Photofacial Applications

A key development in the cosmetic light-based technology arena over the past eight years has been the photofacial, which has become one of the most popular treatments on the mar­ket. This “light-based” facial is aimed at the treatment of vascular issues and epidermal pig­mentation (see Figs. 4.8 and 4.9, respectively), which improves the overall appearance of the skin. The pulsed light system, by nature of incoherent light, uses the majority of its energy up in the very superficial layers of the skin, making it ideal for this type of treatment

The treatment is normally performed with a pulsed light hand piece in the 500-1,200 nm wavelength range, making it ideal for the treatment of both vascular and pigmented lesions. Using the Palomar Lux G hand piece on the Starlux system, the operator utilizes the double cutoff filter (500-670 nm, 870-1,200 nm) to efficiently treat both targets without deposit­ing unnecessary heat in the skin from the 700-900 nm range. The typical treatment involves the treatment of pigmentation in the forehead and outer cheek area using a 10-20 ms pulse

duration, followed by the treatment of smaller vessels on the ridge of the cheekbone below the eyes as well as the chin, which is mostly done with a 10 ms pulse duration. The final part of the treatment is usually targeting the large vessels in the alar groove (Fig. 4.8), which usually requires two pulses, one at 100 ms pulse duration, and one at 20 or 10 ms, all with high fluence. The skin in this area, being very sebaceous, is quite forgiving to this type of light, and therefore can be treated more aggressively than any other area on the body. The desired result for the pigmentation is a slight darkening, enough to indicate an exfoliation of the lesion 7-15 days later, depending upon the body area treated (Fig. 4.9). For the vessels, the desired endpoint is the vasoconstriction or closing of the vessels.