Broadband Light: The Cosmetic Procedure To Slow Aging Skin

Many of the cosmetic treatments we do at Advanced Skin Care and Dermatology Physicians, Inc. produce great results. But, when I’m asked what treatment is my absolute favorite that I could not live without, it’s Intense Pulsed Light (IPL) without question. Intense Pulsed Light is also called Broadband Light or BBL. Treatments almost “magically” stop the clock on skin aging in a natural, and in my opinion, healthy way. I recommend this treatment to just about everyone for two reasons, both of which are backed up by almost unbelievable scientific study results because they show:

• BBL treatments very significantly reduce and delay the visible signs of skin aging when assessed by photographic analysis. In other words, you really can stop the clock on how your skin will age over the years, and you can even set it backward.
• BBL treatments fundamentally rejuvenate human skin genes, setting them back to the way they behaved when they were younger. This means treatments are more impactful than simply altering skin appearance, and why, in my opinion, the treatment benefits skin health as well.

These breakthroughs are exciting, but even more so is the fact that only the beginning pieces of the puzzle have come together. The best is yet to come! Before we dig into this too deeply, let's back up and help you understand this magical treatment. What is BBL (IPL)? IPL (BBL) technology has been out for over 20 years. It is sort of like a laser from the patient perspective in that, during a treatment, powerful light is flashed into the skin to treat an entire area, not just spots. For example, your entire face, not just the brown spots on your face would be treated. In the 20+ years since IPL has been used, we physicians have watched in jaw dropping amazement as the complexions of our IPL (BBL) patients have become almost frozen in time. Two physician leaders behind the technology conducted a study that found phenomenal results. For the study, "blinded evaluators” (meaning, experts who had no information about what they were assessing) assessed the age of "before and after" photos of patients who had full face treatments at least annually for an average of 9 years. The average age of each study patient was 46 years, which, as we all know, is when skin really starts to age quickly. According to this astounding research, evaluators assessed patient’s pre-treatment age pretty much spot-on for their real age, which was 46. However, for post treatment, an average of 9 years later, patients looked younger than before they started treatments! To quote the study:

Although treated skin actually aged a median of 9 years, participants appeared to have aged a median of -2 years. Results from our study indicate that patients who maintain a regular annual or biannual regimen of BBL treatments…. can reduce and delay the long-term signs of skin aging such as photodamage, telangiectases, fine lines and wrinkles, and skin laxity in a natural-looking way.

To make sure we all grasp the impact of this treatment, understand that patients were 9 years older at an age where the signs of skin aging really start to accelerate, and yet they looked 11 years younger – 2 years younger than before treatments began! The following images illustrate the dramatic differences.

(Courtesy of Bitter, P, Pozner, J. (2013) Retrospective Evaluation of the Long-term Antiaging Effects of Broadband Light Therapy. Cosmetic Dermatology, February 2013, 34-40.)

(Courtesy of http://www.sciton.com)

We do not understand exactly how this technology works, but we see it daily. What you need to know is that this technology almost accidentally fell into its skin rejuvenation role. It was initially developed to treat spider leg veins, which it did not do well. Once the machine was in doctor’s offices, they started trying it for other uses, and the impact on aging skin just sort of happened. The science on “why” it works is essentially backward since it was developed with another purpose in mind, but the results are undeniable. And, for those of us who are aging right now, time is of the essence to get our skin aging clock stopped, which is why I highly recommend this treatment for everyone. The Impact of BBL Here at Advanced Skin Care and Dermatology Physicians, Inc., we describe to patients that the treatment results in the skin looking “creamier and younger.” We knew the energy of the light was targeting and reducing brown age spots from sun damage and red “broken capillaries” from rosacea and sun damage, but the “creamier” part we couldn’t quite explain. With IPL, you treat an entire skin area, such as the face, neck and chest. In addition to color issues improving, we saw that actual fine skin texture and youthful appearance were softer and more luminous overall. Still, it was different from the results you get from exfoliation such as acid peels or microdermabraision. It also wasn't like the results we see due to robust collagen formation from ablative laser (like Co2 or our Erbium Profractional or Micro Laser Peel laser). It was something else - there was an almost child’s skin quality of velvety and “creamy” smoothness looking both closely and from a distance. I’ve had many IPL treatments myself, and from the inside out, I can tell you that your skin feels very different too. It is softer in a way that is different than exfoliation. Inflammation like my pesky facial seborrhea and redness from rosacea and sun damage are also stopped for months after I get a procedure. My skin is less inflamed, and it radiates a luminous “creamy and velvety” vitality that is much more than removal of brown sun spots and red “broken” capillaries. But, still, the big question is why? Recently, some of the puzzle pieces fell into place with the gene study I mentioned above. It was done by Stanford and published in the Journal of Investigative Dermatology. Investigators found that, after IPL treatments, human skin genes behave like they did when they were younger. Authors of the study say:

