The Great Debate: IPL or RF…or Both?
Radiofrequency (RF) has been used in Aesthetics, and at Essence, for skin tightening for decades. The deep heat that is generated in the skin enhances elastin and collagen production improving skin quality. Recently there has been discussion in the literature regarding the use of RF for Dry Eyes. The theory behind it is simple: The heat delivered to the Meibomian glands (MBG) in the eyelids helps to open the MBG and allow for better function, much the same way as IPL delivers heat to the eyelids, but RF uses high frequency electrical energy and IPL uses light based energy. Better MBG function means a healthier tear film, less evaporation, and less dry eye symptoms.
Several reports in the literature have reported an improvement in Dry Eye symptoms using Radiofrequency treatment. New technologies are claiming better results with the combination of RF and IPL. The question is, does RF add anything to the treatment that the IPL is not already doing? IPL already delivers heat, but the light based IPL also targets the color Red and coagulates the telangiectasias, tiny blood vessels that release inflammatory components to the eye. RF is color blind. It has no effect on the telangiectasias.
So, is there really any benefit to adding more heat with RF to the IPL treatment? Currently, there is no good scientific evidence in the literature that proves this is the case.
There is a report in the literature cited by many to support the combination of RF and IPL, see reference below. However, as the authors themselves admit, there are many flaws in the study, including the comparison group for IPL alone came from an entirely different study where many other variables were involved, and the authors were paid by a Technology device company that sells the RF/IPL combo device. The authors concluded that “A randomized controlled study comparing the combination of RF and IPL.. with IPL.. alone is required to further elaborate the relative contribution of RF.”
Here is what we know about the use of Radiofrequency and IPL for Dry Eyes
- Both RF and IPL deliver heat to the MBG and can help with the symptoms of dry eyes.
- Both RF and IPL are safe therapies in the hands of skilled clinicians.
- IPL additionally coagulates the telangiectasias that release inflammatory components, RF does not.
- IPL cannot be used in patients with highly pigmented skin, or with Tetracycline related antibiotics. RF can be used for these patients.
- RF cannot be used in patients with any metal implants from the chest up, or a pacemaker. IPL can.
- RF has the added benefit of a cosmetic improvement in the skin quality around the eyes. IPL does not.
- There is no good scientific evidence that has shown that the combination of RF and IPL add to the effect of IPL alone on Dry Eyes. This is yet to be proven.
Both IPL and RF can help with Dry Eyes. If there are no contraindications, IPL is most likely the superior therapy due to the added benefit of its effect on telangiectasias. For patients that have contraindications to IPL, RF may be a good alternative.
If a patient would like to try the combination, realizing there is no scientific evidence that supports it for dry eyes, and there are no contraindications to either therapy, or if the patient desires a cosmetic benefit, RF and IPL treatments may be combined.
At Essence Laser & Wellness we have years of experience using monopolar Radiofrequency, as well as IPL, around the eyes. Our advanced RF technology with the BTL Exilis Device is a monopolar unit that blends Ultrasound with the Radiofrequency for a deeper delivery to the tissue, which may enhance the delivery of heat to the Meibomian Glands for Dry Eyes.
Radiofrequency delivers heat to the skin by high frequency electrical waves. The heat delivered to the eyelids serves to open the meibomian glands and allows for a better oily layer of the tear film, and less evaporation of the tears, thereby improving the symptoms of Dry Eyes.
The BTL EXILIS technology at Essence provides the most advanced technology in RF safely, efficiently, and without pain. Initially, a grounding pad is laid on the back to ground the monopolar energy. A layer of gel is applied to the skin, and a handpiece attached to the energy system is used to deliver heat to the area around the eyes, in a circular continuous motion. Most patients describe the sensation as being comparable to that of a hot stone massage. The treatment is performed in a lying position so you can easily relax during the procedure. The procedure takes about 15-30 minutes. There is no downtime with the RF procedure alone. The presence of any metal implants from the chest up is a contraindication to RF therapy.
A minimum of 3 treatments, but typically 4-5 treatments are given one month apart. After that maintenance treatments are given one to 2 times per year, depending on the severity of the condition.
- The presence of any metal implants from the chest up.
- The presence of a pacemaker
- Pregnancy and/or Breastfeeding
Essence Laser & Wellness, under the supervision of Melinda C ORourke, MD, is a referral center for specialty Dry Eye Therapy, and a Medical Aesthetics Practice, and is not a routine Ophthalmology practice. We ask that you provide a copy of a recent eye exam prior to treatment when seeking IPL for Dry Eye, and/or the PReye shot. No exam is necessary for RF, PReye drops or PRP for Aesthetic purposes.
Ask us about our IPL/PReye®/RF bundling packages.
Chelnis J, Garcia CN, Hamza H. Multi-Frequency RF Combined with Intense Pulsed Light Improves Signs and Symptoms of Dry Eye Disease Due to Meibomian Gland Dysfunction. Clin Ophthalmol. 2023 Oct 20;17:3089-3102.