Efficacy and safety comparison between pulsed dye laser and intense pulsed light configured with different wavelength bands in treating erythematotelangiectatic rosacea.

Previous clinical studies have shown that pulsed dye laser (PDL) and intense pulsed light (IPL) are effective for treating erythematotelangiectatic rosacea(ETR). This article aims to compare the efficacy and safety of PDL and IPL at three different wavelength bands (broad-band, single-narrow-band, and dual-narrow-band) in treating ETR. Sixty subjects with ETR were randomly categorized into four groups and received one of the following laser treatments: PDL (595 nm), IPL with Delicate Pulse Light (DPL, 500-600 nm), IPL with M22 590 (590-1200 nm), or IPL with M22 vascular filter (530-650 nm and 900-1200 nm). Four treatment sessions were administered at 4-week intervals, with one follow-up session 4 weeks after the final treatment. The efficacy of the four lasers was evaluated by comparing the clinical symptom score, total effective rate, VISIA red area absolute score, and RosaQoL score before and after treatment. The safety was evaluated by comparing adverse reactions such as pain, purpura, erythematous edema, and blister. All 60 subjects completed the study. Within-group effects showed that the clinical symptom score, VISIA red area absolute score, and RosaQoL score of all four groups were significantly reduced compared to before treatment (p < 0.001). Between-group effects showed no statistically significant difference among the four laser groups. Safety analysis showed that all four lasers were safe, but the incidence of blister was higher in the M22 vascular group. Nonpurpurogenic PDL, DPL, M22 590, and M22 vascular were equally effective in treating ETR and were well-tolerated. ClinicalTrial.gov Identifier: NCT05360251.

Effect of Intense Pulsed Light versus Intradermal Tranexamic Acid for the Management of Melasma.

OBJECTIVE: To compare the effectiveness of intense pulsed light (IPL) and intradermal tranexamic acid (TXA) in treating melasma. STUDY DESIGN: A cross-sectional analytical study. Place and Duration of the Study: Department of Dermatology, Dow International Medical College, Dow University Hospital, Karachi, Pakistan, from 15th January to 15th July 2023. METHODOLOGY: A total of 62 patients with melasma, aged 20-50 years, were divided into two groups. Group A (32 patients) received IPL (560 nm filter was used) treatment, and Group B (30 patients) received intradermal TXA. Each group underwent four treatment sessions with varying intervals. Melasma area and severity index (MASI) scores were used to compare the effects of treatment. RESULTS: After a 3-month treatment period, both groups showed reduced mMASI scores compared to baseline with a significant initial difference between Group A (8.6 ± 4.2) and Group B (5.4 ± 2.7, p <0.001). However, post-treatment, there was no significant difference in mMASI scores (Group A: 3.8 ± 2.6; Group B: 3.2 ± 2.0, p = 0.29). IPL treatment (Group A) demonstrated a significant reduction in mMASI scores (57.1 ± 19.7) compared to intradermal TXA treatment (Group B, 42.2 ± 18.8, p = 0.0034). CONCLUSION: Both IPL and intradermal TXA treatments effectively reduced melasma, with IPL exhibiting superior results. However, post-treatment outcomes converged, emphasising the need for personalised approaches considering the unique characteristics of South East Asian skin. KEY WORDS: Intense pulsed light, Melasma, Intradermal tranexamic acid.

Intense pulsed light treatment for the management of meibomian gland dysfunction.

PURPOSE OF REVIEW: Meibomian gland dysfunction (MGD) is one of the most common disorders encountered by ophthalmologists, and its management can prove challenging for both clinicians and patients. Intense pulsed light (IPL), which has been historically used in the field of dermatology, has emerged as a tool to help improve meibomian gland function. The goal of this review is to assess the clinical efficacy, utility, and safety of IPL for the treatment of MGD. RECENT FINDINGS: In recent randomized controlled trials, IPL has been shown to improve meibomian gland function, and subsequently tear film quality and dry eye symptoms. The mechanism of action still remains unclear. Recent literature suggests that IPL may also be used in conjunction with other therapies, such as meibomian gland expression, low-level light therapy, and thermal pulsation. Careful attention should be placed on each patient's Fitzpatrick skin type, as well as protecting the ocular structures to reduce the risk of adverse effects. Cost, accessibility, as well as a limited duration of efficacy may be drawbacks. SUMMARY: There is significant evidence supporting that IPL may be used as a potential well tolerated and effective treatment for MGD, though there are certain caveats regarding its long-term efficacy, accessibility, and cost.

