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Low Level Light Therapy with Light-Emitting Diodes for the Aging Face
Abstract
Low level light therapy (LLLT) with light-emitting diodes (LEDs) is emerging from the mists of black magic as a solid medico-scientific modality, with a substantial buildup of corroborative bodies of evidence for its efficacy and elucidation of the modes of action. Reports are appearing from many different specialties; however, of particular interest to plastic surgeons treating the aging face is the proven action of LED-LLLT on skin cells in both the epidermis and dermis and enhanced blood flow. Thus, LED-LLLT is a safe and effective stand-alone therapy for patients who are prepared to wait until the final effect is perceived.
... Despite different treatment options, OM is still a frequent complication decurrent of head and neck cancer treatment [12]. Differences in parameters, such as wavelength and dose, are responsible for a plethora of results regarding LLLT in OM treatment in the literature [13]. LLLT has different effects in OM treatment according to the wavelength [13]. ...
... Differences in parameters, such as wavelength and dose, are responsible for a plethora of results regarding LLLT in OM treatment in the literature [13]. LLLT has different effects in OM treatment according to the wavelength [13]. According to wavelength, LLLT acts differently in the cells [14][15][16][17][18]. ...
... For example, red and infrared light energy induce photon absorption, but both wavebands have different primary targets and photoreactions in target cells [14][15][16][17][18][19]. The red light is mainly absorbed by cytochrome c oxidase while infrared is incorporated in the plasmatic membrane by a photophysical reaction in the cell membrane [13][14][15][16][17][18][19]. It was demonstrated that LLLT at three times superior dose reduced pain and prevented OM [11]. ...
Oral squamous cell carcinoma (OSCC) is the most frequent oral malignant neoplasia. As consequence of OSCC treatment, oral mucositis (OM) is one of the most common adverse effects of OSCC treatment. Currently, there is no consensus for OM treatment. The purpose of the current study was to test the combination of red and infrared low-level laser therapy (LLLT) for OM treatment. Primary culture of human fibroblast was performed to identify LLLT dose. After laboratory tests, a two-arm parallel, single-blind, controlled study was conducted. The two arms were group 1, both 660- and 808-nm wavelengths (300 J/cm2, 9 J of total energy, 100 mW, spot size 3 mm2), and group 2, only 660-nm wavelength (300 J/cm2, 9 J of total energy, 100 mW, spot size 3 mm2). Both treatments were performed twice a week. Group 1 presented a reduction of mucositis grade in comparison to group 2. Group 1 also presented reduction of analgesics prescription. But no significant differences between groups 1 and 2 were observed according to the pain scale. In conclusion, the current study demonstrated that a combination of red and infrared at a higher dose (300 J/cm2) reduced both oral mucositis grade and analgesics prescription. The effects of the combination of RT and LLLT are unclear and need more studies.
... Despite the fact that phototherapy has been proposed as an interesting tool to reduce wrinkles, clinical trials evaluating any real effects are sparse. (11,31,32) Regarding this subject, this study's protocol was designed in order to evaluate the reduction of wrinkles when using red or amber LED devices. This current work has described a study protocol for a unicentric randomized clinical trial based upon the comparison of two interventions. ...
... Firstly, the participants will be their own control, since the measurements are going to be accomplished before and after a series of 10 sessions of in- studies that had demonstrated that an application of red light on the skin could trigger cell proliferation, increased collagen fibers and decreased metalloproteinases; these studies had also demonstrated that an amber light can interact with the epidermal cells, triggering mitosis and cell renewal, as well as acting on the protection and the hydration of the epidermis; all of this information was together with clinical trials showing an improvement of wrinkles by using phototherapy. (11,15,22,32,41) There is no consensus in the literature regarding the washout period for phototherapy, which varies from 7 days to 12 weeks. (42)(43)(44)(45) Due to this, a washout of 180 days for performing the crossover treatment was chosen, in order to evaluate if there were any residual effects from the first photobiomodulation treatment performed. ...
... Despite the fact that phototherapy has been proposed as an interesting tool to reduce wrinkles, clinical trials evaluating any real effects are sparse. (11,39,40) Regarding this subject, this study's protocol was designed in order to evaluate the reduction of wrinkles when using red or amber LED devices. This current work has described a study protocol for a unicentric randomized clinical trial based upon the comparison of two interventions. ...
... Both Red light and laser at 660 nm have also demonstrated efficacy for hair loss, and the use of low-level laser therapy (LLLT), as well as of phototherapy with light-emitting diodes (LEDs), 9 has been intensified to promote hair growth in AGA 7,8 . For years, LED phototherapy has been presented as an effective and safe tool for the treatment of skin, mucous and scalp conditions in which there is an inflammatory component, being used successfully in the treatment of acne 10 , vaginal atrophy 11 , facial aging 12,13 , and also in disorders related to hair growth 14,15 . The innovative combination of LLLT, LEDs, and magnetic field technologies for the treatment of AGA is of recent development. ...
... Mean increase of terminal hair density was 40%, as well as the rest of the variables (23% to 30%), except for vellus hair density, which decreased by 1.7%. Some studies had investigated a variety of light sources and treatment parameters for the management of alopecia, such as LLLT, [16][17][18][19][20][21] various wavelengths of LED light 14,15,22,23 and several techniques combined, such as LED-LLLT 9,12,14,15,19,24 . The device used in this study is a technological innovation that combines, in a synergistic way, Nano Pulsed Cold Laser (NPCL) laser emitters, infrared diodes and RGB diodes in a magnetic tunnel. ...
... Some of the current approaches being used, with the aim of rejuvenation, are peels, fillers, botulinum toxin, cosmetic products, radiofrequency, microneedling, and various forms of phototherapy [intense pulsed light, ablative laser, lowintensity laser, or light-emitting diodes (LEDs)]. [4][5][6][7][8] Photobiomodulation (PBM) is a technique based on the use of a low-intensity laser device, or an LED, in a way that the photons are absorbed by the target tissue, producing a biological response. 6,[9][10][11] The clinical use of PBM has shown many promising results in inflammatory conditions, tissue repair, wound healing, and others. ...
... [4][5][6][7][8] Photobiomodulation (PBM) is a technique based on the use of a low-intensity laser device, or an LED, in a way that the photons are absorbed by the target tissue, producing a biological response. 6,[9][10][11] The clinical use of PBM has shown many promising results in inflammatory conditions, tissue repair, wound healing, and others. 9,12 For rejuvenation, in vitro data have suggested an increase in procollagen I production and gene expression, as well as a reduction in the gene and protein expression of matrix metalloproteinase 1 (MMP-1). ...
Objective: This study aimed to evaluate red and amber light-emitting diode protocols for facial rejuvenation at the same light dose. Background: The demand for minimally invasive cosmetic procedures to address skin aging has grown throughout the world. In vitro red and amber photobiomodulation (PBM) has been shown to improve collagen synthesis. Meanwhile, red PBM has already been studied in clinical trials; however, a comparison of the use of different wavelengths at the same light dose to reduce periocular wrinkles has not yet been performed. Methods: This split-face, randomized clinical trial recruited 137 women (40-65 years old) presenting with skin phototypes II-IV and Glogau photoaging scale types II-IV. The individuals received 10 sessions for 4 weeks of red (660 nm) and amber (590 nm) PBM (3.8 J/cm2), one at each side of the face. The outcomes, measured before and after the treatments, were the periocular wrinkle volume measured by VisioFace® RD equipment; hydration measured by the Corneometer CM 825; skin elasticity measured by the Cutometer Dual MPA 580; and quality of life determined by adapted versions of validated questionnaires [Melasma Quality of Life Scale-Brazilian Portuguese (MelasQoL-BP) and Skindex-29]. Results: There was a significant reduction in wrinkle volume after red (31.6%) and amber (29.9%) PBM. None of the treatments improved skin hydration and viscoelasticity. Both questionnaires showed improvements in participants' quality of life. Conclusions: PBM, both at red and amber wavelengths, is an effective tool for rejuvenation, producing a 30% wrinkle volume reduction. The technique has strong potential in patients with diabetes or those presenting with keloids, conditions for which highly inflammatory rejuvenating procedures are not indicated. Clinical trial registration number: REBEC-6YFCBM.
... 39 Despite the fact that phototherapy has been proposed as an interesting tool to reduce wrinkles, clinical trials evaluating any real effects are sparse. 11 40 41 On this subject, this study's protocol was designed to evaluate the reduction of wrinkles when using red or amber LED devices. This current work has described a study protocol for a unicentric randomised clinical trial based on the comparison of the two interventions. ...
