Intense Pulse Light (IPL) on Dark Skinned Patients

Intense Pulse Light (IPL) on Darker Skin Types

By Helen Molteni

Case Western Reserve University – Class of 2023

Biochemistry and Finance, B.A. Candidate

Class of 2023 President

Intense pulsed light (IPL) is a relatively new method for treating dry eye disease; it works specifically to reduce inflammation, liquify the oil to some extent, and unclog meibomian glands, which prevents tear evaporation, the main cause of dryness.

Numerous studies have demonstrated the safety and efficacy of IPL in treating dry eye, but there remain some questions about the success of IPL for patients with darker skin tones.1

The Fitzpatrick scale classifies skin types on a I-VI scale. Patients with types IV and higher have concerns about potential side effects of IPL, as pain, blisters, and depigmentation have been reported, particularly in IPL treatments for dermatological conditions (hair removal, rosacea, etc).

However, recent studies have shown success in treating patients with darker skin types. A study of type III-IV patients in China found that using a laser with a higher wavelengths and a lower energy is just as effective as a high energy laser, but with reduced side effects.2 Another study in Spain found that a new IPL called Thermaeye plus was effective and safe for treating dry eye disease in patients with skin types I-IV.3

Dr. Cremers has treated 10 patients with Fitzpatrick Type 4 and 2 patients with Fitzpatrick Type V without skin discoloration. Randomized, controlled, double-blinded studies will help determine if IPL, in such patients, is safe long term and equally effective for dry eye disease from meibomian gland dysfunction.

A picture containing graphical user interface

Description automatically generated

Figure 1,2: From paper: Position of IPL for treatment of dry eye disease in dark-skinned patients3

While it is important for dark-skinned patients to be aware of potential risks of undergoing IPL, this treatment certainly remains an option. The key factors to minimize potential side effects are to ensure that the laser’s energy relatively low (8-20 J/cm2) and that the procedure is carried out by a knowledgeable professional that can adjust treatment to accommodate all skin types.

References:

1. Giannaccare, G., Taroni, L., Senni, C., & Scorcia, V. (2019). Intense Pulsed Light Therapy In The Treatment Of Meibomian Gland Dysfunction: Current Perspectives. Clinical optometry, 11, 113–126.

2. Li D, Lin S, Cheng B. Intense pulsed light treatment for meibomian gland dysfunction in skin types III/IV. Photobiomodul Photomed Laser Surg. 2019;37:70–76. doi:10.1089/photob.2018.4509

3. Vergés, C., Salgados-Borges, J., & March de Ribot, F. (2020). Prospective evaluation of a new intense pulsed light, thermaeye plus, in the treatment of dry eye disease due to meibomian gland dysfunction. Journal of Optometry, 1-12.

Pictures:

Fitzpatrick Skin Chart: Sutton Dermatology and Aesthetics

https://suttonderm.com/whats-your-type/

Thermaeye Plus: Optimed

https://optimed.com.au/index.php/our-products/eshop/shopping-cart/thermaeyes