Intense pulsed light therapy for ocular surface diseases.

Intense pulsed light (IPL) is a non-laser, high-intensity light source that has been shown to play a valuable role in dermatology and has been adopted in ophthalmology for treating meibomian gland dysfunction (MGD). In this review, we discuss the mechanism of action of IPL, including its benefits in ophthalmology. IPL therapy has been shown to improve tear film stability, meibomian gland (MG) function, and subjective symptoms of ocular dryness in MGD patients. Moreover, emerging evidence suggests that IPL therapy is beneficial for other ocular surface diseases, such as blepharitis and chalazia. Hence, it can be inferred that IPL has potential as a therapeutic modality in future applications. Large clinical and experimental trials are needed to exploit the full potential of IPL as a treatment for recurrent chalazia, Sjögren's syndrome, and other causes of dry eye disease (DED). This paper reviews the published literature related to the application of IPL for treating ocular surface diseases.

Efficacy and safety of the combination of oral tranexamic acid and intense pulsed light versus oral tranexamic acid alone in the treatment of refractory Riehl's melanosis: A prospective, comparative study.

BACKGROUND: There is no standardized and effective treatment modality for Riehl's melanosis. AIMS: To compare the efficacy and safety of oral tranexamic acid (TXA) combined with intense pulsed light (IPL) versus TXA alone in the treatment of refractory Riehl's melanosis. METHODS: A prospective study of 28 subjects with refractory Riehl's melanosis and Fitzpatrick Skin Types III or IV was conducted. All subjects received oral TXA 500 mg daily and 11 of them were treated in combination with monthly IPL therapy for 6 months. The primary outcome measure was mean melanin index (MI), erythema index (EI) and acquired dermal macular hyperpigmentation area and severity index (DPASI). The Physician Global Assessment (PGA) and patient satisfaction scale were documented. RESULTS: After treatment, DPASI, mean MI, and EI were significantly reduced in both groups. The group treated with combination therapy showed better improvement according to MI (p = 0.0032) and DPASI (p = 0.00468). PGA and patient satisfaction scale showed superior efficacy in the combination group. No significant difference was observed in treatment-related side effects. CONCLUSION: The combination of oral TXA and IPL proves to be a safe and satisfactory treatment strategy for refractory Riehl's melanosis.

IPL-PDT as an effective treatment for mild-to-moderate acne vulgaris: A prospective, single-center, self-controlled study.

BACKGROUND: High recurrence rate of mild-to-moderate acne vulgaris following traditional therapy poses a significant challenge. 5-Aminolaevulinic acid photodynamic therapy (ALA-PDT) with intense pulsed light (IPL) has emerged as a promising intervention. OBJECTIVES: This study aimed to evaluate the efficacy and safety of IPL-PDT for the treatment of mild-to-moderate acne vulgaris. METHODS: In this prospective, self-controlled study, eligible patients aged from 18 to 45 years old with Pillsbury grade Ⅰ-III facial acne were included. Patients were treated with three sessions of IPL-PDT at three-week interval, with follow-ups at 3 weeks and 2 months after the final treatment. RESULTS: A total of 31 patients were enrolled. At 3 weeks post-treatment, the mean count of acne lesions decreased significantly (P < 0.001), with 87.1 % of patients achieving treatment success (defined as ≥ 75 % clearance rate of acne lesions). Recurrence rate at 2-month follow-up was 9.68 %. No severe adverse reactions were observed. LIMITATIONS: This study is a single-center, self-controlled study. Multi-center study designed as randomize controlled trials involving a larger patient cohort is necessary. CONCLUSIONS: IPL-PDT is a promising therapy for mild-to-moderate acne vulgaris, exhibiting high efficacy, minimal adverse effects, and a low recurrence rate.