... 48 49 Here, the choice of wavelengths was made from studies that had demonstrated that an application of red light on the skin could trigger cell proliferation, increased collagen fibres and decreased metalloproteinases; these studies had also demonstrated that an amber light can interact with the epidermal cells, triggering mitosis and cell renewal, as well as acting on the protection and the hydration of the epidermis; all of this information is, together with clinical trials, showing an improvement of wrinkles using phototherapy. 11 15 22 41 50 There is no consensus in the literature regarding the washout period for phototherapy, which varies from 7 days to 12 weeks. [51][52][53][54] Due to this, a washout of 180 days for performing the cross-over treatment was chosen to evaluate if there were any residual effects from the first photobiomodulation treatment performed. ...
Introduction
The skin undergoes morphological and physiological changes with the advancing age of an individual. These changes may be caused by intrinsic and extrinsic factors that contribute to cellular ageing and consequent skin ageing. The term photoageing is used to characterise the ageing of the skin caused by solar radiation. Clinically, the skin becomes more flaccid, thicker and hyperpigmented, while there is an early appearance of wrinkles and other skin changes, such as skin cancer. Nowadays, there are numerous treatments for ageing skin, and one of them is with the use of phototherapy, which uses light-emitting diodes (LEDs). The objective of this study will be to evaluate the percentages of reduction in the volume of periocular wrinkles when treated with red and amber LEDs.
Methods and analysis
All of the participants will receive photobiomodulation to treat their periocular wrinkles. They will be using red and amber LEDs, with one colour being used on each hemiface. The facial side to be treated with each colour will be randomised. After an interval of 180 days, the participants will receive a cross-treatment. The primary variable of the study is the volume of periocular wrinkles (crow’s feet), which will be measured by a VisioFace equipment. The secondary variables are elasticity (measured by Cutometer) and hydration (measured by Corneometer). Quality of life and self-assessment of the participants will be measured using the adapted Melasma Quality of Life scale - Brazilian Portuguese adaption (MelasQoL-BP) and Skindex-29 questionnaires. All of the variables will be measured before and after a group of 10 sessions.
Ethics and dissemination
This protocol was approved by the Research Ethics Committee of the Nove de Julho University (acceptance number: 2.550.732). This trial has been registered in the Registro Brasileiro de Ensaios Clínicos (Brazilian Clinical Trials Registry) (REBEC number: RBR-6YFCBM). This study is not recruiting yet.
Trial registration number
RBR6YFCBM; Pre-results.
... In the last decades, several works evaluated the effectiveness of low power laser therapy (coherent light) in the healing process. Light carries energy that deposited in the cell organelles (mainly mitochondria) of injured tissues and increases the level of biochemical reactions at cellular level, increasing cell metabolism and modulating positively the healing tissue [2][3][4][5][6]. ...
... The fibroblast plays a crucial role in wound healing; most studies published in the literature on low-level laser therapy examined their effects on fibroblasts, cell growth, migration and collagen production 6 . Previous studies demonstrated an increased cellular metabolism, with a higher number of mitochondria in the cytoplasm of fibroblasts in irradiated animals compared to control ones. ...
... Some of the devices employ a fractional approach, such as fractional ablative or non-ablative lasers for skin rejuvenation (5). Another approach frequently used on the face involves photobiomodulation therapy, or the use of low levels of red and/or near infrared light often delivered from safe inexpensive light emitting diodes (LEDs) (6). A different light based approach is called photodynamic therapy (PDT), and this involves combining visible light with an externally applied photosensitizer. ...
... Compared to the lasers typically used in complicated clinical settings, LEDs are safer and more cost-effective, and are well-tolerated by patients of all age groups. Furthermore, there are a plethora of visible blue and red light wavelength LED-based devices already available on the market, used by either patients or healthy individuals, independently in their homes, for some generic dermatological applications [30][31][32]. However, to the best of the authors' knowledge, no studies (or devices) are available in the literature that explore the feasibility of near-infrared LEDs as a reasonable alternative to moxa sticks during moxibustion therapy, and that quantify the relationship between the light-tissue interactions during such a treatment. ...
Acupuncture is one of the most extensively used complementary and alternative medicine therapies worldwide. In this study, we explore the use of near-infrared light-emitting diodes (LEDs) to provide acupuncture-like physical stimulus to the skin tissue, but in a completely non-invasive way. A computational modeling framework has been developed to investigate the light-tissue interaction within a three-dimensional multi-layer model of skin tissue. Finite element-based analysis has been conducted, to obtain the spatiotemporal temperature distribution within the skin tissue, by solving Pennes’ bioheat transfer equation, coupled with the Beer-Lambert law. The irradiation profile of the LED has been experimentally characterized and imposed in the numerical model. The experimental validation of the developed model has been conducted through comparing the numerical model predictions with those obtained experimentally on the agar phantom. The effects of the LED power, treatment duration, LED distance from the skin surface, and usage of multiple LEDs on the temperature distribution attained within the skin tissue have been systematically investigated, highlighting the safe operating power of the selected LEDs. The presented information about the spatiotemporal temperature distribution, and critical factors affecting it, would assist in better optimizing the desired thermal dosage, thereby enabling a safe and effective LED-based photothermal therapy.
... This type of therapy has demonstrated promising results in improving wrinkles and skin laxity. [103][104][105][106][107][108][109][110][111] In animal studies, it has been reported that LLLT can increase the production of collagen and bFGF. 112,113 It has also been reported that LLLT is able to increase microcirculation and vascular perfusion on skin, increase expression of PDGF and TGF-β1, and inhibit apoptosis. ...
The use of lasers for facial esthetics has a long history dating back to the 1960s. While originally clinical procedures and indications were limited to ablative therapies, over the past decade technologic advancements have expanded the applications of lasers in clinical practice. Today over 150 commercially available lasers exist on the market for various indications, including scar revisions, pigmented lesions, vascular lesions, hair removal, facial resurfacing, facial rejuvenation, fat ablation, and laser lipolysis. This chapter provides an in-depth overview of the current state-of-the-art technology and provides specific indications and guidelines regarding the use of lasers in facial esthetics.
... For these reasons, the LLLT use, such as phototherapy with LED [23], has been intensified into the market of devices aiming to stimulate HG in AGA [24,25]. Precedently, LED phototherapy was described as a good and safe procedure for the treatment of acne [26], vaginal atrophy [27], facial aging [28,29], and in HL disorders [30]. Different low-level laser and light sources for the management of alopecia, such as LLLT, [31][32][33][34][35][36], various wavelengths of LED light [11,37], and several other techniques combined, such as LED-LLLT [38], have been analyzed by many investigators, with the aim to establish the related treatment parameters and the outcomes. ...
A procedure based on Microneedling (MND) with Low-Level Led Therapy (LLLT) and Growth Factors (GFs) could be a booster for hair re-growth (HRG) in patients assuming Finasteride®. The study examined the clinical outcomes of a multicentric, observational, retrospective, case-series investigation in which MND with LLLT and GFs was applied to patients suffering from androgenic alopecia (AGA) who were prescribed Finasteride®. Twenty-one patients were initially enrolled, of which seventeen males were classified in stage II–VI by the Norwood–Hamilton scale, and four females were classified in stage II–III by the Ludwig scale. One male patient was excluded after screening (exclusion and inclusion criteria evaluation). Twenty patients were analyzed, of which ten patients’ hair growth has stalled after taking Finasteride®, and ten patients did not achieve good results from Finasteride®. HRG assessment was evaluated with photography, physician’s, and patient’s global assessment scale, in addition to standardized phototrichograms during a short follow-up: T0—baseline, T1—20 weeks (wks). A statistically significant improvement in HRG (p = 0.0822) and an increase in hair density of 19 ± 2 hairs/cm2 at T1 after 20 wks (20 wks vs. 0 wks) in the targeted area over baseline (74 ± 2 hairs/cm2 at T1 versus 55 ± 2 hairs/cm2 at baseline) were reported and described as encouraging results. The effectiveness of MND with LLLT and GFs use was demonstrated in patients whose hair growth stalled after taking Finasteride® and in patients who did not achieve good results from Finasteride®.
... The subsequent 830 nm energy literally 'washes out' the clinical efficacy of the 590 nm energy at more than 3 orders of magnitude greater irradiance, and therefore targets all cells in the eyelids, including the meibomian glands. The combination of the effects of these wavelengths in the system used in the present study has proven highly effective in wound healing and skin rejuvenation, with particular efficacy accorded to the main wavelength of 830 nm 29 . With the combination of the inherent safety associated with noncoherent diffuse LED energy and the use of the metal contact eyeshields, no ocular safety issues were raised, and no serious adverse events occurred during treatment or the follow-up period. ...
