IPL - Intense Pulsed Light Therapy for MGD
IPL is a high intensity light therapy ("Intense Pulsed Light", IPL) in which flashes of white light are placed around the eye in order to improve Dry Eye Disease due to Meibomian Gland Dysfunction (MGD), also when MGD occurs in combination with Rosacea.
The light flashes are applied with a handpiece.
Content of this page:
IPL is an intense light therapy with visible white light from a flash lamp
IPL is applied onto the skin around the eyes to treat the dysfunction of the skin-associated Meibomian oil glands - the main reason for Dry Eyes
Strong light is absorbed by pigments in the skin and therefore IPL treatment must not be used in intensely pigmented skin
The mechanism of action in IPL is not yet completely clear but several studies prove effectiveness
IPL can cause improvement of Meibomian Gland Dysfunction, even in cases resistant to conventional therapy
IPL is a powerful light therapy with visible white light from a flash lamp
The IPL technique uses very strong white light flashes around the eye. The eye itself must remain covered.
The Intense Pulsed Light Therapy (IPL) is a treatment option by using very strong light flashes. They are applied onto the skin by a light applicator inside a handpiece.
IPL is used for improvement of Meibomian gland dysfunction (MDD), with or without chronic eyelid inflammation ()blepharitis), particularly if it is associated with a chronic skin disease such as rosacea (acne rosacea, skin redness) that is known to promote MGD.
IPL comes from the field of dermatology and has evolved from the use of laser light. Laser light was approved in the 1990s by the United States Health Department for use in hair removal.
In contrast to laser light, which is light of only one specific wavelength, IPL uses a light over the entire visible light spectrum. The IPL light thus appears white
Harmful light frequencies, especially ultraviolet (UV) light in the wide blue range, and sometimes infrared (IR) heat radiation are filtered out. The light has a very high strength and is typically produced by xenon flash lamps.
IPL is performed on the skin around the eye
Usually about 4-5 flashes of light are applied onto the skin.
IPL treatment of eyelid related conditions typically involves multiple flashes of light onto the skin area around the eye.
Because of the enormous light intensity, the eyes must be closed and the eyelids additionally covered by a tight protective shell; the doctor must also wear protective goggles.
Therefore, the eyelids themselves and the Meibomian glands inside them do not receive direct light radiation.
IPL treatment must not be used in intensely pigmented skin
IPL light is absorbed by natural but also by artificial pigments in the skin. Such pigments heat up by the strong IPL light or are destroyed. This is the basis for the initial use of IPL for cosmetic hair removal instead of more time-consuming or laborious treatments such as epilation or waxing.
Since IPL causes destruction of highly pigmented skin it must not be used in individuals with a strong natural skin pigmentation and not in areas that have e.g. tatoos.
IPL devices typically come with a color card or even with a software, that shows until which (moderate) skin pigmentation it may be used safely.
IPL - the mechanism of action
The mechanism of action of the IPL treatment in Meibomian gland dysfunction (MGD) is not quite clear at present, even though several studies show beneficial results.
One route of explanation why IPL is an effective treatment for Meibomian gland dysfunction (MGD) is the potential uptake of IPL light by the natural iron-pigment inside the red blood cells.
This may lead to a respective warming of the blood with subsequent up-regulation of skin and gland activity. Destruction of the red blood cells and thus destruction of increased or dilated vessels is another hypothesis (please see image) - this would explain the effect in chronic eyelid inflammation (blepharitis) and in associated rosacea (acne rosacea, skin redness) .
Several other potential but unproven beneficial actions are suggested. This reaches from potential anti-bacterial effects over potential anti-inflammatory effects and stimulating influence on the nervous system to a warming or direct improvement of gland metabolism etc.
IPL devices differ in several respects
The different IPL devices on the market typically differ in several respects. This concerns e,g.
the life-time of the actual light source inside the device,
a potential cooling of the light source and applicator in the handpiece. Cooling is rare and requires a higher investment but is thought to serve for a longer life-time of the device.
the effective size of the contact area of the applicator with the skin
the possible necessity of using a gel between the applicator surface and the skin. Most devices actually need the use of a gel for optimal transmission of IPL light into the skin
different filters may be used as an additional option. This is proposed to apply a light of different preferential frequency bands for different special purposes
… and the price, of course …
IPL is carried out in therapy cycles of several sessions
The IPL therapy of both eyes is typically carried out in a cyle of several (about 3-4) therapy sessions.
A typical therapy scheme is an initial two sessions with about 14 days interval and a further one, two or more sessions at about 1 month interval or until an improvement occurs.
IPL therapy can cause an improvement of Meibomian gland dysfunction (MGD)
Various studies over the last years since about 2015 report a positive effect of different degrees by IPL therapy in dry eye disease due to Meibomian gland dysfunction (MGD). This is reported to apply also in cases that appeared resistant to conventional therapy.
The exact mechanism of action of IPL, which plays a role in the therapy of Meibomian gland dysfunction, is not yet clear.
Professional IPL devices for the medical therapy of Meibomian gland dysfunction (MGD), chronic eyelid inflammation (blepharitis) and rosacea in the doctor's office differ distinctly from private low-performance devices that are occasionally offered in consumer markets Professional IPL devices may only be operated by doctors.
=> An overview of professional IPL devices for the treatment of Meibomian gland dysfunction (MDD) in medical practice
