Some things people bring to a med spa need a doctor rather than a treatment room. Some things people bring to a med spa are not aesthetic problems and need a doctor rather than a treatment room. See a physician or a dermatologist, not us, if you have a mole or a mark that has changed shape, colour or size, or that bleeds, itches or will not heal; a sore anywhere that has been there more than three weeks; a rash you cannot explain; a patch of skin that is newly numb, hard or ulcerated; sudden hair loss in patches, or hair loss alongside fatigue or weight change; or swelling, heat and spreading redness that could be an infection. And if you have had filler treatment anywhere and the area becomes white or mottled, severely painful, or your vision changes, that is an emergency — telephone us immediately if we treated you, and go to an emergency room if you cannot reach somebody within minutes. We would far rather you rang a doctor and never rang us at all.
A laser emits one wavelength; intense pulsed light emits a broad band and uses filters to select the part of it that will be absorbed by whatever is being targeted. Brown pigment and the haemoglobin in small blood vessels both absorb strongly in the ranges used, which is why a single treatment can address freckling, sun spots, background redness and fine broken vessels in the same pass.
What follows is characteristic and worth expecting: brown spots darken markedly over the first two days, look like coffee grounds for three or four more, and then flake away. Red areas fade over one to two weeks. Most people need three to five sessions three to four weeks apart for the face, and the result is maintained rather than permanent — new sun damage arrives at the rate you allow it to, which is what your sunscreen decides.
The important caution is that this treatment is not suitable for everybody, and that is not a matter of adjusting settings. Broad-spectrum light is absorbed by pigment in skin as readily as by pigment in a spot, so on richer skin tones the risk of burns and long-lasting pigment change is high enough that we do not offer it. That is a real limitation of this technology, we would rather say so than take the booking, and there are better answers for pigment on deeper skin, described below.
What it treats, and what it does not
Four honest categories.
Sun spots and freckling
The best use of the treatment. Flat brown marks on the face, chest, shoulders and backs of the hands respond well, often dramatically, across three to five sessions. This is the treatment most likely to make somebody say their skin looks like it did ten years ago, and it is largely a comment on how much of what we read as ageing is actually sun.
Facial redness and small vessels
Background flushing and fine broken vessels on the cheeks and around the nose fade well. Larger, more defined vessels are better treated with a vascular laser, which is a different page. Redness associated with rosacea can improve considerably, though rosacea is a medical condition that needs a diagnosis first — from a dermatologist, not from us.
Melasma — the exception
This is the one people are most often mis-sold. Melasma is a hormonally driven pigment condition, it is heat-sensitive as well as light-sensitive, and intense pulsed light frequently makes it worse rather than better — sometimes considerably and lastingly. We do not treat melasma with this. Anywhere offering to is either not distinguishing it from sun damage or is not being careful.
Texture, lines and laxity
Not what it does. There is a modest general improvement in skin quality reported after a course, and it is genuinely modest. If texture is the goal, microneedling or resurfacing is the treatment, and we will say so instead of selling you five sessions of the wrong thing.
A course, session by session
Straightforward, low-downtime and unglamorous.
Preparation
Four weeks with no sun, no sunbed, no self-tanner. Stop retinoids on the area for five days. Arrive with clean skin and no makeup. If you have had a cold sore in the treated area, tell us.
The session
Twenty to thirty minutes for a full face. Eyewear for everybody, cool gel on the skin, and a series of bright flashes that feel like a rubber band snap with a flash of heat. You see the light through closed eyes and through the eyewear, which surprises people.
The following week
Redness for a few hours, then the characteristic darkening of every pigmented spot for three to seven days before they flake off. Do not scrub or pick them; they leave on their own. Most people are comfortable in public throughout, though the coffee-grounds stage is noticeable close up.
Maintenance
One or two sessions a year keeps a result, and daily sunscreen keeps it far better than that. A client who does not wear sunscreen will be back for the same course in three years, and we would rather tell them that than book it.
Risks and who we decline
The list is short and the first item on it is the one that matters.
Burns and pigment change
The predictable consequence of too much energy for the skin in front of the device, or of treating recently tanned skin. On richer skin tones this risk is high enough that we do not offer the treatment at all, which is a limitation of the technology rather than a judgement about anybody's skin.
Making melasma worse
Well documented and reasonably common. Heat alone can provoke melasma, and a light-based treatment delivers plenty of it. This is why distinguishing melasma from sun damage is the first thing the consultation does.
Eye injury
Light this bright can damage the retina. Eyewear is worn by everybody in the room without exception, and we do not treat close to the eye socket. Anywhere that treats without eyewear is not a place to be treated.
We will not treat
Richer skin tones; anybody with a recent tan or self-tanner; melasma; anybody on medication that increases light sensitivity; anybody pregnant; over a tattoo; and anybody with an undiagnosed skin lesion in the treatment area, who is going to a dermatologist first.
IPL Photofacial in western Queens
A broad flash of filtered light absorbed by brown patches and red vessels, which breaks them up so the body can clear them. Excellent for sun damage on lighter skin — and genuinely risky on richer skin.
