MYSTERY SHOPPER: IPL consultation for pigmentation

Articles on Intense Pulsed Light are a regular feature in BeautyNZ, so we thought it would be interesting to visit a few salons to gauge how best practice is filtering down into everyday business.

I asked Florence Barrett-Hill of Pastiche Resources for a basic list of what to expect from a professional IPL consultation, specifically related to treating pigmentation. She believes that at the very least, salons offering IPL services should take the following into consideration.
“First of all, before anything else, they should establish cause. Certain types of pigmentation will respond to IPL and others won’t. You should be asked to complete a full consultation questionnaire, including medical history.
“The therapist needs to eliminate anything sinister before even considering treating you for pigmentation. If in doubt, they should send you to your GP for a secondary opinion.
“Does the salon have a way of measuring the density of pigment and photo type?
“What other modalities are offered in conjunction with IPL? What do they recommend to prepare the skin for IPL? Ideally, they should clear the skin of incidental ‘rubbish’ first, and stop any new melanin forming, that way when you apply IPL it’s not distracted by any ascending melanin in the epidermis.
“What is the post-IPL care plan? What do they recommend for long term care? A skin-lightening homecare programme should be part of every IPL treatment for pigmentation.
“Are they realistic about the results? Older clients are likely to have a compromised epidermal junction, which reduces the effect of IPL. Clients that carry the redhead gene will also have reduced results because IPL doesn’t touch the red pigment granule in the skin.
“Under no circumstances should you be told that the results are permanent.
“When do they recommend that the IPL treatment takes place? Autumn is the right time to commence an IPL treatment plan, unless you have a winter holiday planned. It is imperative to avoid all sun exposure after IPL.
“A patch test is a MUST. Ideally this will be done 28 days prior to your IPL treatment, and no fewer than 21 days, as this is the period of time it takes for a cell to complete the wound healing process. The patch test should be monitored on a weekly basis.
“The patch test should be done somewhere between the hairline and the nipple, as the melanocytes are similar.”
I booked in for a pigmentation consultation at three New Zealand salons, all advertising themselves as IPL specialists. The area of pigmentation I wanted a consultation on is featured in the image above, and below is my summary of the three consultations.

Mystery Shop #1: Ingrid

Before meeting with my therapist, I was given a comprehensive IPL-specific questionnaire to complete. It included questions about medical history, medications, skin type and suntan history, as well as details of what to expect from the treatment, and contraindications. I was given 15 minutes to complete the questionnaire, then read and sign the client consent form, before my therapist Ingrid took me into a treatment room and went through my consultation with a fine toothed comb. Every question was repeated back to me, discussed and explained, with Ingrid taking great care to emphasise that she was doing so for my safety and satisfaction.
Ingrid then examined the pigmentation and asked me further questions about any medication I had been on, once again stressing that if I remembered anything at a later date, it was important to be up front because a lot of things could impact my treatment. Ingrid was particularly cautious because I had used fertility treatment to conceive my daughter two years earlier, and could possibly require it again in the future. She explained that they have a doctor on call who they speak to about any medical cases, and she always errs on the side of caution.
Ingrid recommended a course of two to three spot IPL treatments, a month apart, starting in late May or early June. She refused flat-out to do the treatment any earlier, citing another example of a client wanting to zap her unwanted pigmentation before a trip to Turkey. That client was also refused, and Ingrid explained that it was because the skin must be completely protected from sun exposure following IPL, otherwise you can wind up with worse pigmentation than you started with.
She stressed that I needed to stop using any vitamin A and AHA products, and apply a tyronaise blocker for at least two weeks prior to IPL treatment, and for three weeks following. She explained that post-treatment my pigmentation would look like little flecks of milo on my skin, and that it would be a gradual process.
She offered to do a patch test, before giving me a $20 new client voucher and her phone number in case I had any further questions. There was no pressure to book the treatment.

Treatment recommendation:    Spot IPL treatment, two to three sessions a month apart, depending on the results.
Cost:    $150 per treatment.
Overall:    Very reassuring, knowledgeable and cautious.

Mystery Shop #2: Jude

After completing a quick questionnaire that included questions about my current regime and previous treatments, my therapist Jude asked to see the pigmentation I wanted to treat. She explained that the location of the pigmentation suggested it was because of sun exposure out the driver’s window of my car, and that I was probably missing that area when I applied my sun block. There was no discussion about medical history or medication, despite me indicating on my questionnaire that I had used the contraceptive pill in the past.
Jude recommended doing an IPL spot treatment that day, followed up with a skin brightening product, which could be combined with my current vitamin A products. She was confident that I would be happy with the results, and that we would quickly know whether more spot treatments would be necessary.
Overall, Jude gave off reassuring confidence in her knowledge and ability to perform the treatment, however I was surprised at the brevity of the consultation, and also that treatment was recommended on the spot.

Treatment recommendation:    Immediate spot IPL treatment, with further sessions required if results not satisfactory.
Cost:    $50 per treatment.
Overall:    Very welcoming and reassuring, but most of the recommended protocols were not followed.

Mystery Shop #3: Diana

I was given a consultation form to read and complete, which included a lot of questions about my tanning habits, skin type and medical history. It also included a client consent form, with detailed information about IPL, the risks and contraindications.
After completing the questionnaire I was taken to a specialised IPL room with my therapist Diana, who went through the questionnaire in great detail. She asked me further questions about most of the sections, especially relating to skin type, and challenged two of my answers based on her visual assessment of my skin. She used a risk assessment machine to measure my skin’s photo type and melanin density, taking readings from my face, inside of my arm and lower back. Further questions were asked about my medical history, especially relating to fertility treatment and the use of the contraceptive pill.
Diana explained that the pigmentation was likely the result of sun exposure through the car window, and offered to do a patch test. She recommended against spot IPL treatment, instead prescribing a course of two to four full face IPL sessions, to ensure that the overall result was uniform.
She explained that I would need to stop using any vitamin A or other exfoliating products in the two weeks prior and following the IPL treatment, and that as part of my treatment plan I would need microdermabrasion and a follow-up consultation after each IPL session. She also recommended using a tyronnaise blocker to prepare the skin, and suggested that I start using one immediately to help reduce the appearance of my pigmentation until I could have the treatment.
I was given a leaflet to take away, along with her phone number in case I had any further questions, and a recommendation to book in for the treatment during the autumn months so that the treatment plan would be completed before next summer.
 
Treatment recommendation:    Full face IPL treatment, two to four sessions a month apart.
Cost:    $295 per treatment, with a two for one deal currently on offer
Overall:    Professional, thorough and knowledgeable, the only salon to meet all recommended protocols.
To summarise, whilst I only visited three salons, it was soon clear that the client experience varies greatly from salon to salon. If your business offers IPL as part of your service menu, are you confident the protocols you have in place would meet the requirements?

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