Changes of Facial Lipidomics by Intense Pulsed Light Treatment Based on LC-MS.

BACKGROUND: Intense pulsed light (IPL) has been widely used to improve cutaneous photoaging in recent years. Several studies began to explore the changes of skin barrier function after treatment, but the changes of skin surface lipids (SSL), especially specific lipid content and types are still unclear. METHODS: A total of 25 female volunteers were included in our study, and each of them received three full-face treatments with one month apart. Before the first treatment and 1 month after the last treatment, we collected clinical photos and skin stratum corneum samples from individuals. A 5-level scale was used to evaluate the efficacy of IPL treatment, liquid chromatography-mass spectrometry (LC-MS), and Orthogonal Partial Least Squares Discrimination Analysis (OPLS-DA) were used to analyze the changes of SSL. RESULTS: Two patients got no improvement after treatment, 6 patients had poor improvement and mild improvement was achieved in 9 patients, 5 and 3 patients reported moderate and significant improvement. The overall "effective" rate was 68 % and the "significant effective" rate was 32 %. The results showed 18 lipid subclasses and 487 lipid molecules were identified. The change of total lipid volume was not statistically significant (P = 0.088>0.05), but lipid subclass analysis showed the amount of Triglyceride (TG), Phosphatidic Acid (PA), Phosphatidylglycerol (PG) and Lysophosphatidylglycerol (LPG) were significantly increased (P < 0.05). There were 55 kinds of lipid molecules with significant difference after treatment (P < 0.05), and 51 of them belong to TG. The analysis of chain saturation of TG showed that the quantity of TG with 0, 1 and 2 unsaturated bonds increased significantly (P < 0.05). CONCLUSIONS: IPL treatment does not have a significant effect on the overall amount of lipids while the amount of TG, PA, PG, LPG were significantly increased. These lipid changes may potentially improve the skin barrier function, but more high-quality and comprehensive studies are still needed. BULLET POINT: Lipidomics analysis based on LC-MS; Changes of skin surface lipid after IPL treatment; the relationships between skin surface lipid and skin barrier functions. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Comparison of clinical outcomes between intense pulsed light therapy using two different filters in meibomian gland dysfunction: prospective randomized study.

Our study compared treatment efficacy between cut-off and notch filters in intense pulsed light (IPL) therapy for meibomian gland dysfunction (MGD) through a prospective, randomized paired-eye trial. Additionally, the efficacy of IPL treatment alone was investigated by restricting other conventional treatments. One eye was randomly selected for an acne filter and the other for a 590-nm filter. Identical four regimens of IPL treatments were administered. The tear break-up time (TBUT), Oxford scale, Sjögren's International Clinical Collaborative Alliance (SICCA) staining score, tear matrix metalloproteinase-9 (MMP-9) expression, tear osmolarity, and Ocular Surface Disease Index (OSDI) questionnaires were evaluated before and after IPL. Meibomian gland (MG) parameters were measured. When combining the results from both filters, the TBUT, SICCA staining score, OSDI score, and upper and lower lid meibum expressibility were improved after IPL. No significant differences were found between the two filters in the TBUT, Oxford scale, SICCA staining score, MMP-9 expression, tear osmolarity, and MG parameters. Although not significant, the acne filter showed better treatment efficacy than that in the 590-nm filter. IPL alone is efficacious in terms of ocular surface parameters, MG function, and subjective symptoms. Regarding filter selection, both acne and 590-nm filters are promising options for MGD treatment.

Efficacy of intense pulsed light therapy on signs and symptoms of dry eye disease: A meta-analysis and systematic review.

