A prospective, randomized, placebo-controlled, double-blinded, and split-face clinical study on LED phototherapy for skin rejuvenation: clinical, profilometric, histologic, ultrastructural, and biochemical evaluations and comparison of three different treatment settings

Organic light-emitting diode therapy promotes longevity through the upregulation of SIRT1 in senescence-accelerated mouse prone 8 mice

Phototherapy has been extensively used to prevent and treat signs of aging and stimulate wound healing, and phototherapy through light-emitting diodes (LEDs). In contrast to LED, organic LED (OLED) devices are composed of organic semiconductors that possess novel characteristics. We investigated the regenerative potential of OLED for restoring cellular potential from senescence and thus delaying animal aging. Bone marrow-derived stem cells (BMSCs) and adipose-derived stem cells (ADSCs) were isolated from the control and OLED- treated groups to evaluate their proliferation, migration, and differentiation potentials. Cellular senescence was evaluated using a senescence-associated β-galactosidase (SA-β-gal) activity assay and gene expression biomarker assessment. OLED treatment significantly increased the cell proliferation, colony formation, and migration abilities of stem cells. SA-β-gal activity was significantly decreased in both ADSCs and BMSCs in the OLED-treated group. Gene expression biomarkers from treated mice indicated a significant upregulation of IGF-1 (insulin growthfactor-1). The upregulation of the SIRT1 gene inhibited the p16 and p19 genes then to downregulate the p53 expressions for regeneration of stem cells in the OLED-treated group. Our findings indicated that the survival rates of 10-month aging senescence-accelerated mouse prone 8 mice were prolonged and that their gross appearance improved markedly after OLED treatment. Histological analysis of skin and brain tissue also indicated significantly greater collagen fibers density, which prevents ocular abnormalities and β-amyloid accumulation. Lordokyphosis and bone characteristics were observed to resemble those of younger mice after OLED treatment. In conclusion, OLED therapy reduced the signs of aging and enhanced stem-cell senescence recovery and then could be used for tissue regeneration.

Neuromuscular electrical stimulation for facial wrinkles and sagging: The 8-week prospective, split-face, controlled trial in Asians

OBJECTIVE

This study aims to fill the knowledge gap regarding the effects of high frequency facial neuromuscular electrical stimulation (fNMES) on facial aging, using a device equipped with CERTEC (Cell Energy Regeneration Technology) operating between 40 and 190 kHz.

METHODS

This prospective split-face study was conducted at Tokyo University Hospital between March and May 2023 with 24 healthy adult women aged 30-59. The intervention group used the fNMES device along with basic skin care on one side of the face, and basic skin care alone on the other side for 8 weeks. Evaluations included changes in skin wrinkles, sagging, and blood flow.

RESULTS

This study found significant improvements in skin elasticity and degree of wrinkles in the areas intervened with fNMES (p < 0.05, respectively). In addition, the intervention resulted in significant improvements in jawline angle (p < 0.01), submental volume (p < 0.05), cheek volume (p < 0.05), maximum nasolabial fold depth (p = 0.03), and total volume of the nasolabial folds (p = 0.03). The fNMES intervention also showed improvement in blood flow (p < 0.05). These improvements were also subjectively assessed by the participants in subject questionnaires at 8 weeks after the intervention (p < 0.05).

CONCLUSION

This study suggests that high frequency fNMES effectively improves facial skin elasticity, reduces wrinkles and sagging, promotes blood flow, and contributes to overall facial appearance rejuvenation. Although further studies are needed, high frequency fNMES appeared promising as a noninvasive anti-aging therapy.

Combining red photobiomodulation therapy with polydioxanone threads for wrinkle reduction in the glabella region: A randomized, controlled, double-blind clinical trial

The combination of polydioxanone (PDO) threads with other technologies has garnered significant interest for rejuvenation purposes. Photobiomodulation (PBM) has the potential to improve patient comfort and recovery after minimally invasive rejuvenation protocols and also contribute to the overall efficacy of these procedures, fostering an integrative approach to cutaneous rejuvenation. The objective os this work was to investigate concurrent application of PDO threads and red LED PBM on glabellar static wrinkles, in a parallel randomized sham-controlled trial. Forty individuals with Glogau aging classification levels 3 and 4, static glabellar wrinkles, and no significant comorbidities received PDO threads applied along glabellar line. Effective PBM group received 1.35 J and 630 nm red LED light punctually along threads, twice weekly for nine sessions over 30 days. The outcome measures were swelling assessment, dermal thickness and PDO thread degradation via linear ultrasound. No swelling was detected 24 h post-PDO thread application, hindering PBM effect assessment. PDO threads induced dermal thickening; no added effect with PBM. No significant difference in thread hydrolysis between groups, though some ultrasound records inconclusive on thread presence. The absence of swelling may stem from various factors, including the timing of post-procedure swelling assessment, operator proficiency in thread application, and procedural characteristics. No evidence supports the notion that PBM augments dermal thickening, however other light parameters should be studied. Insufficient data to demonstrate PBM's effectiveness in controlling post-procedure swelling. Combination of PBM with PDO thread application doesn't enhance dermal thickening, nor accelerate thread degradation at the parameters used here.

