Beyond Lasers: Pulse-Light Therapy for That Fantasy Face

From the WebMD Archives

July 27, 2000 -- It's not as if Tina Huoso needed a face-lift. At age 31, she was essentially wrinkle-free. A handful of superficial acne scars, reminders of her teen-age years, were just about her only blemishes.

But the brown sun blotches that began appearing on her forehead, and especially one above her lip, made Tina self-conscious. "I put a lot of concealer to blend it in, but I really don't like wearing a lot of makeup," she tells WebMD. "It looked like I was covering something up."

Huoso is an assistant to Atlanta facial plastic surgeon Seth Yellin, MD. She took advantage of the newest technology -- intense pulse-light therapy -- to smooth her imperfections. "People commented," she tells WebMD. "They said I looked great, that I glowed." As for the blotches, "They're gone."

It's the new way to keep aging at bay.

Growing numbers of dermatologists are now using intense pulse-light therapy -- instead of lasers -- to smooth and soothe facial woes. With this new magic wand, they can delete fine-to-moderate lines and wrinkles, remove unwanted facial hair, and erase a whole array of pigment problems, including sunspots. Doctors say it actually tightens up those unsightly pores -- perhaps permanently.

And for many people with an embarrassing condition called rosacea -- a facial redness caused by spider veins and acne-like outbreaks -- this may be the first true treatment, doctors say.

Best of all, there's no "downtime" as there is with laser treatments. "It's truly a lunchtime therapy," says Yellin, who is assistant professor of facial plastic surgery at Emory University School of Medicine.

Intense pulse-light skin therapy won FDA approval for hair removal five years ago. In the past few years, dermatologists have discovered many more uses for this technology, which involves pulsed multiple lengths of light rays, explains Yellin.

While it may sound like a laser treatment, "it's not a laser," Yellin tells WebMD. "We can select from multiple wavelengths of light [whereas lasers use one continuous light wavelength.] We can enter into the computer the skin color, body area, skin type to generate specific settings. During treatment, multiple wavelengths of light are entering the skin, concentrating their energy at different levels. That allows us to treat many, many different problems."

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"In terms of superficial problems, it works great," says Ronald Moy, MD, editor-in-chief of the journal Dermatology Surgery. "I've treated famous movie stars, a pretty particular crowd. For those in their 40s and 50s who don't have deep lines, there's really no down side." Moy is also an associate clinical professor at UCLA.

Two years ago, dermatologist Patrick Bitter Sr., MD, of Los Gatos, Calif., developed the first treatment for rosacea. In over 20 years of practice, he had seen no good solutions for this common but complex disorder. "People have tried various laser treatments, but they never were very successful," Bitter tells WebMD.

In his study of 57 patients with an assortment of problems -- photo aging, scars, wrinkles, and rosacea -- Bitter found 89% patient satisfaction with the level of clearing. "Patients were thrilled with it, especially when it came to the redness of rosacea," he tells WebMD. "People suffer from that for years ... it makes a huge difference to them." As for pore problems, Bitter says, genetics rule. "It will not decrease pores beyond the genetic limitations," he says. "But they will be substantially smaller."

During treatments, Yellin explains, "light energy is sent through the outer skin -- the epidermis -- and energy is concentrated on the dermis, the deeper part of the skin. Because the light generates heat, it stimulates cells in the body that go on to form more collagen, as much as 20% more."

Because it "plumps the skin, it's like giving yourself a collagen injection but using your own collagen," says Yellin.

There's no down time because no healing is involved, he says. "Unlike laser therapy, it attacks the problem from the inside. It leaves the outer skin completely intact, so there is no visible damage to skin. Because skin is left completely intact -- because it is not damaged -- it doesn't need to heal."

"The vast number of patients cannot tolerate any down time, don't want the stigma of the red face that comes with lasers," Yellin tells WebMD. "When you laser someone, they may be red for six weeks to six months. There's a week of real peeling, where you have to cover your face with Vaseline and hide. It's a significant disruption in someone's lifestyle."

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"You don't want a shotgun to kill a fly," he adds. For relatively small problems, "pulse-light therapy is fabulous."

Facial therapy procedures take about 45 minutes, whereas hair removal times will vary depending on the area being treated. Afterward, there is "just a flush, not really redness," Huoso says. "It goes away in an hour or two. You can apply makeup right afterwards. I had it done on my lunch hour and went right back to work."

Typically, six treatments are necessary for most problems with a pricetag of a little more than $2,000 for a the series.

While Huoso says she doesn't think the treatments hurt, some might find them a bit painful, she says. She had her procedures done without anesthetic but says some patients may opt to have some anesthetic applied to the skin. "You'd be surprised," she says. "Your face is less sensitive than you would think ... You just feel a bit of heat."

Intense pulse-light therapy won't work with deep wrinkles. "It's not a panacea for everything. But we've replaced almost all other laser treatments with [this technology]."

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