. One stray flash is enough to injure an eye, and an injury to the iris can leave light sensitivity and a pupil that no longer reacts as it did — some of which does not recover. Work at the lid margin needs internal metal shields, not eyewear alone. And if you feel eye pain, light sensitivity or a change in your vision after any session, wherever the light was aimed, the eye is examined that same day, and at the nearest emergency department if it is out of hours.