Intense pulsed light (IPL) and oral isotretinoin (ISOT) are both effective in treating the effects of facial photoaging — but how does IPL stack up as a solo treatment against a combination of the two?
To find out, a research team led by Enrique Hernández-Pérez, M.D., of the Center for Dermatology and Cosmetic Surgery in San Salvador, El Salvador, conducted an open, randomized, comparative and descriptive trial involving 18 hispanic women with grades II- and III-level cutaneous aging.
Researchers divided the patients into two groups. Those in the first group underwent solo IPL treatment with an Alma Laser Harmony XL machine over five sessions with a two-week interval between each. Starting fluence was 12 J/cm2, and was increased to 13 J/cm2. The second group received the same number and type of IPL sessions, but the researchers added 20 mg of oral ISOT, three times a week for 10 weeks.
Two 3-mm punch biopsies were taken from the same site: the first just before the initial treatment, the second, three weeks after the study ended. Follow-up occurred six months after the study’s end. Controls were performed by the physician, a nurse (always the same one) and the patient herself. Two dermatopathologists were in charge of microscopic measurements and statistics.
Researchers found that combination treatment was more effective than IPL alone, clinically, microscopically and statistically.
The idea for the study came about by chance, Dr. Hernández-Pérez tells Cosmetic Surgery Times.
“We noted that patients under ISOT for acne, at the end of the treatment, not only experienced improved acne, but also showed facial rejuvenation, including normalization of skin color, improvement in wrinkles and betterment in skin turgency,” he says. “That took us to assess the use of ISOT in facial rejuvenation.
“A rejuvenated skin has been always the aim in many of the programs looking for facial rejuvenation,” Dr. Hernández-Pérez adds. “It’s possible to get that ‘refreshed’ aspect using a very low dose of ISOT for short periods of time — doses as low as 20 mg three times a week are enough to get it. It is also possible to combine ISOT with, among other procedures, IPL. In other published studies we combined ISOT with invasive and non-invasive surgeries.”