The Right Light: How IPL Treatment Can Improve Your Skin

I grew up in the sun, swimming all summer long and lifeguarding for years in my teens. Then, in my 20s and 30s, I discovered a love for running and racked up thousands of miles outside. Sunscreen wasn't on my radar until around the time I hit 40 and started using it religiously.

Now, at 58, my skin has lost some of its youthful elasticity — I have wrinkles on my forehead and "smile lines" around my eyes. I'm not bothered by them as much as I have been about the broken capillaries and sunspots on my cheeks and around my nose. I'd been covering them with makeup, but last year at my annual skin cancer check, I asked my dermatologist about them. She suggested IPL (intense pulsed light) treatment.

In fact, IPL treatments are among the fourth most popular noninvasive skin treatments, according to recent stats from the American Society of Plastic Surgeons. The treatment can help improve the look of acne scars, discolored skin, fine wrinkles, spider veins and broken blood vessels, and can also be used for permanent hair removal. All good, right? Except that there's conflicting advice about how painful it is, and I'm a wimp.

But after years of feeling self-conscious about my skin, I made the appointment. Here's what to expect and what to keep in mind if you're considering this skin treatment.

"There are a lot of age-related changes to the skin," says Diane S. Berson, MD, FAAD, a board-certified dermatologist in private practice in Manhattan, New York, and an associate clinical professor of dermatology at Weill Cornell School of Medicine. "It becomes more rough and can become more dull. The loss of your barrier [the outermost layer of your skin] leads to dryness and increases fragility and irritation."

"Most of the changes we see are the cumulative effects of sun damage, called photoaging," says Berson. "That includes signs like hyperpigmentation/dark spots, larger pores, redness, capillaries, fine lines and wrinkles. If you compare the outside of your arm to the inside of your arm, the difference in the skin between the two is the result of chronic exposure to ultraviolet light."

IPL is a broadband light that has different wavelengths that target specific chromophores, the cells that color melanin, brown and hemoglobin, red. That's why it's an effective treatment for sun spots, freckles and acne scars, which tend to be brown, and rosacea, broken blood vessels and capillaries, which are red.

"Patients who opt for IPL tend to be concerned with pigmentation or discoloration or redness and capillaries," says Berson. "IPL can help with tone and texture and can help with fine lines but for more substantial wrinkles, you'd need a laser that stimulates the collagen production."

IPL is one of only many options for people over 50 with skin concerns. Popular treatments include chemical peels, non-ablative laser treatment, and injectable toxins and fillers (think Botox and Juvéderm). "We have a lot of tools in our toolbox," she says. "If a person comes in with a complaint, we might recommend a skin care regime, a retinol cream, or a light peel or deeper laser treatment."

I made an appointment with a licensed aesthetician at my dermatologist's office after my annual exam. She examined my face, touching it gently and noting where she would use the IPL device. That felt nice. Then she covered my eyes to protect them from the IPL and gave me a small foam potato to squeeze. "We're starting," she said.

I felt the tip of the device touch my skin and then a "zap," like a mild electric shock. This didn't feel as nice. It felt like someone snapping a rubber band, hard, against my face. It was uncomfortable but bearable, though the spots around my lips and nose were especially sensitive. I took deep breaths through my nose, squeezed the heck out of that potato, and counted the zaps. Somewhere around 80 zaps, she told me she was done and handed me a couple of icepacks to put on my face. The treated areas were red and swollen (I wouldn't have been Zoom-ready), but within a couple of hours, the redness had faded.

Over the next two weeks, some of the dark spots crusted over and fell off, while many of the broken capillaries faded. I went back a month later for another treatment — this one didn't take quite as long. After another two weeks, I could see a noticeable difference in my skin. No, it wasn't the smooth glow I had in my 20s, but most of my sun spots were gone, as were the vast majority of the red threads on my cheeks and around my nose.

Note that not everyone is a candidate for IPL. Because it targets the color of the dark spot or capillary, it isn't effective if you have a suntan or darker skin. It also isn't a permanent treatment; most patients have several treatments over three to five months and then repeat the procedure twice a year.

"It's not a one-and-done treatment," says Berson. "If you have rosacea, your redness will come back. With sun exposure, dark spots will come back, so you'll want to continue some kind of treatment."

That has been the case for me. A year after my second treatment, I've seen a few sun spots and broken capillaries reappear. At some point, I'll probably spend another $200 (which insurance doesn't cover) for another IPL treatment. In the meantime, I'm keeping up with my sunscreen.