TY - JOUR
T1 - Side effects from intense pulsed light
T2 - Importance of skin pigmentation, fluence level and ultraviolet radiation-A randomized controlled trial
AU - Thaysen-Petersen, Daniel
AU - Erlendsson, Andres M
AU - Nash, J F
AU - Beerwerth, Frank
AU - Philipsen, Peter A
AU - Wulf, Hans C
AU - Paasch, Uwe
AU - Haedersdal, Merete
N1 - © 2016 Wiley Periodicals, Inc.
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Background and Objective: Intense pulsed light (IPL) is a mainstream treatment for hair removal. Side effects after IPL are known, but risk factors remain to be investigated. The objective of this study was to assess the contribution of skin pigmentation, fluence level, and ultraviolet radiation (UVR) on IPL-induced side effects. Methods: The study was a blinded, randomized intra-individual controlled trial including 16 healthy subjects with Fitzpatrick Skin Types (FST) II–V. Three test areas were each divided into four sites, randomized to a single IPL exposure of 22, 34, 46 J/cm2 or triple stacking of 46 J/cm2. Areas were subsequently randomized to no UVR or single solar-simulated UVR exposure of 3 Standard Erythema Dose at 30 minutes or 24 hours after IPL. Each area had a corresponding control, resulting in 15 treatment sites. Follow-up visits were scheduled up to 4 weeks after IPL. Outcome measures were: (i) blinded clinical skin reactions; (ii) objectively measured erythema and pigmentation; (iii) pain measured by visual analog scale (VAS); (iv) histology (H&E, Fontana–Masson); and (v) mRNA-expression of p53. Results: Fifteen subjects with FST II–IV completed the protocol. IPL induced a wide range of skin reactions, including erythema (87% of subjects), purpura (27%), blisters (20%), edema (13%), crusting (13%), hyper- (60%), and hypopigmentation (20%). Darker skin pigmentation and increasing IPL fluence were determinants for IPL-induced side effects (P ≤ 0.002), while a single exposure of UVR did not exacerbate side effects (P ≥ 0.180). Clinical findings were confirmed objectively by reflectance spectrometry and qualitatively by histological changes in skin architecture, inflammatory infiltration, and pigmentation. Marker of cellular DNA damage, that is, p53, did not increase after IPL (P ≥ 0.24). Conclusions: Skin pigmentation and IPL fluence are major determinants of side effects after IPL exposure, while a single exposure to three SED of UVR at 30 minutes or 24 hours after IPL, does not amplify such side effects. Lasers Surg. Med. 49:88–96, 2017.
AB - Background and Objective: Intense pulsed light (IPL) is a mainstream treatment for hair removal. Side effects after IPL are known, but risk factors remain to be investigated. The objective of this study was to assess the contribution of skin pigmentation, fluence level, and ultraviolet radiation (UVR) on IPL-induced side effects. Methods: The study was a blinded, randomized intra-individual controlled trial including 16 healthy subjects with Fitzpatrick Skin Types (FST) II–V. Three test areas were each divided into four sites, randomized to a single IPL exposure of 22, 34, 46 J/cm2 or triple stacking of 46 J/cm2. Areas were subsequently randomized to no UVR or single solar-simulated UVR exposure of 3 Standard Erythema Dose at 30 minutes or 24 hours after IPL. Each area had a corresponding control, resulting in 15 treatment sites. Follow-up visits were scheduled up to 4 weeks after IPL. Outcome measures were: (i) blinded clinical skin reactions; (ii) objectively measured erythema and pigmentation; (iii) pain measured by visual analog scale (VAS); (iv) histology (H&E, Fontana–Masson); and (v) mRNA-expression of p53. Results: Fifteen subjects with FST II–IV completed the protocol. IPL induced a wide range of skin reactions, including erythema (87% of subjects), purpura (27%), blisters (20%), edema (13%), crusting (13%), hyper- (60%), and hypopigmentation (20%). Darker skin pigmentation and increasing IPL fluence were determinants for IPL-induced side effects (P ≤ 0.002), while a single exposure of UVR did not exacerbate side effects (P ≥ 0.180). Clinical findings were confirmed objectively by reflectance spectrometry and qualitatively by histological changes in skin architecture, inflammatory infiltration, and pigmentation. Marker of cellular DNA damage, that is, p53, did not increase after IPL (P ≥ 0.24). Conclusions: Skin pigmentation and IPL fluence are major determinants of side effects after IPL exposure, while a single exposure to three SED of UVR at 30 minutes or 24 hours after IPL, does not amplify such side effects. Lasers Surg. Med. 49:88–96, 2017.
KW - Adolescent
KW - Adult
KW - Biopsy, Needle
KW - Blister/etiology
KW - Dose-Response Relationship, Radiation
KW - Edema/etiology
KW - Erythema/etiology
KW - Female
KW - Hair Removal/adverse effects
KW - Healthy Volunteers
KW - Humans
KW - Immunohistochemistry
KW - Low-Level Light Therapy/adverse effects
KW - Male
KW - Pain Measurement
KW - Prospective Studies
KW - Radiation Dosage
KW - Risk Assessment
KW - Single-Blind Method
KW - Skin Pigmentation/radiation effects
KW - Ultraviolet Rays/adverse effects
KW - Young Adult
U2 - 10.1002/lsm.22566
DO - 10.1002/lsm.22566
M3 - Journal article
C2 - 27474536
SN - 0196-8092
VL - 49
SP - 88
EP - 96
JO - Lasers in Surgery and Medicine
JF - Lasers in Surgery and Medicine
IS - 1
ER -