A study to determine the efficacy of combination LED light therapy (633 nm and 830 nm) in facial skin rejuvenation

Background. The use of visible or near infrared spectral light alone for the purpose of skin rejuvenation has been previously reported. A method of light emitting diode (LED) photo rejuvenation incorporating a combination of these wavelengths and thus compounding their distinct stimulation of cellular components is proposed.

Objective. To assess the efficacy and local tolerability of combination light therapy in photo rejuvenation of facial skin.

Methods. Thirty‐one subjects with facial rhytids received nine light therapy treatments using the Omnilux^TM LED system. The treatments combined wavelengths of 633 nm and 830 nm with fluences of 126 J/cm² and 66 J/cm² respectively. Improvements to the skin surface were evaluated at weeks 9 and 12 by profilometry performed on periorbital casts. Additional outcome measures included assessments of clinical photography and patient satisfaction scores.

Results. Key profilometry results Sq, Sa, Sp and St showed significant differences at week 12 follow‐up; 52% of subjects showed a 25%–50% improvement in photoaging scores by week 12; 81% of subjects reported a significant improvement in periorbital wrinkles on completion of follow‐up.

Conclusion. Omnilux^TM combination red and near infrared LED therapy represents an effective and acceptable method of photo rejuvenation. Further study to optimize the parameters of treatment is required.     

A study to determine the effect of combination blue (415 nm) and near-infrared (830 nm) light-emitting diode (LED) therapy for moderate acne vulgaris

Background and objective: Acne vulgaris remains a major problem in dermatological practice. Phototherapy for acne with blue (415 nm) and red (633 nm) light-emitting diode (LED) arrays has recently attracted attention. This pilot study assessed the efficacy of the combination of 415 nm and near-infrared (IR) LED therapy for moderate acne. Methods: Seventeen individuals were recruited: 13 females and four males. Skin types ranged from type II to type VI, and the acne grades at baseline ranged from Burton grade 1 to 5. Patients underwent twice-weekly 20-minute sessions of LED therapy for 4 weeks, alternating between the blue (415 nm) and near-IR (830 nm) heads. No other treatment was allowed. Results were assessed and compared with the baseline values at 1, 4 and 8 weeks post-treatment. Results: Six individuals failed to complete the study. Eleven individuals showed improvement ranging from 0% to 83.3%. A downward shift in the Burton grade was seen overall. Non-inflammatory lesion counts increased in four patients, but improved in the other seven by an average of 48.8%. No adverse effects were reported. Conclusions: The combination therapy for acne produced results which were less effective in the reduction of inflammatory lesions than those achieved with the previously reported blue/red combination. Further study with a much larger patient population is warranted.     

Combination blue (415 nm) and red (633 nm) LED phototherapy in the treatment of mild to severe acne vulgaris.

BACKGROUND AND OBJECTIVE: Acne vulgaris represents both a challenge to the treating dermatologist and a major concern for the patient. Conventional treatments have proved inconsistent with often unacceptable side effects and high rates of recurrence. Non-thermal, non-laser, phototherapy for acne with a combination of blue and red light has recently attracted attention. The present study was designed to assess the efficacy of this combination phototherapy. METHODS: Twenty-four subjects, Fitzpatrick skin types II-V, with mild to severe symmetric facial acne vulgaris were recruited for the study. Subjects were well matched at baseline in terms of both age and duration of acne. Subjects were treated over eight sessions, two per week 3 days apart, alternating between 415 nm blue light (20 minutes/session, 48 J/cm2) and 633 nm red light (20 minutes/session, 96 J/cm2) from a light-emitting diode (LED)-based therapy system. Patients received a mild microdermabrasion before each session. Acne was assessed at baseline and at weeks 2, 4, 8 and 12. RESULTS: Twenty-two patients completed the trial. A mean reduction in lesion count was observed at all follow-up points. At the 4-week follow-up, the mean lesion count reduction was significant at 46% (p=0.001). At the 12-week follow-up, the mean lesion count reduction was also significant at 81% (p=0.001). Patient and dermatologist assessments were similar. Severe acne showed a marginally better response than mild acne. Side effects were minimal and transitory. Comedones did not respond as well as inflammatory lesions. CONCLUSIONS: Combination blue and red LED therapy appears to have excellent potential in the treatment of mild to severe acne. Treatment appears to be both pain- and side effect-free.     

Defocused diode laser therapy (830 nm) in the treatment of unresponsive skin ulcers: a preliminary trial.