Every treatment here starts the same way: a full hour at a table in a room with no treatment couch in it, a proper medical history, your skin looked at in daylight, and then a plain statement of what we think would achieve what you described. You are told what it costs, how many sessions it usually takes, how long it lasts, what the recovery looks like and what can go wrong — on paper, to take home and read somewhere other than a treatment room. If the honest answer is a different treatment, or nothing, or a dermatologist, that is what you get instead, and it costs exactly the same.
Aesthetic treatment is elective medicine, and this page is not medical advice for you. Aesthetic treatment is elective, it is medicine wherever it breaks the skin, and nothing on this website is medical advice for you in particular. We do not diagnose disease. Every treatment here begins with a consultation and a medical history, because your health, your medication, your skin type and what you have had done before all change what is safe and what is sensible. Some people are told no. Being told no is a normal outcome of a consultation here rather than a failure of one, and it costs exactly the same as being told yes.
No before-and-after photographs, and no promised outcome. There are no before-and-after photographs on this website and there never will be. Every set you have seen somewhere else was chosen from a much larger pile, and the second picture is usually taken in different light, at a different angle, at a different time of day, often with makeup and frequently after retouching. Even an entirely honest pair shows you what happened to somebody else's face. What we publish instead is what a treatment typically changes, by roughly how much, how long it lasts, how many sessions it usually takes and how often people are disappointed. We do not guarantee an outcome, we cannot, and anybody who does is either guessing or selling.
The risks, plainly. Every treatment on this site has side effects and some carry real risks. The common ones are minor and short-lived — redness, swelling, tenderness, bruising, a day or two of looking like you have had something done. The uncommon ones matter more: burns, blistering and long-lasting pigment change from light-based treatment, which is a greater risk on deeper skin tones and on recently tanned skin; infection anywhere the skin is broken; and lumps, asymmetry and, very rarely, a blocked blood vessel from injectable filler, which is the one true emergency in this field. We screen for what makes each of these more likely, we tell you your own risk rather than the average one, and we decline to treat when the answer should be no.
What a med spa does not treat. We treat the appearance of healthy skin, hair and body. We do not diagnose or treat disease. If you bring us a mole, a changing mark, an unexplained rash, a sore that will not heal, skin that has become hard or numb, psoriasis, eczema, an autoimmune skin condition, or hair loss that came on suddenly or in patches, what you will get is the name of a doctor rather than a treatment plan. Aesthetic treatment applied on top of an undiagnosed skin problem can mask it, delay the diagnosis and occasionally make it worse. We would rather lose the booking.
Questions
IPL Photofacial — the questions we are asked most
Is this a laser?
No, although it is constantly described as one. A laser emits a single wavelength; intense pulsed light emits a broad band and filters it. The practical difference is that a laser can be aimed precisely at one target while this treats several at once, which is a strength for general sun damage and a weakness where precision matters.
Can I have it if I have olive or dark skin?
Not here. Broad-spectrum light is absorbed by the pigment in skin as well as by the pigment in a spot, and on richer skin the risk of burns and long-lasting pigment change is high enough that we do not offer it. This is a genuine limitation of the technology. Pigment on deeper skin tones is better addressed with chemical peels, prescription-strength topical treatment and, in some cases, microneedling — and we will put you on that path instead.
Will this help my melasma?
No, and it can make it worse. Melasma is hormonally driven and heat-sensitive as well as light-sensitive, and a course of intense pulsed light frequently darkens it, sometimes lastingly. Establishing whether your pigment is melasma or sun damage is the first thing we do, because the two look similar and need opposite treatment.
What will I look like afterwards?
Pink for a few hours. Then every brown spot in the treated area darkens noticeably for three to seven days — people describe it as coffee grounds — before flaking away on its own. It is visible up close and most people carry on normally through it. Do not book it three days before a wedding.
How many sessions?
Three to five for the face, spaced three to four weeks apart, and often more on the chest and hands where sun damage is heavier. You are assessed before each session and you can stop whenever the result is enough for you.
Will the spots come back?
The ones treated do not come back, but new sun damage arrives at whatever rate your sun exposure allows. That is entirely in your hands and it is the reason sunscreen is the first item on our home-care page. Somebody who has a course and then spends every summer weekend outdoors without protection will need another course, and we will not pretend otherwise.
Related
Often seen alongside this
Laser & Light
Laser Hair Reduction
The most reliably satisfying treatment in this building, provided the expectation is right: it is a permanent reduction rather than a permanent removal, and it takes a course spread across months.
Read more
Laser & Light
Laser Skin Resurfacing
Controlled removal of the surface of the skin so that it heals back smoother, or controlled heating beneath it without breaking the surface. The first works better; the second costs you nothing in downtime.
Read more
Laser & Light
Laser Vein Treatment
Light absorbed by blood inside a small unwanted vessel heats it enough to close it, and the body clears it over weeks. Good for facial vessels and fine leg veins — and not a treatment for varicose veins.
Read moreA written plan and a written price before anything is booked
Book a consultation
Pick a clinician and an hour from the calendar — it shows only the times each of them genuinely has free. A consultation is a full hour at a table with no treatment couch in the room, and it costs $85, or $120 with the medical director. If you go ahead, that comes off your first treatment. If we tell you the answer is nothing, or a dermatologist, it costs exactly the same.