Ellipse is frequently asked to provide information for patients. Although we offer (through our distributors) a range of patient brochures, we are sometimes asked to provide an overview of all treatments.
Ellipse I2PL systems represent the cutting edge of light based treatments; hospital-grade systems that are equally at home treating unwanted hair, pigment or vascular problems (that may be sun-induced or have been present since birth), acne, rosacea, skin-texture, wrinkles, even spider veins on the leg. This short guide is designed to give you a quick overview of the treatments that can be carried out, how and why they work, and what to expect in terms of the treatment and the results.
How does it work?
Almost all treatments work on a single model. Two chemicals in the body – haemoglobin in the blood cells, and melanin in hair or pigment in the skin – absorb light of certain specific colours (wavelengths). By aiming a short but very powerful flash of light, filtered so that only the necessary wavelengths hit the skin, it is possible to heat up one or both of these target chemicals as required. The timing of the pulse, and the energy used are controlled so that only excess pigment or excess blood vessels are treated.
The exception to this model is a treatment that use a third natural chemical. Acne bacteria produce a chemical called protoporphyrin, that is sensitive to light. When protoporphrin is exposed to specific wavelengths of lights it reacts and causes damage to the bacteria that store it. The bacteria also absorb protoporphyrin, so that if a photosensitizer is added to the skin, it is absorbed by more bacteria, which die when exposed to the light.
What makes Ellipse I2PL unique?
There is a third chemical in the skin that normally absorbs light, and transforms it to heat – simple water. Most Intense Pulsed Light Systems produce wavelengths that are absorbed by water. This means that most systems heat up the water in the skin, making treatments uncomfortable.
Ellipse I2PL systems have a number of safety controls which make uniquely safe devices:
- Ellipse I2PL systems have a patented method – called Dual Mode Filtering – that removes water-heating wavelengths before they reach the skin. This means that treatments are typically more effective AND less painful. Some treatments, such as age spots or dyspigmentation (caused by too much sun) need only a quarter of the energy compared to rival systems.
- Square Pulse Technology ensures that all pulses of light are safe, delivering the correct energy throughout the entire pulse; many other systems have a light which effectively flickers, going up and down in power.
- Clinical Intelligence Software enables the user to use his skills as a physician to examine a patient, and enter the diagnosis directly into the build-in computer. The exact settings of the light pulse created for the treatment are then automatically set. Of course the physician has the final say.
- Independent pulse and energy controls – with many systems it is only possible to increase one by increasing the other. This may not sound important, but some treatments work best with a long, low energy pulse, while others need a more immediate, high energy setting. With Ellipse systems the right settings are automatically selected.
The treatment procedure
Treatments are extremely quick, and the client is able to return to work immediately afterwards (no down-time). As preparation, just before the treatment, the doctor or an assistant will remove the patient’s make-up , ensure there are no tattoos or permanent make-up in the treatment area and shave the treatment area if required, removing the shaved hairs from the skin. A thin layer of optical gel is applied to the skin to make sure the light does not bounce off the skin surface. A test shot, based on the recommended settings, will be made, and the settings adjusted very slightly to get the best possible reaction. Once this is found, the treatment can proceed quite rapidly, even hair removal on large areas such as the legs, typically takes less than 20 minutes.
Does treatment hurt?
Discomfort is a very individual experience, but hair removal and treatment of pigment and acne are really quite comfortable treatments, such that the occasional patient falls asleep during treatment. Treatment of blood vessels typically feels like a rubber band flicking the skin, followed by a feeling of gentle warmth.
Who can be treated?
Generally, most adults can be treated quickly and comfortably. There are a few medical conditions that may cause problems – chiefly diabetes (if it is severe enough to cause problems with wound-healing), haemophilia and other blood-clotting disorders, and conditions that make you sensitive to light. Pregnant women and patients with heart pacemakers are not treated. Patients taking medicines that increase sensitivity to the light, or that otherwise interfere with the treatment are similarly not treated. All this is explained as part of a pre-treatment interview to discover your suitability as a patient.
In general, treatments work best on skin that does not have too much recent suntan, so we suggest timing the treatments to avoid this, and using good sun-protection.
What can be treated?
The list below shows the most common treatments. The treatments interval is typically 1 month; leg vessels and other conditions treated with Nd:YAG generally have a two month interval. For hair removal, the interval depends on the rate at which new hair grows back, mainly dependant on the body site.
- Hair Removal – Any area can be treated. Hair should be mid-blonde or darker. 6-8 treatments.
- Diffuse Redness – A general redness of the face as if permanently blushing. 1-3 treatments.
- Telangiectasias – Individual enlarged blood vessels, most often on the face. 1-3 treatments.
- Spider Veins – A central red spot, with surrounding small vessels, on the face, torso or legs. 1-3 treatments.
- Port Wine Stain. A birthmark that begins as a general red area, but becomes more blue with age. 3-6 treatments.
- Cherry Angioma. A red spot that grows larger with time, often raised. 1-2 treatments.
- Rosacea. Initially a general redness, usually on the face, that becomes more pronounced with time. 2-4 treatments.
- Acne. This treats the symptoms, but acne may reappear later. 1-4 treatments.
- Skin Texture. A general improvement in skin smoothness, and pore size. 1-3 treatments
- Wrinkles. Light wrinkles around the eye or mouth 3 treatments.
- Sun-Damaged Skin. A combination of pigment problems and redness, on the face neck, chest hands 1-3 treatments.
- Poikiloderma of Civatte. A combination of redness, brown pigmentation and area of loss of pigment coupled with thinner skin. Usually caused by suntan combined with perfume. 1-3 treatments.
- Leg Telangiectasias. Vessels from 0.1mm to 3mm diameter. 1-2 treatments.
- Venous Lakes. Permanent dark blue pooling of blood on the lips or ears. 1-2 treatments.
- Scar Reduction. Reduces the size and normalises the appearance of the scar. 4 treatments.
Note: Not all treatments are available on all machines.
Sun and Sensitizer
Poikiloderma of Civatte is the correct medical name for a condition that consists of a combination of diffuse redness, and pigment changes (areas of both darker and lighter pigmentation) typically at the sides of the neck and on the upper chest. There is also likely to be some thinning of the skin (atrophy). Although there are a few diseases that can increase the likelihood of developing the condition, most patients recognise that the areas in which they personally display the symptoms quite closely match the areas in which they have applied some sort of perfume or after-shave. This strongly suggests that the condition is not so much a disease as a skin reaction to sun and a sensitiser. This is backed up by the fact that areas shaded by the chin, or normally protected by clothing do not show the condition as much.
The condition is most obvious in light skinned individuals, because of the general redness in the affected area, but also because patients with skin types 1 and 2 are more sensitive to the sun.
This blog will always try to be fair in pointing out the various alternative treatments available. But to be fair in this case we have to say that Intense Pulsed Light such as Ellipse I2PL has to be treatment of choice. It is possible to treat with a pulsed dye laser (PDL), but PDL treatment has a higher incidence of causing bruising (purpura), depigmentation and scarring. I2PL generally requires less treatments to achieve a more cosmetically pleasing result.
Treatment with I2PL uses either the VL+ or PR+ applicator, depending on the patient’s skin type and background level of sun tan (though tanning in the month before treatment is strongly discouraged).
Typically from 1 to 3 treatments are required, and treatment settings are virtually identical to those used in Photo Rejuvenation