To evaluate the efficacy of low-level light therapy (LLLT) with near-infrared light-emitting diodes (LED-LLLT) for the treatment of dry eye. 40 patients were randomly assigned with a 1:1 allocation ratio to receive LED-LLLT (LLLT group, n = 20) or placebo treatment (placebo group, n = 20). Patients in the LLLT group received LLLT twice a week for 3 weeks, for a total of 6 treatment sessions. The primary endpoint was the changes in the fluorescein corneal staining (FCS) score. The secondary endpoints were the changes in the ocular surface disease index (OSDI) score, lissamine green conjunctival staining (LGCS) scores, tear film break-up time (TBUT), Schirmer test, and the meibomian gland dysfunction (MGD) index. These were evaluated before treatment and 4 weeks after start of treatment. The mean difference of score change in primary endpoint revealed significant improvement in the LLLT group, compared to the placebo. Among secondary endpoints, LGCS, Schirmer's test, upper meibography scores showed significant improvements, while TBUT, lid debris, lid swelling, lid telangiectasia, meibomian gland secretion and expressibility scores had slight improvement without significant differences. No serious adverse events were observed. The use of LED-LLLT for the treatment of dry eye and MGD appears to be safe and beneficial.
... These biological effects include increased adenosine triphosphate (ATP) production, modulation of intracellular oxidative stress, induction of transcription factors, alteration of collagen synthesis, stimulation of angiogenesis, and increased blood flow (Calderhead, 2007;Sorbellini et al., 2018;Tosa & Ogawa, 2020). PBM has been shown to be useful for wound healing, pain relief, and vitiligo re-pigmentation, as well as for the treatment of photoaging, atopic dermatitis, alopecia areata, and acne vulgaris (Ayuk et al., 2016;Calderhead & Vasily, 2016;Nikolis, 2017;Nunes et al., 2019;Tomazoni et al., 2020). Specifically, wavelengths in the range of 390-600 nm are used to treat superficial tissue, while longer wavelengths (600-1100 nm) penetrate further and are used to treat deeper-seated tissues (Avci et al., 2013). ...
Photobiomodulation (PBM) is a promising medical treatment modality in the area of photodynamic therapy (PDT). In this study, we investigated the effect of combined therapy in a 3D microenvironment using aluminum chloride phthalocyanines (AlClPc) as the photosensitizing agent. Normal human fibroblast-containing collagen biomatrix was prepared and treated with an oil-in-water (o/a) AlClPc-loaded nanoemulsion (from 0.5 to 3.0 μM) and irradiated at a range of fluences (from 0.1 to 3.0 J/cm²) using a continuous-wave light-emitting diode (LED) irradiation system (660 nm). PBM at 1.2 J/cm² and AlClPc/NE at 0.5 μM modified the fibroblast signaling response under 3D conditions, promoting collagen synthesis, ROS production, MMP-9 secretion, proliferation of the actin network, and facile myofibroblastic differentiation. PBM alone (at 1.2 J/cm² and 0.3 J/cm²) had no significant effect on any of these parameters. The combined therapy affected myofibroblastic differentiation, inflammatory response, and extracellular matrix pliability, and should thus be examined further in subsequent studies considering that no side effects of PBM have been reported. Even though significant progress has been made in the field of phototherapy in recent years, it is necessary to further elucidate the detailed mechanisms underlying its effects already shown in 2D conditions to increase the acceptance of this beneficial and non-invasive therapeutic approach.
... Therefore, maintenance of skin is of critical importance, and a number of measures have been proposed and applied for skin rejuvenation [141][142][143][144][145]. Among the various options available, phototherapy has been extensively used as a safe and non-invasive modality to promote fibroblast proliferation and collagen synthesis for skin rejuvenation [146][147][148]. ...
With ever growing interest in far-reaching solutions for pervasive healthcare and medicine, polymer optical fibers have been rendered into textile forms. Having both fiber-optic functionalities and traditional fabric-like comfort, textile-integrated polymer optical fibers have been advocated to remove the technical barriers for long-term uninterrupted health monitoring and treatment. In this context, this paper spotlights and reviews the recently developed textile-integrated polymer optical fibers in conjunction with fabrication techniques, applications in long-term continuous health monitoring and treatment, and future perspectives in the vision of mobile health (mHealth), as well as the introductory basics of polymer optical fibers. It is designed to serve as a topical guidepost for scientists and engineers on this highly interdisciplinary and rapidly growing topic.
... 830 nm LED-LLLT has also shown very powerful synergy as adjunctive therapy after any kind of major or minor aesthetic/cosmetic procedure, shortening downtime by controlling erythema, discomfort and edema, and improving the clinical result [25]. Additional beneficial effects have been reported in turning back the skin ageing clock for the ageing face using 830 nm LED-LLLT either as a stand-alone approach, or in conjunction with other invasive or noninvasive methods [26]. ...
... This result may due to the denaturation in membrane protein of red blood cell [22] . It is believed that when a photon is absorbed by the cell, in this case haemoglobin, it passes on its energy to the cell [23]. ...
This study was conducted to investigate the effect of Low Level Laser Irradiation of ATP content on anaemic human blood cells. This work measured the optical density of RBCs to study the effect of ATP level after irradiated by the laser. The Low Level Laser used in this work is 589nm laser. Two aliquots of normal and anaemic blood sample were prepared, one as the control (un-irradiated) while the other one was irradiated with the laser at 20 mW, 40 mW and 60 mW which each have been irradiated at 15 minutes, 30 minutes and 45 minutes of exposure time. The ATP level of RBCs of normal and anaemic blood sample were measured by using CellTiter-Glo Luminescent cell Viability Assay Kit which generates a glow signal produced by luciferase reaction. Optical Density, as the unit to measured ATP level was tested using ELISA reader. The result shows that the ATP level is increased for anaemic RBCs after the irradiation for 20 mW, 40 mW and 60 mW, each at 15 minutes, 30 minutes and 45 minutes of exposure time. The cell viability for the anaemic also shows an increase compared to the un-irradiated one. The paired T-test is used to analyse each power irradiation and the effect of irradiation on RBCs were significant over different exposure time which all p-value is p = 0.000.
... The efficacy of this treatment has been also demonstrated in a larger study, involving 94 subjects [105]. LED therapy has also been successfully coupled with LLLT as adjuvant therapy for enhancing existing result from photo rejuvenation treatments [106]. ...
Benefit deriving from the use of light is known since ancient time, but, only in the last decades of twentieth century, we witnessed the rapid expansion of knowledge and techniques. Light-emitted diode (LED)-based devices represent the emerging and safest tool for the treatment of many conditions such as skin inflammatory conditions, aging, and disorders linked to hair growth. The present work reviews the current knowledge about LED-based therapeutic approaches in different skin and hair disorders. LED therapy represents the emerging and safest tool for the treatment of many conditions such as skin inflammatory conditions, aging, and disorders linked to hair growth. The use of LED in the treatment of such conditions has now entered common practice among dermatologists. Additional controlled studies are still needed to corroborate the efficacy of such kind of treatment.
... Noninvasive and less invasive treatments, as compared to conventional cosmetic surgery, including treatments using energy such as laser, visible right, infrared radiation, electromagnetic waves (RF) and ultrasound and injection therapy, tend to be preferred for facial treatment [1] [2] [3] [4] [5]. In addition, many home-use products for facial treatment or depilation available in the market are popular, because treatment using these products is more convenient than treatment at medical institutions. ...
... 30 Photorejuvenation with LED-LLLT is proving very popular. 31,32 Sports medicine is another fast-growing field, and one study reported that return to play was halved in injured athletes treated with 830 nm LED-LLLT compared with best standard care. 33 The most popular wavelength for all indications appears to be 830 nm because of its deep penetration as seen in Fig. 2 above, and also because of the different cell types in the wound healing cycle which respond best to 830 nm compared with other wavelengths. ...
... Therefore, dermatologists are constantly seeking new therapeutic options. Over the past decades, LED photomodulation has been proved to be effective in photorejuvenation [7,8], relieving post-treatment erythema [9,10], radiation-induced dermatitis [11], treating acne vulgaris [12,13] and decreasing skin scarring [14]. Intriguingly, LED photomodulation has also become more and more popular in relieving hyperpigmentation diseases, such as melasma and post-inflammatory hyperpigmentation in clinical practice. ...
Background:
Melasma is a common hyperpigmentation skin disease on face. Light-emitting diode (LED) photomodulation (585nm) is reported to be effective for the treatment of melasma. However, whether and how LED photomodulation would influence melanogenesis of human epidermal melanocytes (HEMs) is unknown.
Objective:
To evaluate the effects of LED photomodulation (585nm) on melanogenesis in HEMs.
Methods:
HEMs were irradiated with fluences of 0, 5, 10 and 20J/cm(2) 585nm LED light. After 5-day treatment, cell viability was analyzed by CCK-8 assay, and apoptosis was assessed by Annexin V APC assay. Melanin content and tyrosinase activity were measured by spectrophotometer. Melanosome stage and autophagosomes were determined under transmission electron microscope (TEM). The formation of autophagic punctate structures was observed under confocal microscope. RT-PCR and western blotting were used to assess the expression of relative mRNA and protein levels.