This study reviewed the efficacy and safety of intense pulsed light (IPL) for the treatment of dry eye disease (DED). The PubMed database was used to conduct the literature search, which used the keywords "intense pulsed light" and "dry eye disease". After the authors evaluated the articles for relevancy, 49 articles were reviewed. In general, all treatment modalities were proven to be clinically effective in reducing dry eye (DE) signs and symptoms; however, the level of improvement and persistence of outcomes differed amongst them. Meta-analysis indicated significant improvement in the Ocular Surface Disease Index (OSDI) scores post-treatment with a standardized mean difference (SMD) = -1.63; confidence interval (CI): -2.42 to -0.84. Moreover, a meta-analysis indicated a significant improvement in tear break-up time (TBUT) test values with SMD = 1.77; CI: 0.49 to 3.05. Research suggests that additive therapies, such as meibomian gland expression (MGX), sodium hyaluronate eye drops, heated eye mask, warm compress, lid hygiene, lid margin scrub, eyelid massage, antibiotic drops, cyclosporine drops, omega-3 supplements, steroid drops, and warm compresses along with IPL, have been found to work in tandem for greater effectiveness; however, in clinical practice, its feasibility and cost-effectiveness have to be taken into consideration. Current findings suggest that IPL therapy is suitable when lifestyle modifications such as reducing or eliminating the use of contact lenses, lubricating eye drops/gels, and warm compresses/eye masks fail to improve signs and symptoms of DE. Moreover, patients with compliance issues have been shown to benefit well as the effects of IPL therapy is sustained for over several months. DED is a multifactorial disorder, and IPL therapy has been found to be safe and efficient in reducing its signs and symptoms of meibomian gland dysfunction (MGD)-related DE. Although the treatment protocol varies among authors, current findings suggest that IPL has a positive effect on the signs and symptoms of MGD-related DE. However, patients in the early stages can benefit more from IPL therapy. Moreover, IPL has a better maintenance impact when used in conjunction with other traditional therapies. Further research is needed to assess cost-utility analysis for IPL.

Assessment of adverse events for a home-use intense pulsed light hair removal device using postmarketing surveillance.

BACKGROUND AND OBJECTIVES: Home-use intense pulsed light (IPL) hair removal devices are convenient for consumers. Consumer safety associated with home-use IPL devices, however, remains a subject of interest. In this descriptive analysis, we assessed the most commonly reported adverse events (AEs) for a home-use IPL device from postmarketing surveillance and qualitatively compared these with AEs from clinical studies and medical device reports of home-use IPL treatments. MATERIALS AND METHODS: For this analysis of voluntary reports, we queried a distributor's postmarketing database for IPL devices for the period beginning January 1, 2016, to December 31, 2021. All sources of comments, for example, phone, e-mail, company-sponsored web sites, were included in the analysis. AE data were coded according to the Medical Dictionary for Regulatory Activities (MedDRA) terminology. Also, we conducted a PubMed search to identify AE profiles from existing literature on home-use IPL devices and we searched the Manufacturer and User Facility Device Experience (MAUDE) database for reports on home-use IPL devices. These results were qualitatively compared to the data in the postmarketing surveillance database. RESULTS: A total of 1692 cases involving IPL were identified from voluntary reports of AEs between 2016 and 2021. The shipment-adjusted reporting rate for AE cases (number of AE cases/100,000 shipped IPL devices) was 67/100,000 during this 6-year period. The most commonly reported AEs were pain of skin 27.8% (470/1692), "thermal burn" 18.7% (316/1692), and erythema 16.0% (271/1692). Among the top 25 AEs reported, no unexpected health events were observed. The reported AEs were qualitatively similar to the pattern seen in clinical studies and the MAUDE database associated with such home-use IPL treatments. CONCLUSION: This is the first such report documenting AEs for home-use IPL hair removal from a postmarketing surveillance program. These data are supportive of the safety of such home-use low-fluence IPL technology.

Expert opinion about laser and intense pulsed light (IPL)-induced leukoderma or vitiligo: a cross-sectional survey study.