BACKGROUND: Skin ulcers with compromised healing remain a major problem for plastic and dermatological surgeons. Low incident levels of laser energy have been shown to increase the blood flow rate and volume and to accelerate the wound healing process, thus raising the possibility in augmenting treatment for skin ulcers. METHODS: Preliminary controlled experiments with a 830 nm GaAlAs diode laser in axial pattern flap survival in the rat model showed statistically significant improvement in survival for the irradiated versus unirradiated control animals. In the present study, a newly developed defocused GaAlAs diode laser (830 nm, continuous wave, 669 mW/cm(2)) was applied once or twice per week in an uncontrolled study of five patients (aged between 5 and 81 years old, average 46.6 years old, doses from 6.3 J/cm(2) to 21 J/cm(2)) with previously unresponsive ulcers of various aetiologies. RESULTS: In all five patients, the ulcers healed completely between 3 weeks and 7 months (22.8 +/- 19.3 weeks), without recurrence during a minimum 12-month follow-up. CONCLUSIONS: Defocused 830 nm diode laser therapy was well tolerated, and was very effective in the treatment of this small number of compromised skin ulcers of different aetiologies and in a large range of patient ages. Further controlled studies in larger populations are required. Defocused diode laser therapy nonetheless appears to be a very useful adjunctive method in the treatment of slow-to-heal and non-healing skin ulcers.     

A retrospective study on the clinical efficacy of the intense pulsed light source for photodamage and skin rejuvenation

Objective: The objective of this retrospective review is to investigate the long-term effect of skin rejuvenation by the intense pulsed light (IPL) source for the treatment of photoaging. Methods: From 5300 clinical cases that our department has treated with the IPL, the first 2534 were chosen for this study. Each patient received a minimum of 3 IPL treatments during this time—many were yearly treatments. Clinical photographs were taken on a yearly basis for up to 12 years and sent to a blinded independent panel to study the effects of continuous IPL treatments. Results: Results showed that the effective rate for the IPL was between 88.24% and 96.45%. Conclusions: IPL therapy is an effective treatment for photoaging and can truly have an effect on reversing the signs of photodamage on skin.     

Fractional carbon dioxide laser for facial rejuvenation: A prospective study to evaluate the efficacy and the safety

Background: The aim of this study was to evaluate the efficacy and safety of the fractional ablative carbon dioxide laser for facial rejuvenation. Materials and Methods: Twenty-nine female who have the complaint of facial aging were recruited for the study. Participants received a maximum of three laser treatment sessions with one-month intervals and were scored using a 5-point scale on seven categories for facial aging before and after the treatment by the physicians. Self-assessments by participants were done at the last month of follow-up period and 3 years after the last session. Results: Mean facial aging score before the treatment was 11,24 ± 4,30 and after the treatment was 10,51 ± 3,86 (p = 0.003). The decrease in the score was mild in 18 (62,1%) participants, whereas it was moderate in only 1 (3,4%) participant. None of the participants had significant or perfect improvement. When the seven categories were analyzed seperately, the only statistically significant alteration in the score was found in the skin tone category (p = 0.0001). Conclusion: Results show that rejuvenation with the fractional ablative carbon dioxide laser decreases mildly the symptoms of facial aging in more than half of the patients.     

5%米诺地尔酊联合670nm+830nm激光治疗雄激素性脱发的疗效评价

目的：评价670nm+830nm激光联合5%米诺地尔酊对雄激素性秃发的疗效。方法：将60例雄激素性秃发患者随机分为治疗组与对照组：对照组单纯外用5%米诺地尔酊治疗,治疗组在对照组基础上加用670nm+830nm激光照射治疗,每周治疗2次,30分钟/次,6个月后进行疗效评定。结果：实际完成治疗及观察人数58例（实验组2例失访),治疗组总有效率为85.7％,对照组为53.3％,差异显著（χ2=10.02 ,P<0.01）,两组不良反应发生率无显著差异(χ2=0 ,P>0.05）。结论：670nm+830nm激光联合5%米诺地尔酊治疗雄激素性秃发安全、有效,可推广应用。     

Histological evidence for skin rejuvenation using a combination of pneumatic energy,broadband light,and growth factor therapy

Abstract

Background and objective: A variety of laser or light-based devices have been developed for skin rejuvenation. This study evaluates the efficacy (at the microscopic level) of a combination of pneumatic energy, broadband light, and profusion tip-delivered epidermal growth factor (EGF). Methods: Healthy adult Japanese volunteers were recruited for this study. The posterior parts of the left and right arms were treated with a device that combines pneumatic energy and broadband light (Isolaz device). The left arms were also treated with EGF through a tip. Each subject received four treatments at 10-day intervals. Biopsy specimens obtained 3 weeks after the second treatment and 3 weeks after the fourth treatment were examined for histological study. Results: After two treatments, elastin fibers and fibroblasts in the dermal papillary layers of the left arms were increased compared to the right arms. A mean of 173.9 cells positive for proliferating cell nuclear antibody (PCNA) were observed on the left arm compared to 101.0 on the right arm. After the fourth treatment, angiogenesis and increased collagen fibers were observed in the dermal papillary layers of both arms. Conclusion: Four treatments with the addition of the profusion tip appear to hasten new collagen and elastin fiber formation, and the increase of PCNA positive cells so that dermal remodeling begins at an earlier stage than with the Isolaz alone.     

