BBL treatment: Light therapy for skin spots

Broad band light (BBL) is a light-based procedure similar to a laser that can treat the signs of sun-damaged and ageing skin such as freckles, blood vessels and loose skin with fine wrinkles.

What conditions can be treated with BBL laser treatment

At Spot Check Clinic, we mainly use BBL treatment for areas of skin that have visible signs of sun damage. Pigmented conditions that are treated by BBL include:

• lentigines
• age spots
• liver spots
• freckles
• some "beauty spots"

The treatment is also effective at treating vascular lesions such as:

• telangiectasia or broken blood vessels
• variations of rosacea
• angiomas and spider angiomas
• poikiloderma of Civatte and
• vascular birthmarks such as port wine stains

The treated skin looks clearer, younger and healthier after treatment.

In limited cases, BBL can potentially reduce the risk of skin cancer in the treated area, but for most people, it should be considered a cosmetic treatment only.

Other uses of BBL include:

• Treatment of certain skin cancers or areas of pre-cancerous sun damage in situations where surgical or other non-surgical treatments are not appropriate
• Treatment of overgrown or discoloured scars
• Treatment of acne
• Treatment of rosacea
• Hair removal
• Treatment of loose skin and fine lines and wrinkles

BBL is not the best treatment for cosmetic removal of moles, seborrhoeic keratoses, skin tags or other raised skin lesions. We offer other treatments such as radiosurgery, electrosurgery, cryotherapy and shave excisions to better manage these lesions.

Skin rejuvenation and anti-ageing effects

BBL treatment has been shown to have rejuvenating effects on the skin (Bitter 2013).

• Treated skin looks younger
• BBL treatment boosts the production of collagen and elastin, which are depleted in ageing skin.
• BBL stimulates genes in skin cells to function more like genes in younger skin (Chang 2013).
• The skin becomes thicker
• There is a decrease in the production of hormones and inflammatory chemicals associated with skin ageing and skin cancer.

Note: BBL has not been shown to reduce the risk of skin cancer except in cases where it is used to treat solar keratoses.

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What is intense pulsed light?

BBL is a type of intense pulsed light (IPL) treatment. IPL is extremely bright light applied to the skin in short concentrated flashes.

The colour or wavelength of light can be selected to target selected structures in the skin:

• Brown (freckles, “age spots”, flat seborrhoeic keratoses, hair)
• Red (blood vessels, angiomas)

Cosmetic treatments like BBL are effective because the energy applied to the skin is so intense that it heats and damages the target structures, leaving normal skin behind.

There is a highly efficient cooling system built into the BBL handpiece that maintains a low skin surface temperature after the short burst of light. This cooling protects the skin surface and typically results in a short flash of warmth rather than a burning sensation. In some cases, we use more intense energy to treat prominent pigmentation or blood vessels. This sometimes feels like a very brief flash of pain, which subsides almost instantly.

Because the light generated by BBL equipment is extremely bright, you will need to wear block-out goggles or tinted glasses to protect your eyes when receiving a full-face treatment.

Treatment can be applied in different ways:

• General treatment to improve the condition of an area of skin (e.g. face, neck, hands, arms)
• Focused treatment to reduce or eliminate specific spots
• Heat treatment to stimulate collagen production and tighten skin

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BBL-Hero: a new IPL technology

"Hero" refers to High Energy Rapid Output (proprietary name).

This form of skin treatment is available only on Sciton equipment which has been available in Australia since 2000.

Advantages over conventional/older IPL treatments include:

• Treatment is more comfortable due to superior cooling and a more concentrated delivery of energy to target tissues
• Treatment tends to be in a smooth gliding motion rather than "stamping" the skin, leading to less risk of uneven results
• Less discomfort and skin irritation following treatment. No downtime means that most people can return to normal activities immediately after treatment.

Customised treatment

BBL treatment is delivered by the Sciton mJoule device.

The BBL equipment provides a range of specialised programs and settings which can be tailored for your specific needs:

• The problem or condition you wish to treat
• The part of the body to be treated
• Your skin type
• Your comfort level during treatment

You will usually need more than one treatment session to obtain the best possible result. The settings are re-evaluated after each session to optimise results and your experience during treatment.