Vitiligo patients may desire laser hair removal, skin rejuvenation, vascular treatments, and other laser or intense pulsed light (IPL) assisted treatments. However, there is a risk of inducing new depigmented patches (Koebner phenomenon). In absence of guidelines on the safe use of laser or IPL in vitiligo patients, dermatologists tend to be reluctant to administer these treatments. The aim of this survey study was to provide an estimation of the occurrence and related risk factors of laser/IPL-induced leukoderma or vitiligo. A cross-sectional survey study was performed among 15 vitiligo experts from 11 countries, with 14 questions about affected patients, involved laser/IPL treatments and the physicians' approach. In a total of 11,300 vitiligo patients, laser/IPL-induced leukoderma or vitiligo was reported in 30 patients (0.27%). Of these, 12 (40%) patients had a medical history of vitiligo and seven (58%) of these patients had stable (> 12 months) vitiligo before the treatment. Most frequently reported were hair removal procedures and localization of the face and legs. Side effects like blistering, crusting, and erosions occurred in 56.7% of the cases. These vitiligo experts based their advice on the risk of the laser treatment on stability of the vitiligo (43%) and activity signs (50%), and 50% discuss the risks before starting a laser treatment. Relevant activity signs are the Koebner phenomenon (57.1%), confetti-like lesions (57.1%) and hypochromic borders (50%). Laser-induced leukoderma or vitiligo is an uncommon phenomenon. Remarkably, a minority had a medical history of vitiligo of which 58% were stable. Consequently, most cases could not have been prevented by not treating vitiligo patients. However, a majority had laser/IPL-induced skin damage. Therefore, caution is advised with aggressive settings and test-spots prior to the treatment are recommended. This study showed significant variation in the current recommendations and approach of vitiligo experts regarding laser/IPL-induced leukoderma or vitiligo.

Intense Pulsed Light Attenuates Oxidative Stress in Perennial Allergic Conjunctivitis.

Objective: To assess the effects of intense pulsed light (IPL) on oxidative stress (OS) in perennial allergic conjunctivitis (PAC). Background: IPL treatment has been proven effective for dry eye disease (DED). However, we have observed that, after IPL treatment, some patients with DED combined with allergic conjunctivitis (AC), an immune response condition in which excessive OS causes and exacerbates inflammatory damage, not only show an improvement in eye dryness, but also their AC-related eye itching is relieved. The mechanism by which IPL inhibits allergic reactions is not clear. Methods: Five patients with moderate-to-severe PAC were given two IPL treatments on the periorbital skin with a 2-week interval. Visual analog scale (VAS) scores and signs of AC, including eye redness and conjunctival follicles, were assessed before the first treatment (day 1) and 2 weeks after the second treatment (day 30). Tears were also collected at the same time, and lipid oxidation (LPO) metabolite analysis was performed using liquid chromatography tandem mass spectrometry (LC-MS/MS) to investigate the effects of IPL on OS response. Results: The average VAS score significantly decreased with treatment (30.2 for day 1, 10.6 for day 30; p < 0.001). The general signs of PAC showed no difference (p > 0.05). LPO metabolite analysis revealed that 17,18-diHETE, which is an oxidation product of eicosapentaenoic acid, and 13-OXoODE, which is an oxidation product of linoleic acid, are significantly downregulated after IPL treatment. Conclusions: The photothermal effect of IPL attenuates OS in PAC, and this seems to be one of the mechanisms by which IPL treatment improves PAC. Clinical Trial Registration number: ChiCTR1900022202.

Low-Level Light Therapy Versus Intense Pulsed Light for the Treatment of Meibomian Gland Dysfunction: Preliminary Results From a Prospective Randomized Comparative Study.

