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THE EVOLUTION OF IPL The Sciton BBL features a broad range of wavelengths delivered through its dual-lamp technology. Interchangeable ���lters allow users to treat multiple indications in a single handpiece. The BBL also offers integrated sapphire cooling that can be adjusted from 0�� C to 30�� C and Finesse Adapters for hardto-reach areas. Contact: 888.646.6999, sciton.com. Onyx Medical���s Bright Light offers two spot sizes���9cm x 9cm and 3cm x 3cm and a spectral output of 420nm ��� 1200nm. Users can adjust pulse width and ���uence. Contact: 800.333.5773, onyxmedical.com. Viora���s Trios offers three treatment ���lters: 530nm1200nm, 570nm-1200nm and 400nm-1200nm, a 15mm x 50mm spot size and 25ms pulse duration. Contact: 201.332.4100, vioramed.com. The Cutera Limelight incorporates real-time calibration for consistent energy output during treatment, adjustable cooling, and three pre-set treatment ���lters for redness, . lowand high-contrast pigment, and lentigines. Contact: 888.428.8372, cutera.com. Palomar Medical developed what it refers to as ���Smooth Pulse��� technology for its MaxG handpiece. ���If you choose a treatment pulse of 20ms, for instance, our pulse light handpiece has one continuous pulse over that 20ms, so the distribution of energy is very uniform,��� says Richard Bankowski, ���eld clinical director, Palomar Medical Technologies (palomarmedical.com). Controlled Cooling Early IPLs gained a negative reputation due to high incidences of burning. The devices often left stamp-shaped burn marks on patients and caused long-term pigmentation problems. While many of these adverse events can be traced to poor training, innovations in cooling technologies are helping to decrease these risks. Several systems offer sapphire contact cooling. Sapphire has high thermal conductivity that allows it to hold a steady temperature and helps to wick heat away from the skin. ���When you chill a piece of sapphire and put it against the skin, it chills the skin very effectively,��� says Bankowski. ���That���s how we chill our handpieces: We have a sapphire window and chilled liquid that circulates around the handpiece.��� In many systems, users can control the level of cooling through the IPL's software by either turning the 28 MARCH/APRIL 2013 | MedEsthetics cooling on and off or adjusting the desired temperature. ���When you can control the degree of cooling, you can control your outcome,��� explains Deguara. ���You can say, ���I want 18 degrees or 20 degrees of cooling during treatment.��� This is bene���cial because you���re targeting different chromoforms at different depths. To treat the hair in the hair shaft, you need to be able to heat deeper and protect the surface of the skin; whereas with super���cial pigment, you don���t need to drive the heat deep.��� Advanced Filtering Another innovation that has improved IPLs is advanced ���ltering, which controls the range of wavelengths emitted by the device. The ���lters help improve outcomes, reduce the number of adverse events and make results more consistent. ���The early IPLs didn���t have cooling, they didn���t have any pulse variables and they weren���t blocking a lot of the light, so there was a lot of burning,��� says Fuller. Some devices offer one speci���c range of light that can be used to target redness, pigment and destroy unwanted hair, while others offer multiple ���lters to target each of these speci���c concerns. The ���lters are offered as either snapon/snap-off pieces that ���t on the end of the handpiece or as multiple handpieces that can be changed out on the