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Possible side effects of treatment

• Redness: The treated area commonly looks and feels like a mild sunburn for a few hours.
• Itching
• Swelling
• Light bruising
• Peeling
• Scabbing

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Potential risks and their management

Compared with traditional laser treatments, BBL is a relatively safe process. This is one of the reasons we offer this treatment, which has most laser benefits without some of its major drawbacks.

Significant problems are rare but can occur:

• Burns
• Eye irritation
• Cold sore outbreaks if not on preventative medication
• Accidental bleaching/hiding of skin cancers
• Increased or decreased pigmentation of treated areas

We manage these risks by carefully selecting machine settings and checking your medical history, medications, previous skin treatments and sun exposure.

Any suspicious-looking skin lesions, spots or lumps will be checked by an experienced skin cancer doctor prior to treatment. We can provide preventative medication to reduce the risk of cold sore outbreaks if required. The possibility of burns is greatly reduced with the BBL technology but can occur. If a burn does occur, our doctor and nurse will instigate a treatment program, which produces excellent results.

Preparation for treatment

If you are properly prepared for treatment, treatment is more effective in a shorter period, and there is much less risk of discomfort and irritation during and after the procedure.

Avoid potentially irritant skin products

For at least two days before (and after) treatment, do not use any active skin product which might make your skin sensitive. These include:

• tretinoin or any other product containing a retinoid
• vitamin C/ascorbic acid
• other acids such as alpha-hydroxy acid, beta-hydroxy acid, salicylic acid

Note: In some cases, your doctor will prescribe a cream or ointment for the area to be treated. This is more likely if your BBL treatment is for a skin cancer or pre-cancer condition. In this case, we will provide advice about how to use the prescribed/recommended medication or product.

Keep the area as pale as possible

If the skin is pigmented or tanned, it's harder for the BBL to target specific problem areas and structures.

For two weeks before your treatment, we recommend that you avoid:

• sun exposure to the treated area (even with sunscreen)
• fake tan/spray tan

Don't use tinted cosmetics or sunscreens on the area for 2-3 days before your treatment.

On the day of treatment

If there is any hair in the treatment area, shave it off as closely as possible.

Do not wear make-up of any kind.

Wear light-coloured loose clothing that will allow access to the area to be treated, e.g. a singlet for treatment of arms, shoulders or chest.

Pre- and post-treatment photos

We take photos of your skin before every treatment. This provides evidence of how well the treatment has worked on your skin.

All photos are stored in the MoleScope/DermEngine shared medical record system so that you can follow your progress by looking at the photos. You can add your own photos to this record if you wish.

We can add resources about your treatments and aftercare to ensure that you have information about your treatments and follow-up.

What to expect

You will wear tinted glasses or goggles to protect your eyes from bright flashes of light during the treatment.

The nurse or dermal therapist administering your treatment will apply a gel to the treatment area. This gel improves the contact between the handpiece and the skin, as well as reducing friction. Anaesthetic creams or gels are not required.

During treatment

Bright light is emitted from a handpiece in contact with the skin:

• Usually the therapist or nurse will use a smooth gliding motion in several passes over the treatment area. This technique is best for treating large areas of skin, or if the objective is to improve the general appearance.
• Sometimes, they will hold the handpiece stationary directly over a problem spot, such as a cluster of blood vessels or a dark freckle. This is known as corrective treatment.

Treatments usually last only a few minutes for each body area.

During treatment, the handpiece emits extremely bright flashes of light, which only last a fraction of a second. If the therapist is using a gliding motion, flashes of light occur 3 or 4 times per second.

Each flash feels like a very brief hot and sharp sensation. This immediately settles due to cooling from the handpiece straight after the flash of light.

After treatment

Your nurse or therapist will clean and moisturise the area and apply sunscreen.

You will discuss whether further treatments are required and book a follow-up appointment if necessary.

The results of treatment are usually visible in about 2 weeks for facial treatments and 4 weeks for other parts of the body. In the meantime, you may notice mild redness, followed by small dark dots in the treated area. This is a sign that the treatment has damaged pigmented structures in the skin and your immune system is "cleaning up" leftover pigment.

You should avoid sun exposure and any irritant creams, ointments or cosmetics unless they have been specifically recommended by your therapist or doctor.

See our Aftercare page for further information.

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