PURPOSE: The purpose of this study was to evaluate and compare the safety and efficacy of low-level light therapy (LLLT) and intense pulsed light (IPL) for the treatment of meibomian gland dysfunction (MGD). METHODS: Forty eyes of 40 patients with MGD were randomized to receive either LLLT or IPL. Four weekly sessions of LLLT (MY MASK-E, Espansione Marketing S.p.A., Bologna, Italy) and IPL (Eye-light device, Espansione Marketing S.p.A., Bologna, Italy) were performed. The following parameters were evaluated before and 2 weeks after the last session for each treatment: Standard Patient Evaluation of Eye Dryness questionnaire, noninvasive break-up time, tear meniscus height, redness score, meiboscore, and meibomian gland loss. RESULTS: All patients completed regularly all the scheduled sessions, and no adverse events were reported in any of the groups. The Standard Patient Evaluation of Eye Dryness score significantly decreased after both LLLT and IPL (P < 0.001) although the improvement was significantly greater in the LLLT compared with the IPL group (-9.9 ± 3.2 vs. -6.75 ± 4.5; P = 0.014). Patients in the LLLT group showed a significantly higher increase in tear meniscus height compared with those in the IPL group (0.06 ± 0.10 mm vs. -0.01 ± 0.014; P = 0.040). In both groups, the noninvasive break-up time, redness score, meiboscore, and meibomian gland loss did not vary significantly after treatment (all P > 0.05). CONCLUSIONS: Both LLLT and IPL were safe and effective in improving ocular discomfort symptoms in patients with MGD; however, the former determined a greater improvement in symptoms and an improvement of tear volume.

Intense Pulsed Light Therapy to Inhibit Meibomian Gland Inflammation: Untargeted Metabolomics Analysis of Meibomian Gland Secretions.

Objective: To assess the inhibitory effects of intense pulsed light (IPL) on meibomian gland (MG) inflammation. Background: IPL treatment is effective for dry eye disease (DED) caused by meibomian gland dysfunction (MGD). However, the anti-inflammatory and regeneration stimulating effects of IPL on MGD remain unclear. Moreover, studies on inflammatory metabolites in MG secretions are lacking. Methods: Six patients with DED were administered two IPL treatments. Ocular surface disease index (OSDI) questionnaires were used to assess DED, MGD signs, including degree of obstruction, secretion, and atrophy of the MG, tear film break-up time (TBUT) was assessed before and after treatments. To determine IPL treatment-induced changes in metabolites, liquid chromatography tandem mass spectrometry (LC-MS/MS) was used to analyze MG secretions. Results: Data were gathered before the first treatment (time A) and 2 weeks after the second treatment (time B). Average OSDI score showed a significant decrease (time A and B measurements were 44.07 and 16.65, respectively). Besides, statistically significant differences were observed in MG signs before and after treatments: degree of obstruction improved and secretions became thinner. TBUT was significantly increased to the normal range. LC-MS/MS led to the identification of 53 differential metabolites: 23 were upregulated (e.g., estradiol, coenzyme Q, and azelaic acid) and 30 were downregulated (e.g., prostaglandins, 20-hydroxyeicosatetraenoic acid, and arachidonic acid). Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis showed that most differential metabolites were involved in steroid hormone biosynthesis. Conclusions: Periorbital IPL treatment can improve chronic inflammation of the MG and promote its normal secretion. The steroid hormone biosynthetic pathways may be activated to participate in this anti-inflammatory effect.

Efficacy and safety of intense pulsed light direct eyelid application.

To describe the efficacy and safety of intense pulsed light (IPL) applied directly on the eyelids of patients with Meibomian gland dysfunction (MGD) without corneal shield protector. Observational retrospective single centre study where patients underwent 3 treatment sessions of IPL with 2 weeks of interval. The IPL was carried out with Lumenis OPT M22 with a double pass technique of 12 impacts on the infraorbital/lower eyelid region with the 15 × 35 mm guide light (step 1) and a double pass technique of 3 impacts over the upper eyelids with the 8 × 15 mm guide light (step 2). The follow up was conducted through Oculus Keratograph 5 M. 30 patients were enrolled in the study. Although there were no significant differences (p > 0.05), non-invasive tear break-up time, ocular redness, and OSDI questionnaire improved during the 3 IPL sessions. A significant improvement (p = 0.024) in the percentage of meibomian gland loss was also observed. Regarding tear meniscus, it was found similar measurements before and after treatment. No serious adverse effects were reported during the procedure or in subsequent follow-up. Preliminary results suggest that IPL therapy applied directly on the eyelids without corneal shield could be safe and effective in the treatment of MGD.

