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Split-Face Treatment of Facial Dyschromia: Pulsed Dye Laser with a Compression Handpiece versus Intense Pulsed Light


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Address correspondence and reprint requests to: Kenneth J. Galeckas, MD, Department of Dermatology, Naval Medical Center San Diego, Suite 300, 34520 Bob Wilson Drive, San Diego, CA 92134, or e-mail:


BACKGROUND Many visible light lasers and intense pulsed light (IPL) devices are available to treat photodamaged skin.

OBJECTIVES The objective was to perform a multiple-treatment split-face comparison evaluating a pulsed dye laser (PDL) with a compression handpiece versus IPL for photorejuvenation.

METHODS Ten subjects were treated three times at 3- to 4-week intervals. One side of the face was treated with the PDL with compression handpiece, and the other with IPL. One month after final treatment, blinded evaluation assessed for improvements in dyschromias and texture. Patients provided self-assessment of improvement in dyschromias and texture. Time to complete final treatments and pain during all treatments were recorded for each device.

RESULTS Improvement of the PDL was (mean) 86.5, 65, 85, 38, and 40% for dark lentigines, light lentigines, vessels <0.6 mm, vessels >0.6 mm, and texture, respectively, versus 82, 62.5, 78.5, 32.5, and 32%, respectively, for the IPL side. Patient-evaluated difference in improvement for vascular lesions significantly favored the PDL (p=.011). Mean third treatment times were 7.7 minutes for PDL versus 4.6 minutes for the IPL (p=.005). Mean pain ratings were 5.8 for the PDL and 3.1 for the IPL (p=.007). Purpura-free procedures depended on proper technical use of the compression handpiece when treating lentigines with the PDL.

CONCLUSIONS The PDL with compression handpiece and IPL are highly effective for photorejuvenation.

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