The development of a filter to enhance the efficacy and safety of excimer light (308 nm) therapy

Background: Excimer light (308 nm) therapy is a new ultraviolet (UV) B phototherapy for which the efficacy and resulting DNA damage are not well established.
Purpose: To develop an effective and safe phototherapy using the excimer lamp, we studied the effects of different light cut-off filters, A and B.
Methods: Efficacy was evaluated by measuring apoptosis using fluorescence-activated cell sorting analysis. DNA damage was evaluated by measuring cyclobutane pyrimidine dimers (CPDs). Light sources, including normal wave and short wave (SW) excimer light, broad-band (BB) UVB, and narrow-band (NB) UVB, were examined using the filters. A human skin equivalent model was also examined.
Results: The ratio of positive apoptosis to CPD formation normalized to the mean induced by NB-UVB was 5.7 using the excimer lamp without a filter, 6.3 using the excimer lamp with the A filter, 6.4 using the SW excimer lamp without a filter, and 4.2 using the BB-UVB. The A filter reduced CPD formation induced by the normal wave and SW excimer lamp. In the human skin equivalent model, the use of filters significantly decreased the amount of CPD-positive cells.
Conclusions: These findings suggest that using the A filter with the excimer lamp increases the efficacy and safety of excimer light therapy.     

A prospective study of safety and efficacy of combination therapy with bipolar radiofrequency-based intense pulsed light,infrared light,and diode laser in Chinese subjects with photoaged skin

Objective: To further evaluate the safety and effectiveness of bipolar RF-based optical therapy combining intense pulsed light (IPL), infrared light, and diode laser in the treatment of photoaged skin in Chinese subjects. Methods: Twenty-seven subjects received five treatments at 3-week intervals. Triple therapy was applied in one session to the face. Images and data were obtained 30 and 180 days after the last treatment. Objective measurements (including photometric analysis of skin pigmentation, texture and wrinkles, ultrasonic measurement of dermal thickness and dermal echo intensity, and public and self-assessment of apparent age), clinical assessment, and safety were evaluated. Results: Objective measurements of pigmentation, texture, wrinkles, and dermal echo intensity improved significantly, regardless of age. Self-assessment of apparent age at 30 and 180 days was reduced by an average of 2.7 and 2.2 years, respectively, and public assessment of apparent age was reduced by an average of 3.14 years and 2.95 years, respectively. Global scores for photoaging were improved in all patients. Adverse events were generally transient and mild. Conclusion: Sequential combination treatment reported here could significantly reduce skin pigmentation, texture and wrinkles, improve dermal intensity, and reduce the self and publicly perceived age. This therapy is safe and well tolerated.     

The use of lasers and light sources in skin rejuvenation

Smooth, wrinkle-free skin is associated with supposed attractiveness, youthfulness, and health, while rhytids have a negative impact on one’s perceived appearance, image, and self-esteem. Noninvasive esthetic procedures such as laser or light therapy have been used to achieve and attain a more youthful appearance. Currently, there is a wide range of lasers and devices available for the regeneration and healing of skin. Lasers and light sources for skin rejuvenation involve the removal of aged skin tissue via thermal heat from high-powered lasers, stimulating the surrounding tissues to recover through natural wound-healing processes. In contrast, photobiomodulation, which makes use of low energy lasers or light emitting diodes, uses no heat and has shown positive effects in the reduction of wrinkles and improving skin laxity.     

Combined fractional resurfacing (10600 nm/1540 nm): Tridimensional imaging evaluation of a new device for skin rejuvenation

In this study were described the results, by tridimensional imaging evaluation, of the new “Combined Fractional Resurfacing” technique with the first fractional laser that overtakes the limits of traditional ablative, nonablative fractional resurfacing by combining CO₂ ablative and GaAs nonablative lasers. These two wavelengths can work separately or in a mixed modality to give the best treatment choice to all the patients. In this study, it is demonstrated that the simultaneous combination of the CO₂ wavelength (10600 nm) and GaAs wavelength (1540 nm) reduced the downtime, reduced pain during the treatment, and produced better results on fine wrinkles reduction and almost the same results on pigmentation as seen with 3D analysis by Antera (Miravex).     