Effect of Intense Pulsed Light Therapy in Dry Eye Disease Caused by Meibomian Gland Dysfunction: A Systematic Review and Meta-Analysis.

BACKGROUND: This study aimed to systematically evaluate the effect of intense pulsed light (IPL) therapy in patients harboring dry eye disease caused by meibomian gland dysfunction (MGD) based on qualified studies. METHODS: The electronic databases, including PubMed, Cochrane, and Embase, were searched using keywords to identify available publications updated to November 2021. Relative risk or weighted mean difference combined with 95% confidence interval was used to synthesize the outcomes of included studies. The meta-analysis included 15 randomized controlled trials with 1,142 patients (2,284 eyes). RESULTS: The results revealed that IPL could significantly decrease the ocular surface disease index (OSDI), standard patient evaluation of eye dryness (SPEED), artificial tear usage, tear film lipid layer, meibomian gland quality (MGQ), meibomian gland expression (MGX), and corneal fluorescein staining (CFS) while increase tear break-up time (TBUT) and noninvasive tear break-up time (NIBUT) compared with sham. Compared with MGX, IPL+MGX markedly decreased the SPEED, CFS, and tear meniscus height (TMH), but with increased TBUT. Compared with MGX, IPL showed significant effect in increasing the OSDI and TBUT, but decreasing the TMH and NIBUT. However, no significant differences were seen between IP+MGX and MGX in OSDI, MGQ, and MGX, nor between IPL and MGX in OSDI, SPEED, and TBUT. CONCLUSION: We identified that the application of IPL alone or IPL combined with MGX elicited superior clinical effect for improving the eye function and symptoms in the treatment of MGD-related dry eye disease, which is considered available for wide clinical application.

Will repeated Intense Pulsed Light (IPL) treatment sessions affect facial skin sensitivity? Results of a twelve-Month, prospective, randomized split-face study.

BACKGROUND: Despite the widespread use of intense pulsed light (IPL) technology in cosmetic dermatology, the effects of its repeated use on facial skin sensitivity in healthy individuals remains unknown. METHODS: Seventeen healthy female volunteers were included in the study. We measured objective biophysical parameters of the skin, including transepidermal water loss (TEWL), skin glossiness, thickness and density of the epidermis and dermis, sensory nerve current perception threshold (CPT), and regional blood flow before and after treatment at different time points. RESULTS: Sixteen volunteers completed a follow-up of 12 months. The treated side of the face showed a decreased TEWL on D1 and D3, which reverted to normal on D7. Epidermal thickness increased and skin glossiness decreased on the treated side on D1, but returned to normal on D3. We found no statistically significant differences in CPT values or in regional blood flow volume and velocity, with the exception of D1, which exhibited a higher regional blood flow volume on the treated side. CONCLUSION: Repeated IPL treatments had no effects on facial skin barrier function, skin nerve sensitivity, or local microcirculation among healthy individuals. IPL is a safe skin care procedure that does not affect skin sensitivity.

Treatment Effect and Pain During Treatment With Intense Pulsed-Light Therapy According to the Light Guide in Patients With Meibomian Gland Dysfunction.

PURPOSE: We investigated whether there is a difference in the treatment effect and pain during the treatment of meibomian gland dysfunction (MGD) with intense pulsed-light (IPL) between new light guide and conventional light guide. METHODS: We retrospectively reviewed medical records of 85 patients (170 eyes) who underwent IPL treatment of the upper and lower eyelids 3 times, at 3-week intervals, for MGD. Patients treated with the 6-mm or 8 × 15-mm cylindrical light guide were designated as group A or group B, respectively. The ocular surface disease index (OSDI), dry eye (DE), and MGD parameters were obtained before the first and after the third IPL treatments. Visual analog scale (VAS) scores were obtained at every IPL treatment. OSDI, DE, and MGD parameters and VAS scores were compared between the groups. RESULTS: VAS scores at the first, second, and third IPL treatments were lower in group A than in group B. OSDI, DE, and MGD parameters were improved after 3 IPL treatments in both groups. There were no significant differences in OSDI, DE symptoms, and MGD parameters between before the first IPL treatment and after the third IPL treatment between the groups. CONCLUSIONS: Using the new 6-mm cylindrical light guide for IPL treatment in patients with MGD induced less pain during treatment and had similar treatment effects to the conventional 8 × 15-mm light guide. The new 6-mm cylindrical light guide can be useful when treating patients with dark or hyperpigmented skin and for pediatric patients with low compliance.

