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LIGHT-EMITTING DIODE (LED): COMBINED 633 NM AND 830 NM LED TREATMENT OF FACIAL PHOTOAGING

During 2007, Lee et al of Korea , have demonstrated that LED is effective for non-ablative facial skin rejuvenation. David Goldberg from the United States , and working independently, published data on facial photo rejuvenation in Annals of Drugs in Dermatology 2006. (See www.encyclopedia.com ). Their group studied the efficacy of and ultra structural changes in photo-aged skins after combined 633 nm and 830 nm LED treatment (Omnilux TM ). Results from that study showed:

  1. Statistical and objective improvement in wrinkles was detectable and the skin was rendered soft, smooth and firm in a high proportion of cases.
  2. Skin biopsies and EM showed deposition of collagen fibres. This confirmed the finding of post-LED treatment dermal thickening by collagen.
  3. LED can be used either as a primary or adjunctive treatment modality for facial rejuvenation, and can ameliorate wrinkles.
  4. They used the Glogau scale to select patients and gauge aging.
  5. Fitzpatrick skin grading was also used to select clients for the trial.
  6. The Omnilux Revive (TM) and Omnilux Plus (TM) were used. The one delivers noncoherent but quasimonochromatic red light at a wavelength of 633 nm and an intensity of 105 mW/cm 2 for a total of 126 J/cm 2 after 20 minutes of exposure. The other light-head delivers noncoherent light at a wavelength of 830 nm and 55 mW/cm 2 intensity for a total dose of 66 J/cm 2 after 20 minutes exposure. Skin furrowing as determined by profilometry was significantly reduced. Photoaging assessment scores after treatment also improved. Most patients reported softening of periorbital wrinkles. All reported improved skin softness, smoothness and firmness. Very few minor side effects were recorded and no down-time. LED has a far safer treatment profile than ablative methodologies for skin rejuvenation such as aggressive chemical peels and laser resurfacing.

According to the work of Goldberg and co-researchers, LED therapy involves the absorption of a specific wavelength of light by a photo-acceptor molecule. Irradiation of the photo-acceptor generates production of cytotoxic singlet oxygen. A cascade of cellular responses is thus initiated, resulting in modulation of cell function, cell proliferation and repair of compromised cells (Karu et al 1987; Karu et al 1989). The process of cell function enhancement is called photobiomodulation . Radiation of fibroblasts with 633 nm wavelength light increases procollagen synthesis fourfold from baseline. Irradiation with this red light increases fibroblastic growth factor synthesis from photoactivated macrophages and accelerated mast cell degranulation (Glogau et al 1996).

Other studies have indicated that LED 630 to 700 nm penetrates tissue to a depth of about 10 mm (see www.elixa.com ). This proves useful for the wound healing of cuts, scars, trigger and acupuncture points, and low grade soft tissue infections.

Other eminent workers in the field include Glen Calderhead of Japan who has a great understanding of the mechanism of photobiomodulation, and published widely in the field.

Non-ablative skin rejuvenation is divided into thermal (photo-thermal reaction i.e. controlled thermal damage to invoke a wound healing process) and photobiomodulation (i.e. LED stimulates cell activities and cell proliferation). The key components of photobiomodulation include:

  • Fibroblast proliferation.
  • Synthesis of collagen and procollagen.
  • Growth factor production (i.e. TGF, PDGF).
  • Macrophage and lymphocyte stimulation.
  • Extra cellular matrix production.
  • Improvement of microcirculation.

TREATMENT OF FACIAL PHOTOAGING WITH LED THERAPY:

  • LED is better for prevention than curing of late face solar changes.
  • LED is a good adjunct to microdermabrasion, peels, IPL and lasers.
  • A younger skin responds better to LED photobiomodulation.
  • Narrow band 830 nm and 633 nm are effective for non-ablative skin rejuvenation.

WAVELENGTH-SPECIFIC ACTIONS OF LIGHT ON TARGETED CELLS

 

Mast

Leukocyte

Macrophage

Fibroblast

Myofibroblast

633

++

+

++

+++

+

830

+++

+++

+++

+

+++

INFLAMMATORY CASCADE: WOUND HEALING CONCEPTS

  • In the inflammatory phase, 830 nm is effective on monocytes, mast cells and macrophages.
  • In the proliferation phase, 633 nm is functional.
  • In the remodeling phase, 830 nm stimulates fibrocytes, endotheliocytes, fibroblasts and myofibroblasts.

METABOLIC AND BIOCHEMICAL EFFECTS: MOLECULAR COMPONENTS AFTER LED TREATMENT: SEE LEE (et al 2007).

  • ADP
  • ATP
  • Ca ++
  • NAD
  • NAD + and H +
  • Na + K + ATPase
  • TIMP-1
  • IL-6
  • TNF-a
  • ICam-L
  • Connexion-43
  • Reduced IL-6

EFFECTS OF LED ON THE FACIAL SKIN: OUTCOMES:

  1. Reduced melasma and chloasma.
  2. Improved skin texture and tone if combined with Neostrata glycolic acid peel.
  3. Lightening of cavernous haemangioma (but not cure).
  4. Reduced facial pigmentation.
  5. Reduction of moderate wrinkles, horizontal and vertical crepe lines of the face and décolleté.
  6. Can be combined with Botox in young persons: athermal process
  7. Histology: Biopsy studies demonstrate increased deposition of collagen and elastin (MT stains, von Giesson and Alcian blue stains).
  8. EM: showed fibroblast proliferation and release of collagen.
  9. There is thus clinical and histological evidence to confirm improvement of the aged skin after LED phototherapy. The rejuvenation of the skin after LED phototherapy is safe and predictable. The rejuvenation of the skin is based on the following hypothesis:
  • Activation of fibroblasts.
  • Induction of TIMP-1 and 2
  • Inhibition of MMP activities on new collagen.
  • Increase in the mRNA levels of IL-1 , TNF- a and Connexion 43.
  • Wound healing by activation of (IL-1 and TNF- a).
  • Propagation of cellular responses through GJIC.

CLINICAL APPLICATION OF LED IN THE CLINIC: WOUND HEALING

  1. Wound healing (reduction of wound scars, mammoreduction, blepharoplasty, sutured wounds).
  2. Aesthetic: skin rejuvenation.
  3. Acne (use alternating blue and red LED irradiation).
  4. Indolent sole ulcers (diabetic and non-diabetic).
  5. Sacral sores (indolent).
  6. Treatment of cellulite (see Sasaki et al, J Cosm Laser Ther , 2007: 9:87-96).

BOLANDCELL ACADEMIC REFERENCES: OCTOBER 2007

  1. Lee et al : A prospective, randomized, placebo-controlled, double blinded and split-face clinical study on LED phototherapy for skin rejuvenation. J Photochem and Photobiology, 88 ( 2007), 51-67.
  2. Goldberg DJ. New collagen formation after dermal remodeling with an intense pulsed light source. J Cutan Laser Ther, (2) ( 2000): 59-61.
  3. Calderhead RG et al: Phototherapy unveiled.. Laser Therapy 2005; 14;87-95

OMNILUX (LED) DEVICE FOR WOUND HEALING AND REJUVENATION Go to top of page

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