Results:
Yellow light LED 585nm had no effects on HEMs cell viability and apoptosis. Treatment with LED 585nm from 5J/cm(2) to 20J/cm(2) inhibited melanosome maturation, decreased melanin content and tyrosinase activity. Inhibition was accompanied by the decreased expression of tyrosinase (TYR), tyrosinase-related protein-1 (TRP-1) and microphthalmia-associated transcription factor (MITF) on both mRNA and protein levels. Autophagosomes were observed under TEM. Autophagic punctate structures of microtubule-associated protein light chain 3 (LC3) proteins were induced by LED 585nm light. The configuration change of LC3 from LC3-I to LC3-II, and the degradation of p62 protein were observed after LED 585nm. Furthermore, we also revealed that the anti-melanogenic effect of LED 585nm photomodulation was reversed by 3-Methyladenine (3-MA), which inhibits autophagy by blocking autophagosome formation via the inhibition of type III Phosphatidylinositol 3-kinases (PI-3K).
Conclusions:
Our finding demonstrated that LED photomodulation with 585nm wavelength suppressed melanin content in HEMs, and the effect was caused by its dose-dependent inhibition on melanogenesis and the induction of HEMs autophagy. This may provide new insights into the efficacy of LED photomodulation in the treatment of hyperpigmentation disorders.
... Calderhead and colleagues reviewed 830 nm LED-LLLT both in stand-alone and in adjunctive indications and came to the same conclusion [56]. In a recent invited review for Clinics in Plastic Surgery, Calderhead and Vasily examined the efficacy of LED-LLLT in the aging face, and again pointed to the overall efficacy of the 830 nm wavelength [57]. Having said that, 633 nm has shown interesting results on induction of fibroplasia in fibroblasts in a human in vivo model, so cannot be discounted [32]. ...
Sunlight is essential to almost all forms of life for both light and heat. Plants need sunlight for photosynthesis, and man and animals alike need plants for many vital purposes. The sun featured many Millennia ago not only as a deity but also as a therapeutic source, so phototherapy is by no means a recent phenomenon. Niels Finsen's therapeutic arc lamp system in the early 1900s replaced the sun as a therapeutic source. Since then, many light sources have been successfully applied for phototherapy, with laser diodes and light-emitting diodes the most efficient. This chapter will explore what phototherapy is, and examine its important role in the fast-developing indication of skin rejuvenation. Systems used in phototherapy will be discussed and compared. Photobiological basics and light/ tissue interaction underlying the process will be examined, together with the importance of treatment parameters. The wound healing process, on which skin rejuvenation rests, will be dissected with a discussion of the optimum wavelengths to photoactivate the skin cells, leading to the clinical indications in photorejuvenation.
... As the provisional extracellular matrix deposition occurs around the 14th day after the RF treatment (22), it was hypothesized that the LLLT acts on the inflammatory and early proliferative phases of tissue repair. Recently, scientific community has aroused interest about photobiomodulation for skin (12,23), but there is still a lack of literature regarding the use of LLLT in aged human skin. ...
Objectives:
To evaluate the effects of Non-ablative Radiofrequency (RF) associated or not with Low-Level Laser Therapy (LLLT) on aspect of facial wrinkles among adult women.
Methods:
Forty-six participants were randomized into three groups: Control Group (CG, n=15); RF Group (RG, n=16), RF and LLLT Group (RLG, n=15). Every participant was evaluated on baseline (T0), after eight weeks (T8) and eight weeks after the completion of treatment (follow-up). They were photographed in order to classify nasolabial folds and periorbital wrinkles (Modified Fitzpatrick Wrinkle Scale and Fitzpatrick Wrinkle Classification System, respectively) and improvement on appearance (Global Aesthetic Improvement Scale). Photograph analyzes were performed by 3-blinded evaluators.
Results:
Nasolabial and periorbital wrinkles classification did not show any significant difference between groups. Aesthetic appearance indicated a significant improvement for nasolabial folds on the right side of face immediately after treatment (p=0.018) and follow-up (p=0.029) comparison. RG presented better results than CG on T8 (p=0.041, ES=-0.49) and on follow-up (p=0.041, ES=-0.49) and better than RLG on T8 (p=0.041, ES=-0.49). RLG presented better results than CG on follow up (p=0.007, ES=-0.37).
Conclusion:
Nasolabial folds and periorbital wrinkles did not change throughout the study; however, it was observed some aesthetic improvement. LLLT did not potentiate RF treatment.
A celulite possui uma etiologia multifatorial e causa alterações significativas na camada subcutânea, incluindo edema, lipodistrofia e desvio fibroso do tecido conjuntivo. Essas mudanças estão relacionadas a fatores hormonais e à presença de mediadores inflamatórios. Neste contexto, o infravermelho longo (IVL) tem apresentado efeitos benéficos sobre o metabolismo e função celular, aumentando a biodisponibilidade de óxido nítrico (NO) e Ca2+, melhorando a circulação sanguínea. Este estudo objetivou avaliar os efeitos do uso de uma calça confeccionada com tecido emissor de IVL em mulheres com celulite. Esta pesquisa foi submetida e aprovada por Comitê de Ética em Pesquisa. Foram selecionadas 16 mulheres, sedentárias, de 30 a 55 anos, com grau 1 a 4 de celulite. As participantes receberam duas calças confeccionada com tecido emissor de IVL, tecnologia INFUSION (BEAUTYTECH®, Guariba, SP, Brasil). O uso da calça foi por um período de 6 horas diárias (8:00 as 18:00h), 5 vezes na semana, durante um mês. Avaliações antes e após tratamento foram realizadas (fotografia, ultrassom e termografia). Os dados quantitativos foram tabulados para realização da análise estatística. As imagens foram analisadas qualitativamente. O uso de uma calça confeccionada com tecido emissor de infravermelho longo (IVL), nas condições experimentais apresentadas, demonstrou promover uma discreta redução do edema e uma significativa diminuição da temperatura superficial. Esses efeitos resultaram em uma melhoria qualitativa na aparência das alterações cutâneas, incluindo a textura da pele e a profundidade das depressões. Os resultados preliminares indicam que essa tecnologia pode ser uma estratégia terapêutica promissora no tratamento da celulite.
Drowsy driving is a common, but underestimated phenomenon in terms of associated risks as it often results in crashes causing fatalities and serious injuries. It is a challenging task to alert or reduce the driver’s drowsy state using non-invasive techniques. In this study, a drowsiness reduction strategy has been developed and analyzed using exposure to different light colors and recording the corresponding electrical and biological brain activities. 31 subjects were examined by dividing them into 2 classes, a control group, and a healthy group. Fourteen EEG and 42 fNIRS channels were used to gather neurological data from two brain regions (prefrontal and visual cortices). Experiments shining 3 different colored lights have been carried out on them at certain times when there is a high probability to get drowsy. The results of this study show that there is a significant increase in HbO of a sleep-deprived participant when he is exposed to blue light. Similarly, the beta band of EEG also showed an increased response. However, the study found that there is no considerable increase in HbO and beta band power in the case of red and green light exposures. In addition to that, values of other physiological signals acquired such as heart rate, eye blinking, and self-reported Karolinska Sleepiness Scale scores validated the findings predicted by the electrical and biological signals. The statistical significance of the signals achieved has been tested using repeated measures ANOVA and t-tests. Correlation scores were also calculated to find the association between the changes in the data signals with the corresponding changes in the alertness level.
In this report the use of eye cosmetic products and procedures and how this represents a lifestyle challenge that may exacerbate or promote the development of ocular surface and adnexal disease is discussed. Multiple aspects of eye cosmetics are addressed, including their history and market value, psychological and social impacts, possible problems associated with cosmetic ingredients, products, and procedures, and regulations for eye cosmetic use. In addition, a systematic review that critically appraises randomized controlled trial evidence concerning the ocular effects of eyelash growth products is included. The findings of this systematic review highlight the evidence gaps and indicate future directions for research to focus on ocular surface outcomes associated with eyelash growth products.
LEDs have a small semiconductor chip in the center that generates light when current flows [1] (Table 14.1). Thus, LEDs are light, not lasers. There are several advantages of LEDs. First, very little current is needed to produce light. Second, since LEDs are solid semiconductors, there is no need for flash lamps such as filaments or fluorescent lamps, i.e., there is no need for consumables. This is why signs and indoor lamps are changed to LEDs these days. Third, due to quasimonochromaticity (light with a wavelength range of several nanometers) LEDs have target specificity, like a laser. Fourth, hands-free operation is possible because the LEDs can be closely arranged in a large area so that the entire face can be irradiated at once. Fifth, the biggest advantage is the low price. Another advantage is that there are no pain and side effects, and it can be used at any age from infants to the elderly, which is not necessarily an advantage of LEDs, but the advantage of LLLT (low level light therapy, photomodulation).
Usually, only one wavelength comes out in one laser device, but lasers that can express multiple wavelengths in one laser device are being released recently. V-laser (WONTECH Co. Ltd. Daejeon, Korea) combines long-pulsed KTP laser (532 nm) and long-pulsed Nd:YAG laser (1064 nm) together to achieve 532 nm and 1064 nm wavelength in one laser device (Fig. 7.1). This chapter describes a long-pulsed Nd:YAG laser and will focus on 1064 nm wavelength.