Intense Pulsed Light on skin rejuvenation: a systematic review.

Aged skin is characterized by appearance of wrinkles, vascular lesions, hyperpigmentation, lentignes, texture, rhytides, and pores. These changes occur under the influence of intrinsic and extrinsic factors, as hormone alterations and exposure to ultraviolet light (UV) irradiation, respectively. Skin changes associated with aging have been assuming an important role in nowadays and bring to affect the quality of life. Intense Pulsed Light (ILP) is a noncollimated, polychromatic, and noncoherent non-surgical cosmetic therapy to skin rejuvenation. This is the first systematic review evaluating ILP treatment on skin rejuvenation evaluated by digital photographs and self-reported treatment efficacy. A PRISMA compliant review includes a search of the databases Scopus and PubMed. Sixteen studies treating 637 participants (with Fitzpatrick skin types I to IV and age varying from 21 to 80 years) were included. Patients were treated a mean of 4.29 sessions (range 3-7). The most studies results showed the efficacy of IPL treatment in telangiectasia, wrinkles, pore, erythema, rhytids, texture, lentigines, hiperpigmentation, and photoaging score. Six studies showed IPL-positive effects in association with other treatment and seven studies showed superior effect of other treatment or association to IPL with other treatment related to IPL alone. Nine studies showed low methodological quality. In conclusion, ILP treatment is effective on skin rejuvenation. However, there is no consensus about the parameters and future studies are needed to sample size limitations, made RCTs with low risk of bias, and improve the methodological quality its. Trial registration: Prospero Systematic Review Registration ID: CRD42021237817.

Efficacy of five-flash intense pulsed light therapy technique in patients with meibomian gland dysfunction.

CLINICAL RELEVANCE: Meibomian gland dysfunction is the main cause of evaporative dry eye disease and can lead to ocular discomfort and ocular surface damage. Early diagnosis and management of this condition can prevent its impact on patients 'visual health and quality of life. BACKGROUND: In the last decade, intense pulsed light therapy (IPL) has been introduced as a therapeutic option for patients with meibomian gland dysfunction (MGD). Various treatment modalities and protocols have been reported to increase the efficacy of this technique. This study aimed to assess the efficacy of a novel five-flash IPL technique in combination with home-based therapy and to compare it with conventional home care alone in patients with MGD. METHODS: In a randomised controlled trial, 100 symptomatic MGD patients were enrolled. The treatment group underwent three sessions of a five-flash IPL therapy. For all participants, eyelid warming, lid hygiene and lubricant therapy was prescribed. Ocular surface parameters were compared for control and treatment groups. RESULTS: Ocular Surface Disease Index (OSDI), non-invasive keratograph tear break up time (NIKBUT), fluorescein TBUT, MG expressibility, meibum quality and tear osmolarity were improved at follow up visits in both groups (p < 0.05). On day 75, NIKBUT was significantly higher in the IPL group (p = 0.045). The IPL treatment effect was not statistically significant (p > 0.05), except for bulbar and limbal hyperaemia (p = 0.02 and p = 0.02). In both groups, younger patients showed more improvement in NIKBUT (p = 0.02, r = -0.32; p < 0.001, r = -0.52). CONCLUSION: IPL therapy combined with conventional home-based therapy, and home care alone are both effective for patients with MGD. IPL may have an additional role in the improvement of ocular hyperaemia.