Intense pulsed light (IPL) (=BBL)

IPL, or Intense Pulsed Light, has become one of the most versatile and rewarding tools in cosmetic dermatology. 

Whether you're aiming to fade sunspots, reduce facial redness, remove unwanted hair, or improve the overall texture and glow of your skin, IPL can likely help — and without the downtime or invasiveness of surgery or more aggressive lasers.

But how does it work? And what should you realistically expect? Let me explain — not just with science (although I’ll certainly reference the latest medical research), but also with the benefit of over two decades of clinical experience treating real patients with IPL.

Intense Pulsed Light isn’t a laser — not technically. While both lasers and IPL devices use light to heat and treat skin tissues, lasers use a single, focused wavelength of light, whereas IPL emits broad-spectrum light across multiple wavelengths. That’s what gives it its name: it delivers intensely bright flashes of light, each lasting just milliseconds.

The key to IPL’s magic lies in a principle called selective photothermolysis. That’s a fancy way of saying we can use light to heat up specific targets in the skin — like brown pigment or red blood vessels — while leaving the surrounding skin unharmed. 

The analogy I often use with patients is the classic zebra crossing at the beach. You step barefoot across it on a hot summer day. The black stripes burn your feet, but the white stripes don’t. 

Why? 

Because the dark surfaces absorb more heat. 

In exactly the same way, IPL light of the right wavelength will selectively heat and destroy the pigmented cells or vessels we’re aiming at — while sparing everything else.

You might also hear IPL referred to as BBL, or BroadBand Light. 

They’re essentially the same technology. 

"IPL" is actually a trademarked term by a major U.S. laser company. 

So when competitors wanted to market similar machines, they needed a different name — hence BBL. But whether you’re using “IPL” or “BBL,” the principles and clinical results are largely the same.

This one’s a joy to treat. 

Freckles — the real kind — are technically known as ephelides, and they sit right at the dermoepidermal junction, meaning they’re extremely superficial. That makes them perfect candidates for IPL. Honestly, some of the most satisfying patient transformations I’ve seen have involved freckle treatments. A single session can often lift 70–100% of the pigment, and the treated freckles literally flake off within about a week, like coffee grounds. It’s almost too good to be true.

And the literature supports this. A randomized, physician-blinded split-face study published in JAAD (2006) confirmed that IPL was superior to Q-switched lasers in treating freckles and lentigines, with faster pigment clearance and less downtime (Tremblay et al., 2006).

Now, not all pigment is equal. Freckles are straightforward. Melasma, on the other hand, is notoriously difficult. In fact, IPL can sometimes make melasma worse, particularly if used improperly or on darker skin tones. Why? Because melasma isn’t just surface pigment — it has a deep dermal component and is often hormonally driven. The heat from IPL can trigger rebound pigmentation.

Same with seborrheic keratoses, or pigmented moles — IPL won’t do much for these. And of course, pigmented skin cancers should never be treated with IPL. Diagnosis first — always. If you’re unsure what the lesion is, get a dermatoscopic evaluation or biopsy before you even think of using light on it.

For safer pigment removal, patients with Fitzpatrick skin types I–III, and clear-cut sunspots, freckles, or solar lentigines tend to do best. A 2020 review published in Lasers in Medical Science emphasized the importance of matching treatment to lesion type and depth to avoid complications (Pavicic et al., 2020).

One of the most rewarding applications of IPL is treating solar dyschromia — that blotchy, uneven mix of dark and pale patches that many fair-skinned people develop after decades in the sun. Think of it as a mosaic of sun damage: freckling, lentigines, dullness, patchy red capillaries. IPL can dramatically restore uniformity in this type of photoaged skin.

There’s real science behind this. A 2021 randomized trial in Dermatologic Surgery followed 60 patients with sun-damaged skin over six months and found that three sessions of IPL significantly improved skin brightness, tone, and pigmentation, with visible histological evidence of new collagen deposition (Li et al., 2021).

Personally, I always recommend a series of treatments — usually three sessions spaced four weeks apart, followed by maintenance once or twice per year depending on sun exposure.

If you suffer from erythematotelangiectatic rosacea — the kind marked by facial redness and those fine “broken capillaries” around the cheeks and nose — IPL is often life-changing. Multiple passes at different depths can target the superficial and mid-level blood vessels, and patients typically notice a gradual fading of diffuse redness over several sessions.

A 2020 randomized controlled trial published in Experimental and Therapeutic Medicine found that three IPL sessions over six weeks resulted in significant reductions in facial erythema and telangiectasia in rosacea patients, with an excellent safety profile (Liu et al., 2020).

Now, be realistic — IPL won’t cure rosacea, and some vascularity may return, especially with triggers like heat, wine, or stress. But it can provide long-term control, reduce reliance on medications, and greatly improve skin confidence.

Here’s a personal story: laser hair removal was my introduction to the world of aesthetic medicine, back when I was running Newtown Medical Centre. In the early days, lasers were slow and expensive. IPL was a game-changer — larger treatment heads, faster sessions, and for many patients, just as effective.

Several comparative studies now show that while diode lasers may work faster on coarse hair, IPL offers broader usability, especially for larger areas like backs and legs. A 2023 meta-analysis in Aesthetic Plastic Surgery concluded that IPL was as effective as diode lasers for long-term hair reduction in Fitzpatrick I–III skin types, provided that energy levels and pulse durations were carefully adjusted (Kwon et al., 2023).

In my own clinic, I’ve treated thousands of patients with IPL hair removal. We’ve refined our protocols over the years, and results are consistently reliable — especially when patients follow through on the full course of 6–8 sessions.

One of my favorite IPL anecdotes involves Dr. Patrick Bitter, a pioneer of IPL photorejuvenation and an early innovator in the U.S. I’ve met Patrick — he’s charismatic, brilliant, and, yes, he looks about ten years younger than his real age. He’s openly stated that he’s had an IPL session every month for the last 25 years.

And he’s not alone. A landmark study published in Journal of Investigative Dermatology showed that ongoing IPL treatments not only improve skin appearance but also reverse gene expression associated with skin aging, effectively restoring a more youthful molecular profile in treated skin (Chang et al., 2013).

In practical terms, IPL can reduce:

• Fine lines and wrinkles (by stimulating new collagen)
• Uneven tone and sunspots
• Skin dullness and large pores

For patients not yet ready for lasers or injectables, IPL is a brilliant “entry-level rejuvenator” with zero downtime and very low risk.

Treatments usually take 20–30 minutes (or, obviously, much longer if treating the back or the legs) and you’ll feel a series of brief snaps of heat — like an elastic band flick. Most patients tolerate it very well, especially with pre-cooling or contact crystal tips. Post-treatment, expect some redness, maybe mild swelling, and in cases of pigment removal, temporary darkening before flaking off.

It’s not for everyone: those with deep tans, active infections, very dark skin types (Fitzpatrick V–VI), or photosensitizing medications should avoid IPL. 

A proper consultation is essential.

Whether you’re treating freckles, rosacea, sun damage, or simply looking for a brighter, more youthful complexion — IPL is a remarkable tool when used thoughtfully. It’s one of the few technologies that delivers visible results with minimal fuss, and with the right protocols and patient selection, the outcomes are both natural-looking and long-lasting.

If you’re considering it — or if you’re unsure whether it’s right for your skin — come in and have a chat. Like the zebra crossing on a sunny day, it’s all about stepping on the white stripes — targeted, precise, and safe