One laser text classifies cosmetic procedures into four types according to the purpose of the procedure and describes them as “4 R’s” (Table 2.1) [2]. First, refill. These procedures fill in the gaps. Typical procedures include fillers and fat grafting. Second, relax. These procedures prevent thick wrinkles by relaxing the muscles or reduce the volume of the muscles by contracting them. For example, toxins are used to prevent wrinkles of the glabella, forehead, and crow’s feet. They also reduce the volume of the masseter muscles to make the face appear slimmer. Third, resurface. These procedures improve the skin. All the lasers and procedures described in this book fall under this category. Fourth, resuspend or lift. These procedures lift the sagging tissue that has lost its elasticity by pulling it.
We consider the effect of a tightly focused laser beam with a wavelength of 1064 nm and a power from 10 to 160 mW on red blood cells during their optical trapping with optical tweezers. It is found that the shape of a red blood cell, which alters after optical trapping, ceases to change when the trapping duration is less than 5 min and the laser beam power is less than 60 mW. At a beam power above 80 mW, the red blood cell begins to fold at a trapping duration of about 1 min, and at powers above 100-150 mW, the red blood cell membrane ruptures in 1-3 min after optical trapping. It is also found that with repeated short-term capture of a red blood cell in an optical trap, the deformation properties of the membrane change: it becomes more rigid. The obtained results are important both for understanding the mechanisms of interaction of a laser beam with red blood cells and for optimising the technique of optical experiments, especially for measuring the deformation properties of a membrane using optical tweezers.
A new biotechnology based on micro-needling (MND) with low-level light/laser therapy (LLLT) that is used for hair re-growth (HR-G) needs to be standardized. The study aims to report the clinical outcomes resulting from a multicentric, retrospective, observational, case-series study in which MND with LLLT was used on patients affected by androgenic alopecia (AGA). Twenty-six patients were initially enrolled of which 15 males were classified as stages I–III of vertex by the Norwood–Hamilton scale, and 11 females was classified in stages I–II by the Ludwig scale. Twenty patients (10 females and 10 males) were analyzed after their screening (the exclusion and inclusion criteria evaluation). The HR-G assessment was evaluated with photography, as well as the physician’s and patient’s global assessment scales, in addition to standardized phototrichograms, during a short follow-up at T0-baseline, T1-16 weeks. Encouraging results represented by a hair density increase of 12 ± 2 hairs/cm2 at T1 after 16 weeks (16 weeks vs. 0 weeks) in the targeted area, compared with the baseline results (59 ± 2 hairs/cm2 at T1 versus 47 ± 2 hairs/cm2 at baseline), were observed using computerized trichograms with a statistically significant difference in hair re-growth (p = 0.0238). The effectiveness of MND with LLLT use has been demonstrated in mild to moderate AGA patients.
Photo-biomodulation (PBM) also known as low-level laser therapy is a rising technology with multiple potential uses in medicine and recently in the cosmetic field for the treatment of skin conditions and skin rejuvenation. Due to its wound healing and anti-inflammatory properties, there is an increase in popularity in its use as adjunctive treatment before and after surgical procedures in the face and neck.
Purpose:
To analyze swept source optical coherence angiography (SS-OCTA) images acquired at different depths above and below the default location of the Zeiss PLEX Elite 9000.
Methods:
Normal eyes of subjects in their 20s and 30s were evaluated. Angiographic slab images were taken at the default location of 29-49 µm below the retinal pigment epithelium (RPE) as well as 21-41 µm through 52-72 µm below in steps. The images were processed using the projection removal function from the device´s software. Raw images were evaluated, as were images that underwent a published compensation technique that adjusts for light penetration to the sampled layer.
Results:
11 eyes of 11 subjects were evaluated for the uncompensated and the compensated sets with the projection removal function turned off and on. The default location, 29-49 µm below the RPE, showed a granular choriocapillaris appearance. This appearance remained in all slabs from each group, differing slightly throughout depth. The projection removal function modified the grayscale values and diminished projection from overlaying retinal vessels. The compensation technique altered the appearance of flow deficits and the changes induced by it were more evident on the images were the projection removal function was turned on.
Conclusion:
Flow images in SS-OCTA of the choriocapillaris from varying levels are similar in appearance, suggesting projection from the choriocapillaris is important in image formation, although layers of vessels in the inner choroid may contribute by various amounts. A model explaining the prominent projection artifacts observed in the choroid with SS-OCTA imaging is presented.
Skin rejuvenation is a treatment that targets age-related pigmentation disorders and telangiectasia or improves wrinkles and skin texture [1]. It can be classified by treatment methods; ablative rejuvenation (AR) by CO2 laser and erbium-doped yttrium aluminium garnet (Er:YAG) laser or nonablative rejuvenation (NAR), which induces a selective thermal reaction to the dermis and subcutaneous fat while sparing the epidermis. It can also be classified by treatment targets; type I rejuvenation targets pigmentation and vascular disorders while type II rejuvenation focuses on improving wrinkles and skin texture. For example, AR and NAR are both treatment modalities for type II rejuvenation (Table 9.1). Generally, NAR refers to rejuvenation treatment that uses nonablative methods to improve wrinkles and skin texture (type II rejuvenation).
Low level laser therapy (LLLT), including coherent and non-coherent light sources, also known as photobiomodulation, is a non-ablative treatment modality that alters cellular biochemical processes through its action on the mitochondria and by changing the cellular redox state. Treatment is delivered by exposing cells or tissue to light of low energy densities for a specific amount of time. This process has been reported to have beneficial therapeutic effects on a wide variety of conditions that benefit from alleviation of pain or inflammation, immunomodulation, and promotion of wound healing and tissue regeneration. LLLT’s use in dermatology is still considered experimental and investigational, hence it is currently used primarily as an adjunct therapy. Skepticisms mostly stem from ambiguities in its mechanism of action and the complexity of its dosimetry. For the same reasons, guidelines directing its use are not yet well established. Nonetheless, many recent studies have reported favorable outcomes achieved with LLLT in a number of indications (e.g. wound healing, hair growth, skin rejuvenation, fibrosis) with minimal adverse events.
Background: Sphingosine kinase 1 (SPHK1) and heat shock protein 27 (HSP27) are important for antioxidant and anti-inflammatory effects after red light irradiation in an inflammatory model. Objective: The purpose of the present study was to evaluate whether SPHK1 and HSP27 work independently or are dependent on some other regulator after 625 nm light-emitting diode irradiation in the human keratinocyte (HaCaT) cell line. Methods: Differentially expressed genes (DEGs) were identified between groups with or without 625 nm photobiomodulation (PBM) in the inflammatory model. Potential transcription factors (TFs) of key DEGs were predicted using the iRegulon plugin. The mechanism was investigated by analyzing mRNA and protein expression levels, prostaglandin E2 levels, and intracellular reactive oxygen species (ROS) in phorbol 12-myristate 13-acetate (PMA)-induced HaCaT cells after 625 nm PBM. Results: A total of 6 TFs (e.g., E2F1) and 51 key DEGs (e.g., SPHK1) were identified after 625 nm PBM in PMA-stimulated HaCaT cells. E2F1 worked as a regulator of SPHK1; however, it did not affect HSP27. E2F1 knockdown drastically decreased the SPHK1 expression level and increased the intracellular ROS, as well as the expression levels of inflammation-related proteins in PMA-induced HaCaT cells. In addition, the inhibition of HSP27 decreased the anti-inflammatory effect of 625 nm PBM. Conclusions:E2F1 worked as a TF of SPHK1 and exhibited anti-inflammatory and antioxidative effects through SPHK1 in PMA-induced HaCaT cells after 625 nm PBM. HSP27 is essential for the 625 nm PBM-induced anti-inflammatory function. Therefore, E2F1/SPHK1 and HSP27 could be used as potential biomarkers for anti-inflammatory therapy with 625 nm PBM.
Background: Laser is a device that emits light through a process of optical amplification based on the stimulated emission of electromagnetic radiation; it can be used for surgery, detoxification, bio stimulation and antibacterial. However, lasers have Biphasic Dose Response (BDR), which is bio stimulation and bio inhibition. To determine if 405 nm laser diode is biocompatible, viability test is necessary before these lasers can be labeled as viable to use in dental therapy. Aim: To prove the variation of radiation time of the 405 nm laser diode radiation can cause bio stimulation and bio inhibition response that affects the viability of BHK-21 fibroblast cells. Method: Viability test was carried out using BHK-21 fibroblast cells which were inserted into 96-well microplate, then radiated with 405 nm laser diode with varying irradiation time of 30s, 60s, 120s, 240s and 480s. After radiation, the cells are then incubated for 24h. Cytotoxicity was observed using MTT assay and ELISA reader. Data was analyzed using the Kolmogorov-Smirnov test, Levene Test, Welch ANOVA, and Tukey HSD. Results: BHK-21 fibroblast cells radiated with 405 nm laser diode with radiation time of 30s, 60s, 120s, and 240s have the same viability as the control cell, while at 480 seconds the viability exceeds that of the control cell. Conclusion: 405 nm laser diode with radiation times of 30s, 60s, 120s, and 240s do not affect the viability of BHK-21 fibroblast cells. Meanwhile, 480s irradiation time of 405 nm laser diode causes bio stimulation response that increases the viability of BHK-21 fibroblast cells.