Calcipotriol vs. tazarotene as combination therapy with narrowband ultraviolet B (311 nm): efficacy in patients with severe psoriasis

BACKGROUND: Phototherapy has been shown to be one of the most effective treatment modalities for patients with psoriasis. Nevertheless, photocombination therapies capable both of reducing cumulative ultraviolet (UV) doses and of accelerating clearance of skin lesions are important and of high interest. There have been no published studies comparing the effect of narrowband UVB irradiation in combination with topical application of tazarotene vs. calcipotriol. OBJECTIVES: To determine, in a half-side manner, whether a combination of UVB (311 nm) and tazarotene is superior to UVB (311 nm) plus calcipotriol or vice versa. METHODS: Ten patients suffering from widespread symmetrical psoriasis were treated for at least 4 weeks with topical calcipotriol and tazarotene in a half-side distribution. Additionally, the whole body was irradiated with narrowband UVB (311 nm) four times a week. Before treatment and once weekly during therapy a modified Psoriasis Area and Severity Index was estimated for each body half. The total treatment time, number of treatment sessions and cumulative UVB dose necessary for clearance of skin lesions were determined in an observer-blind fashion for each patient. Furthermore, all patients completed a quality of life questionnaire. RESULTS: Clearance of psoriasis was observed after a median of 19 treatment sessions (range 14-28) and a median cumulative UVB dose of 22.98 J cm-2 (range 9.24-58.22) simultaneously for both body halves. On the side treated with topical tazarotene gel, four patients complained of itching and dryness of the skin, and skin irritation was observed in three of them. Six patients preferred the application of tazarotene gel, while four preferred calcipotriol. CONCLUSIONS: Our clinical comparison of narrowband UVB with either topical calcipotriol or topical tazarotene revealed no significant therapeutic difference between both regimens. Although these results need to be confirmed in larger patient groups, we feel that both photocombination therapies can broaden the therapeutic options for moderate to severe psoriasis vulgaris and may reduce the cumulative UVB dose during therapy.     

Effect of a new infrared light device (1100-1800 nm) on facial lifting.

Laser skin resurfacing procedures can be classed into two categories - invasive and non-invasive. The last several decades have witnessed a host of advancements in ablative laser therapy and other ablative modalities for the rejuvenation of skin, including the CO(2) laser, the erbium : yttrium aluminum garnet laser, chemical peels, and dermabrasion. Despite the excellent results that can result from the practice of these techniques by experienced surgeons, the invasive nature of these devices is associated with inherent risks and patient discomfort. Therefore, much of the focus has been on non-ablative lasers and intense-pulsed light devices. We evaluated the efficacy and safety of treatment with the new infrared light device (1100-1800 nm), Titan, and assessed the degree of improvement associated with two-time laser treatments, as compared to one-time laser treatment.     

A prospective randomized comparative study on 60 Indian patients of melasma,comparing pixel Q-switched NdYAG (1064 nm), super skin rejuvenation (540 nm) and ablative pixel erbium YAG (2940 nm) lasers,with a review of the literature

Background: Treating melasma is a challenge due to suboptimal efficacy and recurrence encountered with most modalities. There is inadequate literature regarding the use of lasers for melasma in Indian skin. We compared three modalities SSR (Super Skin Rejuvenation 540 nm), PQSNDY (pixel Q-switched Nd: YAG 1064 nm), and ablative pixel-Er: YAG (2940 nm) laser in melasma, amongst Indian patients.

Materials/Methods: Sixty patients of recalcitrant melasma were enrolled and randomized into three groups with 20 patients each. These were treated with SSR, low fluence PQSNDY, and pixel-Er: YAG, respectively, for five sessions at 3-week intervals. Results were evaluated using Modified melasma area severity index (mMASI) by blinded comparison of digital photographs at baseline, each visit and 6 months (i.e. 2 months after the last session).

Results: All groups showed a highly significant reduction in the mMASI score (p < .001). Pixel-Er: YAG maximally reduced mMASI and homogeneity (p < .001), while the other groups showed a more uniform fading. Epidermal melasma had best results with SSR and PQSNDY (p < .001), while recalcitrant cases of dermal and mixed melasma with pixel-Er: YAG laser (p < .001). There was no persistent or rebound pigmentation observed.

Conclusions: All three modalities are effective and safe for melasma in Indian patients. Fractional technology, low fluences, adequate recovery time between sessions and a sound maintenance plan ensure efficacy and safety.