An Analysis of Dermatology-Related Red-Light Therapy Patient Questions on Reddit

BACKGROUND

Reddit is one of the world's most popular social media platforms and is increasingly used as a health information resource for patients on topics such as red-light (RL) therapy.

OBJECTIVE

In this article, the authors present an analysis of prevalent patient questions and concerns regarding RL therapy.

METHODS

All posts on the "Hot" page of the r/redlighttherapy subreddit were analyzed and categorized.

RESULTS

A total of 930 questions from 664 posts were analyzed. The most commonly asked question category was related to product recommendations or feedback (29.7%), followed by usage instructions (15.3%), safety and side effects (12.6%), and indications and efficacy (12.3%).

CONCLUSION

Understanding patient concerns and questions about RL, as expressed on online platforms like Reddit, can help clinicians improve patient satisfaction, education, and clinical outcomes. The study offers an innovative approach by using social media to uncover valuable patient insights that might not be easily observable within clinical settings.

Histological In Vivo Evaluation of Intense Pulsed Light Technology: Assessing the Safety on Oral Soft and Hard Tissues

Intense pulsed light (IPL) is used for aesthetic and therapeutic purposes. According to recent literature, utilizing IPL may boost upregulation of anti-inflammatory cytokines, and downregulation of pro-inflammatory cytokines. Concerns have been raised about potential thermal damage to the soft and hard tissues in the oral cavity. Therefore, the aim of this study was to determine the safety of using IPL of various intensities in the tissues of the oral cavity.

METHODS

Three adult pigs were included in the trial. The oral cavity was divided into four quadrants and projected with a wide range of IPL settings. Alveolar bone, buccal mucosa, and gingival tissue samples were taken immediately and after 24 h. In each animal, one quadrant of the jaw was left untreated and served as a control. All samples were processed and stained with H&E.

RESULTS

Clinical examination showed no evidence of changes in the integrity of the examined tissues. Histological examination of the different tissues did not demonstrate significant thermal damage or changes in the characterization of the cells compared to the control tissues.

CONCLUSIONS

The use of IPL in the oral cavity is safe and does not negatively affect the tissues.

Intense pulsed light therapy for ocular surface diseases

Intense pulsed light (IPL) is a non-laser, high-intensity light source that has been shown to play a valuable role in dermatology and has been adopted in ophthalmology for treating meibomian gland dysfunction (MGD). In this review, we discuss the mechanism of action of IPL, including its benefits in ophthalmology. IPL therapy has been shown to improve tear film stability, meibomian gland (MG) function, and subjective symptoms of ocular dryness in MGD patients. Moreover, emerging evidence suggests that IPL therapy is beneficial for other ocular surface diseases, such as blepharitis and chalazia. Hence, it can be inferred that IPL has potential as a therapeutic modality in future applications. Large clinical and experimental trials are needed to exploit the full potential of IPL as a treatment for recurrent chalazia, Sjögren's syndrome, and other causes of dry eye disease (DED). This paper reviews the published literature related to the application of IPL for treating ocular surface diseases.

Unlocking the Power of Light on the Skin: A Comprehensive Review on Photobiomodulation

Photobiomodulation (PBM) is a procedure that uses light to modulate cellular functions and biological processes. Over the past decades, PBM has gained considerable attention for its potential in various medical applications due to its non-invasive nature and minimal side effects. We conducted a narrative review including articles about photobiomodulation, LED light therapy or low-level laser therapy and their applications on dermatology published over the last 6 years, encompassing research studies, clinical trials, and technological developments. This review highlights the mechanisms of action underlying PBM, including the interaction with cellular chromophores and the activation of intracellular signaling pathways. The evidence from clinical trials and experimental studies to evaluate the efficacy of PBM in clinical practice is summarized with a special emphasis on dermatology. Furthermore, advancements in PBM technology, such as novel light sources and treatment protocols, are discussed in the context of optimizing therapeutic outcomes and improving patient care. This narrative review underscores the promising role of PBM as a non-invasive therapeutic approach with broad clinical applicability. Despite the need for further research to develop standard protocols, PBM holds great potential for addressing a wide range of medical conditions and enhancing patient outcomes in modern healthcare practice.