Introduction
Mini-invasive therapies based on autologous non-activated Platelet-Rich Plasma (ANA-PRP), Low-Level Laser Therapy (LLL-T), and Micro-Needling Technique (MN-T) used in combining for hair re-growth need to be standardized.
Objectives
The work aims to show in vivo outcomes resulted from retrospective case-series study in which ANA-PRP + MN-T + LLL-T were used in combined in patients affected by Androgenic alopecia.
Methods
23 patients were treated, of which 13 males were classified in stage I - V by the Norwood–Hamilton scale, and 10 females were classified in stage I - III by the Ludwig scale. Assessment of hair re-growth was evaluated with photography, physician’s and patient’s global assessment scale, and standardized phototrichograms during a follow-up: T0 - baseline, T1 - 12 weeks, T2 - 23 weeks, T3 - 44 weeks, T4 - 58 weeks.
Results
Interesting outcomes represented by a hair density increase of 81 ± 5 hairs/cm² and 57 ± 7 hairs/cm² respectively at T1 and T2 compared with baseline (173 ± 5 hairs/cm² at T1 and 149 ± 9 hairs/cm² at T2 versus 92 ± 2 hairs/cm² at baseline) were observed using computerized trichograms.
Conclusions
The effect of the combined use of MN-T, LLL-T, and ANA-PRP has been demonstrated.
Background: Photodynamic therapy has now become popular, but its cytotoxic effect is still unclear. In order to be considered suitable for oral cavity therapy, the therapy must not be toxic or cause adverse effects on the target tissue. Viability testing for photodynamic therapy is important to do. Fibroblast cells are often used for testing the toxicity of dentistry because they are the most important cells in the components of the pulp, periodontal ligament, and gingiva. Purpose: To prove the effect of irradiation distance on photodynamic therapy on the viability of BHK-21 fibroblast cells. Method: Viability test was performed with BHK-21 fibroblast cells placed on a 96 well microplate which was then irradiated with 405 nm photodynamic therapy with varying irradiation distances of 1, 4, 7, 10, 13, and 16 mm. After irradiation, cell viability was tested by MTT assay and ELISA Reader. Data were analyzed using Kolmogorov-Smirnov, Levene’s test, Kruskall Wallis, and Tukey HSD. Result: Fibroblast cells with 4 mm irradiation distance have viability over control cells, whereas at irradiation distances 1, 7, 10, 13, and 16 mm have less viability than control cells. Conclusion: Photodynamic therapy 405 nm with 4 mm irradiation distance gives a biostimulation response so that the viability of BHK-21 fibroblast cells increases.
Phototherapy in its broadest sense means any kind of treatment (from the Greek therapeia ‘curing, healing,’ from therapeuein ‘to cure, treat.’) with any kind of light (from the Greek phos, photos ‘light’). The modern accepted definition of phototherapy, however, has become accepted as: “the use of low incident levels of light energy to achieve an athermal and atraumatic, but clinically useful, effect in tissue”. Under its basic original definition, phototherapy is an ancient art because the oldest light source in the world is the sun, and therapy with sunlight, or heliotherapy, has been in use for over 4000 years with the earliest recorded use being by the Ancient Egyptians (Giese, Living with our Sun’s ultraviolet rays, Springer, New York, 1976). They would treat what was probably vitiligo by rubbing the affected area with a crushed herb similar to parsley, then expose the treated area to sunlight. The photosensitizing properties of the parsley caused an intense photoreaction in the skin leading to a very nasty sunburn, which in turn hopefully led to the appearance of postinflammatory secondary hyperpigmentation, or ‘suntan’ thereby repigmenting the depigmented area. In their turn the Ancient Greeks and Romans used the healing power of the sun, and it was still being actively used in Europe in the eighteenth, nineteenth and early twentieth century, particularly red light therapy carried out with the patient placed in a room with red-tinted windows. One famous patient was King George III of Great Britain and Northern Ireland who ruled from 1760 to 1801, popularly though erroneously known as ‘Mad King George’. We now strongly suspect that he was actually suffering from the blood disease porphyria, so being shut in a room with red-draped walls and red tinted windows to treat his depression probably only served to make him even more mad, since porphyria is often associated with severe photosensitivity! Entities treated this way included the eruptive skin lesions of rubella and rubeola, and even ‘melancholia’, as was the case with King George III, now recognised as clinical depression. Hippocrates, the Father of Medicine, certainly concurred with the latter application some two millennia before King George: Hippocrates prescribed sunlight for depressive patients and believed that the Greeks were more naturally cheerier than their northern neighbors because of the greater exposure to the sun.
Background
Antimicrobial photodynamic therapy (APDT) has become a potential regimen to treat multidrug-resistant bacterial infections. Limited data showed indocyanine green (ICG), a safe and inexpensive contrast medium for eye angiography and hepatic function examination, is an effective photosensitizer in APDT to kill methicillin-resistant Staphylococcus aureus (MRSA) after excitation with laser.
Objective
We investigated the potentials of ICG-APDT with an inexpensive, non-coherent commercial near infrared (NIR) lamp against MRSA.
Methods
The inhibition of MRSA was studied after exposing bacteria to NIR with different light doses and concentrations of ICG. The selectivity on MRSA was examined on human fibroblasts. Bacterial virulence including the activities of coagulase and enterotoxin was investigated. The effects of singlet oxygen scavengers (tryptophan and ascorbic acid) and H2O2 on cell survival were evaluated. The morphology of bacteria after PDT was observed by transmission electron microscopy.
Results
ICG-PDT inhibited the growth of bacteria by 5 log (99.999% inhibition) with 200 J/cm² at 65.5 mW/cm² in the presence of 100 μg/mL ICG. Adding 0.1% H2O2 at a lower PDT dose (25 μg/mL ICG and 100 J/cm²) increased its efficacy by 5 log. This PDT dose was not toxic to human fibroblasts. PDT significantly reduced the level of bacterial virulence factors. The inhibition effects were decreased by tryptophan and ascorbic acid suggested singlet oxygen involved in the process. TEM showed severe non-selective cell destruction immediately after irradiation.
Conclusion
The study reveals ICG-PDT has the potential to treat MRSA by using a clinical accessible NIR lamp and photosensitizer.
Background:
Aggressive, or even minimally aggressive, aesthetic interventions are almost inevitably followed by such events as discomfort, erythema, edema and hematoma formation which could lengthen patient downtime and represent a major problem to the surgeon. Recently, low level light therapy with light-emitting diodes (LED-LLLT) at 830 nm has attracted attention in wound healing indications for its anti-inflammatory effects and control of erythema, edema and bruising.
Rationale:
The wavelength of 830 nm offers deep penetration into living biological tissue, including bone. A new-generation of 830 nm LEDs, based on those developed in the NASA Space Medicine Laboratory, has enabled the construction of planar array-based LED-LLLT systems with clinically useful irradiances. Irradiation with 830 nm energy has been shown in vitro and in vivo to increase the action potential of epidermal and dermal cells significantly. The response of the inflammatory stage cells is enhanced both in terms of function and trophic factor release, and fibroblasts demonstrate superior collagenesis and elastinogenesis.
Conclusions:
A growing body of clinical evidence is showing that applying 830 nm LED-LLLT as soon as possible post-procedure, both invasive and noninvasive, successfully hastens the resolution of sequelae associated with patient downtime in addition to significantly speeding up frank wound healing. This article reviews that evidence, and attempts to show that 830 nm LED-LLLT delivers swift resolution of postoperative sequelae, minimizes downtime and enhances patient satisfaction.
Low-level laser therapy (LLLT) continues to receive much attention in many clinical fields. Also, LLLT has been used to enhance the proliferation of various cell lines, including stem cells. This study investigated the effect of LLLT on human adipose-derived stem cells (ADSCs) through in vitro and in vivo studies.
Low-level laser irradiation of cultured ADSCs was performed using a 830 nm Ga-Al-As (gallium-aluminum-arsenide) laser. Then, proliferation of ADSCs was quantified by a cell counting kit-8. In the in vivo study, irradiated ADSCs or non-irradiated ADSCs were transplanted, and then, low-level laser irradiation of each rat was performed as per the protocol. Cell viability was quantified by immunofluorescent staining using the human mitochondria antibody.