...BBL treatment can restore gene expression pattern of photoaged and intrinsically aged human skin to resemble young skin. (1)

Distilling down the science speak, this means that genes that are “retired and semi-retired” in skin due to aging, and thus they are not working very hard. But, after this treatment, they are now very busy and back at work. As the study explains:

Aging is associated with large-scale changes in gene expression… We examine (d) the molecular basis of the BBL treatment response by defining the global gene expression programs of photoaged and intrinsically aged human skin and response to BBL…. Our results suggest that regulators of organismal aging can be altered in human skin using commonly available BBL technology. (1)

In the study, investigators tested about 3530 skin genes and found that 1293 of the genes were “rejuvenated,” or back on the job at the rate seen in younger skin. Interestingly, they were genes coding for aging and immune function, not just genes related to skin wounding as seen with laser or skin acid peels. While the story is far from settled, I find this fascinating – admitting that we are still far from intellectually satiated with scientific explanations, I just call it “IPL/BBL magic!” How do you get the IPL (BBL) “Magic”? In order for the BBL treatment to be effective, you have to have an initial series to “load” the technology’s impact into your skin. This means 3-5 treatments at monthly intervals. Then, we recommend 1-2 treatments a year, either spaced out at about 6 months or back to back a month apart. We usually do 2 treatments and decide how to space them based on each patient's skin. For instance,  if you have a lot of brown and red “targets” that need back-to-back treatment with advancing power, we do the 2 treatments a month apart. If it’s really just maintenance, then we spread them out. It is never too late or too early to start these treatments once your skin has reached adulthood. Understand that your skin needs to be as fair as possible when receiving IPL (BBL) treatment because tan or brown color blocks the rays from getting in and can result in “overheating” the skin. The fairer your skin, the better candidate you are for this technology. It also means that many people choose to have treatments in the fall and winter months when they are out of the sun. In our Sonoma County office, patients usually start with face, neck, chest and the back of the hands for the first year. The next year, when they are now needing only the 2 annual maintenance treatments, they often tackle a new series on the arms. Many of our patients are long term and have followed my skin care recommendations and advice, including BBL. Like the patients in the study, they have undeniable healthier and more attractive skin than other people in our community who are their age. We see it every day, and I’m really proud and happy to have helped. We always start with a foundation of skin care that includes sunscreen and products to fight skin aging (click here for that information). The second step is to add procedures and BBL is at the top of that list when a patient can make the commitment. In my opinion, it is possible to beat Mother Nature when it comes to skin aging with a natural result of youthful appearing and healthy skin. As you digest this information, think about this one other thought from the first study:

Although BBL technology has been harnessed for its ability to produce a more clinically “youthful” appearance, our study suggests that “rejuvenation” at a molecular level has also occurred, with a number of genes linked to the aging process being altered in expression after treatment to more closely resemble young skin. Hence, it is possible that the clinical phenotype represents a functional rejuvenation……. rather than just a cosmetic mimic of youthful appearance. (1.)

When added on top of a good solid routine of anti-aging skin care, IPL (BBL) treatment takes the complexion to a new level of youthfulness. And, again, it is never too early or too late to start! References 1. Chang A, Bitter P, et al. (2012) Journal of Investigative Dermatology advance online publication 30 August 2012; doi: 10.1038/jid.2012.287 2. Bitter, P, Pozner, J. (2013) Retrospective Evaluation of the Long-term Antiaging Effects of Broadband Light Therapy. Cosmetic Dermatology, February 2013, 34-40. 3. Sciton Web Site http://foreveryoungbbl.com/clinical_evidence.php Mark your calendars for Thursday, October 1, 2015 from 5-7 PM! Advanced Skin Care and Dermatology Physicians, Inc. is kicking off fall with an exclusive office event, and you're invited! You can learn more about cosmetic procedures like the BBL, experience color matching with our aesthetician, sample products, win prizes, meet Dr. Hayes, and much more. For more information and to RSVP, call our office at 707-829-5778. We hope to see you there!