The effect of combined red, blue, and near-infrared light-emitting diode (LED) photobiomodulation therapy on speed of wound healing after superficial ablative fractional resurfacing

Objective of the study is to assess the effects of wound healing with a commercially available light emitting diode (LED) photo biomodulation (PBM) device that emits three wavelengths (465, 640 and 880nm) after ablative fractional laser (AFL) treatment to healthy skin on the bilateral inner biceps. We conducted a prospective intraindividual randomized controlled study with 25 volunteers. AFL treatment was performed on healthy skin of the bilateral inner biceps. Subjects applied the LED light device for 30 min to the assigned bicep 3 times a week over 4 weeks, beginning on day 0. Subjects were followed up on days 2, 4, 6, 9, 13, 20 and 27 for treatment with the PBM device, clinical digital photography of the test and control sites, and in-person subject assessment, with follow ups on days 34 and 55 for clinical photography and assessment. Three blinded evaluators were asked to determine which bicep healed faster between day 0 to day 13. Pain, discomfort, and itch were also assessed. The three blinded evaluators chose the treatment arm as the faster healed arm in greater than 50% of the images, although the results were not statistically significant. There was no statistically significant difference between test and control arms in terms of pain, discomfort and itch. In conclusion, PBM therapy has the potential to improve wound healing. In this study, a three wavelength PBM device resulted in some subjects achieving faster healing after AFL but the results were not statistically significant.

The effects of infrared radiation on the human skin

BACKGROUND

Infrared radiation (IR) is the portion of the electromagnetic spectrum between visible light (VL) and microwaves, with wavelengths between 700 nm and 1 mm. Humans are mainly exposed to ultraviolet (UV) radiation (UVR) and IR through the sun. Unlike UVR which is well known for its carcinogenic properties, the relationship between IR and skin health has not been as extensively studied; as such, we gather the available published evidence here to better elucidate this relationship.

METHODS

Several databases including Pubmed, Google Scholar, and Embase were searched for articles relating to infrared radiation and the skin. Articles were selected for their relevance and novelty.

RESULTS

Detrimental effects such as thermal burns, photocarcinogenesis, and photoaging have been reported, though evidence suggests that these may be due to the thermal effects produced secondary to IR exposure rather than the isolated effect of IR. There are currently no chemical or physical filters specifically available for protection against IR, and existing compounds are not known to have IR-filtering capacity. Interestingly, IR may have some photoprotective properties against the carcinogenic effects of UVR. Furthermore, IR has been used with encouraging results in skin rejuvenation, wound healing, and hair restoration when given at an appropriate therapeutic dose.

CONCLUSION

A better understanding of the current landscape of research surrounding IR can help illuminate its effects on the skin and highlight areas for further research. Here, we review relevant data on IR to assess its deleterious and beneficial effects on human skin, along with possible means for IR photoprotection.

Development and Application of Prototype System Based on Light-Emitting Diode Arrays (660 nm) with a Top Hat Beam Profile in Order to Optimize Photobiomodulation Protocols for Treatment of Radiation-Induced Oral Mucositis in Rats

Background: Oral mucositis (OM) is a common adverse effect of radiation to the head and neck. Recent research has shown that extra oral photobiomodulation (EO-PBM) reduces the severity of OM. However, appropriate EO-PBM therapy parameters for OM severity reduction have not been documented. Objective: This work aims to optimize EO-PBM radiation parameters for lowering the severity of radiation-induced OM in rats by establishing a photobiomodulation (PBM) treatment system based on light-emitting diode arrays with top-hat beam profile. Methods: The 36 rats are separated into 2 control groups and 4 groups receiving PBM treatment. The PBM groups are exposed to irradiance between 4 and 24 J/cm2 at 660 nm. The cheek pouch mucosa is removed after scarification for biochemical and histological examination. Student's t-test, and one-way analysis of variance (ANOVA) followed by Tukey's Multiple were applied to compare the statistical significance of differences between control groups and PBM treatment groups. Results: Statistical analysis reveals that PBM irradiation at 12 J/cm2 (200 sec) with a flatness of 0.8 and a diameter of 3 cm substantially decreased the level of inflammatory cytokines compared with the positive control group. Conclusions: Our results indicate that the designed treatment PBM system is capable of delivering the optical parameters necessary for therapeutic treatment.

Cutaneous interaction with visible light: What do we know?

Visible light has been used therapeutically in dermatology for years for a variety of cosmetic and medical indications, including skin rejuvenation and the treatment of inflammatory and neoplastic conditions, among others. Until recently, visible light was thought to be relatively inert compared to its spectral neighbors, ultraviolet and infrared radiation. However, recent literature has described the ability of visible light to cause erythema in light skin and pigmentary changes in individuals with darker skin types. Concern surrounding its potentially damaging cutaneous effects has been raised in both the medical community and social media outlets. In this article, we provide an evidenced-based review describing what is currently known about visible light, focusing on its role in dermatologic diseases including disorders of hyperpigmentation such as melasma and postinflammatory hyperpigmentation.