In the in vitro study, the laser-irradiated groups showed an increase in absorbance compared to the control group. Also, in the in vivo study, there was a significant increase in the number of human ADSCs in the laser-irradiated groups compared to the control group (p < 0.001).
Our study showed that LLLT could enhance the proliferation and viability of ADSCs. The ADSCs enhanced by LLLT could be applied in various clinical fields. With the use of LLLT, the proliferation and viability of various cells can be enhanced, besides ADSCs.
This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .
This work is supported and managed through the NASA Marshall Space
Flight Center-SBIR Program. Studies on cells exposed to microgravity and
hypergravity indicate that human cells need gravity to stimulate cell
growth. As the gravitational force increases or decreases, the cell
function responds in a linear fashion. This poses significant health
risks for astronauts in long termspace flight. LED-technology developed
for NASA plant growth experiments in space shows promise for delivering
light deep into tissues of the body to promote wound healing and human
tissue growth. This LED-technology is also biologically optimal for
photodynamic therapy of cancer. .
Background:
Low level light therapy (LLLT) has attracted attention in many clinical fields with a new generation of light-emitting diodes (LEDs) which can irradiate large targets. To pain control, the first main application of LLLT, have been added LED-LLLT in the accelerated healing of wounds, both traumatic and iatrogenic, inflammatory acne and the patient-driven application of skin rejuvenation. Rationale and Applications: The rationale behind LED-LLLT is underpinned by the reported efficacy of LED-LLLT at a cellular and subcellular level, particularly for the 633 nm and 830 nm wavelengths, and evidence for this is presented. Improved blood flow and neovascularization are associated with 830 nm. A large variety of cytokines, chemokines and macromolecules can be induced by LED phototherapy. Among the clinical applications, non-healing wounds can be healed through restoring the collagenesis/collagenase imbalance in such examples, and 'normal' wounds heal faster and better. Pain, including postoperative pain, postoperative edema and many types of inflammation can be significantly reduced. Experimental and clinical evidence: Some personal examples of evidence are offered by the first author, including controlled animal models demonstrating the systemic effect of 830 nm LED-LLLT on wound healing and on induced inflammation. Human patients are presented to illustrate the efficacy of LED phototherapy on treatment-resistant inflammatory disorders.
Conclusions:
Provided an LED phototherapy system has the correct wavelength for the target cells, delivers an appropriate power density and an adequate energy density, then it will be at least partly, if not significantly, effective. The use of LED-LLLT as an adjunct to conventional surgical or nonsurgical indications is an even more exciting prospect. LED-LLLT is here to stay.
Low-level laser (light) therapy (LLLT) has been known since 1967 but still remains controversial due to incomplete understanding of the basic mechanisms and the selection of inappropriate dosimetric parameters that led to negative studies. The biphasic dose-response or Arndt-Schulz curve in LLLT has been shown both in vitro studies and in animal experiments. This review will provide an update to our previous (Huang et al. 2009) coverage of this topic. In vitro mediators of LLLT such as adenosine triphosphate (ATP) and mitochondrial membrane potential show biphasic patterns, while others such as mitochondrial reactive oxygen species show a triphasic dose-response with two distinct peaks. The Janus nature of reactive oxygen species (ROS) that may act as a beneficial signaling molecule at low concentrations and a harmful cytotoxic agent at high concentrations, may partly explain the observed responses in vivo. Transcranial LLLT for traumatic brain injury (TBI) in mice shows a distinct biphasic pattern with peaks in beneficial neurological effects observed when the number of treatments is varied, and when the energy density of an individual treatment is varied. Further understanding of the extent to which biphasic dose responses apply in LLLT will be necessary to optimize clinical treatments.
Femoral vein (FV) catheterization is required for critically ill patients, patients with difficult peripheral intravenous access, and patients undergoing major surgery. The purpose of this study was to evaluate the effects of hip abduction with external rotation (frog-leg position), and the frog-leg position during the reverse Trendelenburg position on diameter, cross-sectional area (CSA), exposed width and ratio of the FV using ultrasound investigation.
Ultrasonographic FV images of 50 adult subjects were obtained: 1) in the neutral position (N position); 2) in the frog-leg position (F position); 3) in the F position during the reverse Trendelenburg position (FRT position). Diameter, CSA, and exposed width of the FV were measured. Exposed ratio of the FV was calculated.
The F and FRT positions increased diameter, CSA and exposed width of the FV significantly compared with the N position. However, the F and FRT positions had no significant effect on exposed ratio of the FV compared with the N position. The FRT position was more effective than the F position in increasing FV size.
The F and FRT positions can be used to increase FV size during catheterization. These positions may increase success rate and reduce complication rate and, therefore, can be useful for patients with difficult central venous access or at high-risk of catheter-related complication.
Those who pioneered the use of surgical lasers as a therapeutic modality were the first to report that patients undergoing laser surgery experienced less post-surgical pain and inflammation as compared with the traditional cold scalpel. Moreover, these early adopters of surgical lasers reported that wound healing was not compromised after laser surgery. This was finally found to be due to the “L” of LASER, namely light, because in addition to the surgical effect of the incident light energy, a series of other effects with descending photothermal activity occurred simultaneously as the photon intensity propagating through the tissue decreased, finally arriving at the phototherapeutic zone (Mester et al. Acta Chir Acad Sci Hung 9:349–57, 1968). Thus, incident light energy was suggested as a potential link between lasers and wound healing.
Background:
Abnormal wound-healing after thyroidectomy with a resulting scar is a common dermatologic consultation. Despite many medical and surgical approaches, prevention of postoperative scars is challenging.
Objective:
This study validated the efficacy and safety of low-level light therapy (LLLT) using an 830/590 nm light-emitting diode (LED)-based device for prevention of thyroidectomy scars.
Methods and materials:
Thirty-five patients with linear surgical suture lines after thyroidectomy were treated with 830/590 nm LED-LLLT. Daily application of 60 J/cm (11 minutes) for 1 week starting on postoperative day 1 was followed by treatment 3 times per week for 3 additional weeks. The control group (n = 15) remained untreated. Scar-prevention effects were evaluated 1 and 3 months after thyroidectomy with colorimetric evaluation using a tristimulus-color analyzer. The Vancouver Scar Scale (VSS) score, global assessment, and a subjective satisfaction score (range: 1-4) were also determined.
Results:
Lightness (L*) and chrome values (a*) decreased significantly at the 3-month follow-up visit in the treatment group compared with those of controls. The average VSS and GAS scores were lower in the treatment group, whereas the subjective score was not significantly different.
Conclusion:
Light-emitting diode based LLLT treatment suppressed the formation of scars after thyroidectomy and could be safely used without noticeable adverse effects.
Low reactive-level laser therapy (LLLT) has been reported as having a beneficial effect in the therapy of rheumatoid arthritis. Some concerns have been expressed about the possible photothermal damage to articular tissue, for example the synovial membrane, following extended doses of LLLT such as are usually applied. The present study was designed to assess qualitatively and quantitatively the possible photothermal damage to articular membranous tissue foltowing an extended exposure (30 min) of infrared laser radiation on the rat synovial membrane, both through the capsule and with the capsule dissected away to aliow direct exposure. A third group of unirradiated anima]s acted as the control. The laser was a gallium aluminium arsenide (GaAlAs) diode laser system, delivering 60 mW, to a total spot size from three diodes of approximately 0.3 cm2, power density ≅ 0.2 W/cm2, incident energy 108 J, energy density 360 J/cm2. Evaluation of any photoinduced thermal damage was made both macroscopically and with blinded microscopic histological assessment. No damage was macroscopically visible, and no difference was found in the histology of the control, indirectly and directly-irradiated synovial membrane specimens. The authors conclude that, at the wavelength and delivery parameters given, even with extended dosage, laser therapy has no adverse photothermal effects on encapsulated or exposed synovial membrane in vivo.
In the last decade the applications of the laser in surgery and medicine have increased dramatically. With the increase of indications has come a concomitant increase in possible classification of laser reactions. The author presents a classification which is based on the laser/tissue reaction rather than on the hardware used to produce the laser beam. Laser/tissue reactions fall into two broad groups. When the tissue reaction to absorption of the incident laser energy results in photodestruction of, or an irreversible photomodulated change to the tissue architecture, then the level of reaction is higher than the survival threshold of the target cells. The author refers to this as high reactive-level laser treatment (HLLT), or more generally as laser surgery. On the other hand, the level of tissue reactivity to very low incident power and energy densities is well below the cells’ survival threshold so that instead of being damaged the cells are directly activated by the low incident photon density. In this case the changes in the irradiated tissue are photoactivative and reversible: the author refers to this group of reactions as low reactive-level laser therapy (LLLT), or more generally as laser therapy. Both of these groups can be classed under the general heading of laser treatment (LT). LT is further subdivided into three main types: mono-type LT (Mo-LT, single laser treatment; multi-type LT (Mu-LT, multi-laser treatment); and concomitant LT (Cc-LT), in which any of the above LT types can be used in combination with conventional treatment methods. Mo-LT in turn contains pure LT (Pu-LT) single laser, single reaction; and auto-simultaneous LT (ASi-LT), single laser with a range of reaction types, each of which has its own abbreviation. Mu-LT contains two main sub-types, combined LT (Cb-LT) and compound LT (Cp-LT). Cb-LT concerns the same disease whereas Cp-LT is used to describe 2 or more diseases treated with the same or different lasers. Both Cb-LT and Cp-LT are further subclassified into the homogeneous and xenogeneous types, referring to the use of the same or different types of laser, respectively. If the lasers are applied at the same time, that is homo- or xeno-simultaneous laser treatment (HoSi-LT, XeSi-LT), and if at different times the term is homo- or xeno-succesive laser treatment (HoSu-LT, XeSu-LT). The various sub-sets of Mono-type and Multi-type laser treatment are further expanded, to give an accurate, treatment-based categorization of laser treatment. In addition to the above classification, the author has devised a graphical representation of laser surgical and therapeutic beams whereby the laser type, parameters, penetration depth, and tissue reaction can all be shown in a single illustration, which the author has termed the ‘Laser Apple’, due to the typical pattern generated when a laser beam is incident on tissue. Apple types fall into two main subdivisions, destructive or D-Apples (HLLT) which include the C-Apple (carbonization), V-Apple (vaporization) and so on, and the activative or A-Apple type (LLLT). When the above classification is combined and illustrated with the appropriate laser apple type or types, the author feels this offers an accurate and simple method of classifying laser/tissue reactions by the reaction, rather than by the laser used to produce the reaction.
LED therapy accelerates healing post-resurfacing. Laser ablative resurfacing is still the most effective method for the rejuvenation of severely photoaged and photodamaged facial skin, but the long-healing time coupled with other troublesome sequelae mean a long patient downtime. Phototherapy with light-emitting diodes (LEDs) has recently been attracting attention in accelerating wound healing. The current study was designed to assess the beneficial effects of LED phototherapy on wound healing and postoperative sequelae following laser ablative resurfacing. The study had both a prospective and retrospective arm. The prospective study population consisted of 28 female patients who underwent ablative Er:YAG/CO2 laser resurfacing (four full face, eight periocular, 16 perioral), followed by hemifacial LED therapy with 830nm followed by 633nm LED panels, 20min/session (55 and 98J/cm2, respectively. The contralateral side of the face was covered with an opaque material to prevent exposure to the LED energy. A similar number of age- and treatment-matched patients previously treated in the same way, but without LED therapy, formed the retrospective arm. Tissue healing time and postoperative sequelae were compared for the treated and untreated sides in the prospective group and for the untreated retrospective group. The healing time in the LED-treated side was around 50% faster and sequelae significantly less compared with the untreated side, but interestingly these factors were slightly better in the untreated side compared with the retrospective untreated controls. At a 6-month follow-up in the prospective group, no significant difference in wrinkle improvement was seen between the treated and untreated side, but the skin appeared younger-looking on the LED-treated compared with the untreated side. Combined LED therapy significantly improved healing time and treatment sequelae in laser ablative resurfaced photoaged facial skin. It appears that this combined LED therapy approach may also help to sustain the good results through a maintenance therapy program.
Formation of the American Society for Photobiology for meeting the needs
of investigators studying the effects of light on man and other organisms is
described. The scientific program of the first meeting of the society included
discussions of the followiug topics: detrimental effects of excessive exposure to
sunlight and artificial uv radiation; repair of uv-induced damage to cells; the
roles of light in the human environnnent; photochemistry in photobiology; effects
of near uv light; photosynthesis; bioluminescence; light perception without eyes;
chronobiology; the ultraviolet world of insects; vision; and solar energy
conversion. (HLW)
Cytochrome c oxidase is discussed as a possible photoacceptor when cells are irradiated with monochromatic red to near-IR radiation. Four primary action mechanisms are reviewed: changes in the redox properties of the respiratory chain components following photoexcitation of their electronic states, generation of singlet oxygen, localized transient heating of absorbing chromophores, and increased superoxide anion production with subsequent increase in concentration of the product of its dismutation, H2O2. A cascade of reactions connected with alteration in cellular homeostasis parameters (pHi, [Cai], cAMP, Eh, [ATP] and some others) is considered as a photosignal transduction and amplification chain in a cell (secondary mechanisms).
The purpose of this study was to assess the effects of hyperbaric oxygen (HBO) and near-infrared light therapy on wound healing.
Light-emitting diodes (LED), originally developed for NASA plant growth experiments in space show promise for delivering light deep into tissues of the body to promote wound healing and human tissue growth. In this paper, we review and present our new data of LED treatment on cells grown in culture, on ischemic and diabetic wounds in rat models, and on acute and chronic wounds in humans.
In vitro and in vivo (animal and human) studies utilized a variety of LED wavelength, power intensity, and energy density parameters to begin to identify conditions for each biological tissue that are optimal for biostimulation. Results: LED produced in vitro increases of cell growth of 140-200% in mouse-derived fibroblasts, rat-derived osteoblasts, and rat-derived skeletal muscle cells, and increases in growth of 155-171% of normal human epithelial cells. Wound size decreased up to 36% in conjunction with HBO in ischemic rat models. LED produced improvement of greater than 40% in musculoskeletal training injuries in Navy SEAL team members, and decreased wound healing time in crew members aboard a U.S. Naval submarine. LED produced a 47% reduction in pain of children suffering from oral mucositis.
We believe that the use of NASA LED for light therapy alone, and in conjunction with hyperbaric oxygen, will greatly enhance the natural wound healing process, and more quickly return the patient to a preinjury/illness level of activity. This work is supported and managed through the NASA Marshall Space Flight Center-SBIR Program.
Light-emitting diodes (LEDs) are considered to be effective in skin rejuvenation. We investigated the clinical efficacy of LED phototherapy for skin rejuvenation through the comparison with three different treatment parameters and a control, and also examined the LED-induced histological, ultrastructural, and biochemical changes. Seventy-six patients with facial wrinkles were treated with quasimonochromatic LED devices on the right half of their faces. All subjects were randomly divided into four groups treated with either 830nm alone, 633nm alone, a combination of 830 and 633nm, or a sham treatment light, twice a week for four weeks. Serial photography, profilometry, and objective measurements of the skin elasticity and melanin were performed during the treatment period with a three-month follow-up period. The subject's and investigator's assessments were double-blinded. Skin specimens were evaluated for the histologic and ultrastructural changes, alteration in the status of matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs), and the changes in the mRNA levels of IL-1ss, TNF-alpha, ICAM-1, IL-6 and connexin 43 (Cx43), by utilizing specific stains, TEM, immunohistochemistry, and real-time RT-PCR, respectively. In the results, objectively measured data showed significant reductions of wrinkles (maximum: 36%) and increases of skin elasticity (maximum: 19%) compared to baseline on the treated face in the three treatment groups. Histologically, a marked increase in the amount of collagen and elastic fibers in all treatment groups was observed. Ultrastructural examination demonstrated highly activated fibroblasts, surrounded by abundant elastic and collagen fibers. Immunohistochemistry showed an increase of TIMP-1 and 2. RT-PCR results showed the mRNA levels of IL-1ss, TNF-alpha, ICAM-1, and Cx43 increased after LED phototherapy whereas that of IL-6 decreased. This therapy was well-tolerated by all patients with no adverse effects. We concluded that 830 and 633nm LED phototherapy is an effective approach for skin rejuvenation.
Low level laser therapy: a practical introduction
- T Ohshiro
- R G Calderhead
Ohshiro T, Calderhead RG. Low level laser therapy:
a practical introduction. Chichester (United
Kingdom): John Wiley and Sons, Limited; 1988.
Low reactive-level laser therapy: practical application
- T Ohshiro
Ohshiro T. Low reactive-level laser therapy: practical
application. Chichester (United Kingdom): John Wiley and Sons, Ltd; 1991.
Effect of NASA light-emitting diode (LED) irradiation on wound healing
- Ht Whelan
- Rl Smits
- Jr
- Ev Buchman
Whelan HT, Smits RL Jr, Buchman EV, et al. Effect of
NASA light-emitting diode (LED) irradiation on wound
healing. J Clin Laser Med Surg 2001;19:305-14.
Ten lectures on basic science of laser phototherapy. Grä ngesberg (Sweden): Prima Books AB
- T I Karu
Karu TI. Identifying the photoreceptors. In: Karu TI,
editor. Ten lectures on basic science of laser phototherapy. Grä ngesberg (Sweden): Prima Books AB;
2007. p. 115-42.
Lasers and lights in wound healing
- R G Calderhead
- Bcl Goo
Calderhead RG, Goo BCL. Lasers and lights in
wound healing. In: Nouri K, editor. Handbook of lasers in dermatology. New York: Springer Medical;
2014. p. 329-59.