Novel treatment of chalazion using light-guided-tip intense pulsed light

We assessed the effectiveness of light-guided-tip intense pulsed light (IPL) with meibomian gland expression (MGX) in chalazion treatment. Ninety-five eyes with chalazion received a light-guided-tip IPL-MGX treatment (IPL-MGX group), and another 95 eyes with chalazion received incision with curettage treatment (Control group). Prior to IPL or incision, as well as 1 month after the final treatment, data were gathered pertaining to the lesion location and size, hyperemia, lesions regression or recurrence, and a comprehensive ophthalmic examination. The total size of the chalazia in the IPL-MGX group was significantly reduced after the final treatment, with an average resolution rate of 70.5%, which is comparable to excision surgery. A significant decrease in chalazion recurrence rate was apparent after treatment in the IPL-MGX group compared with control. Moreover, the IPL-MGX demonstrated significant advancements throughout noninvasive tear film breakup time (NIBUT) as well as meibum grade in comparison to baseline and those in the the Control group. The use of IPL-MGX was found to be an efficient therapy for reducing the size and recurring frequency of chalazia, as well as for improving the meibomian gland function. It may be considered as a first-line treatment for cases of primary or recurrent chalazia with inflammation.

Reverse skin aging signs by red light photobiomodulation

BACKGROUND

Photobiomodulation is a process by which the absorption of red light energy produces a series of physiological effects at the cellular level such as the enhancement of mitochondrial Adenosine Triphosphate (ATP) production, cell signaling and growth factor synthesis, and the reduction of oxidative stress. Light emitting diodes (LEDs) photobiomodulation is an increasingly popular therapy for treating skin problems, especially for reversing the signs of skin aging.

OBJECTIVE

The objective of this study is to demonstrate the effectiveness of a photobiomodulation treatment using red LEDs on the facial skin at a rate of two sessions per week for 3 months. The LED mask used is the Skin Light Dior x Lucibel mask diffusing a cold red light with a wavelength of 630 ± 10 nm and a power of 15.6 J/cm2 for a duration of 12 min.

METHOD

In order to demonstrate the effectiveness of the mask in reversing the signs of skin aging, a clinical study was conducted on 20 healthy Caucasian women: the antiwrinkle effect by measuring the depth of the crow's feet wrinkle, the relaxation of the oval of the face by clinical scoring, the firmness and elasticity of the skin by cutometric measurement, the density of the dermis by ultrasound analysis, the smoothness of the skin by measuring the roughness at the cheek, the homogeneity of the complexion by chromametric measurement, the diameter of the pores by macrophotographs and finally the sebo-regulating effect by measurement of the rate of sebum and quantification of the number of pores containing porphyrin in the subjects presenting a mixed to oily skin. The satisfaction of the volunteers was also evaluated at the end of the study via a self-questionnaire.

RESULTS

The efficacy results measured after 1, 2, and 3 months of use are progressive and confirm the interest of LED photobiomodulation to reverse the visible signs of skin aging. All the volunteers observed an overall improvement in skin quality.

CONCLUSION

All the results observed confirm the interest of using photobiomodulation to reverse the visible signs of aging. These results last for up to 1 month after stopping the use of the mask, which is a sign of lasting structural and functional rejuvenation of the skin.

The safety and effectiveness of low-level light therapy (LLLT) with light-emitting diode (LED) bed system and a novel topical anti-cellulite gel on grades 1-2 thigh/buttock cellulite: a randomized, comparative-controlled split-thigh/buttock IRB study

BACKGROUND

Cellulite of the upper lateral and posterior thighs and lower buttocks represents a common unwanted condition.

OBJECTIVES

The author sought to comparea LLLT-LED bed therapy and a novel topical anti-cellulite gel on one thigh/buttock cellulite vs light therapy for cellulite to the opposite side.

METHODS

Eight healthy female subjects were randomly treated with a LLLT-LED bed twice weekly for 20 minutes in prone/supine positions with twice daily application of a novel anti-cellulite gel to one randomized thigh/buttock.

RESULTS

At the end of the 3-month trial, skin elasticity increased after combined therapy on one thigh but decreased with only LLLT-LED bed treatments on the opposite thigh. Thighs treated with active gel and LLLT-LED bed, were downgraded to a lower cellulite grade, while monotherapy did not demonstrate any change from their baseline cellulite grading. Changes in thigh circumference did not correlate with either treatments regimens.Subject and investigator questionnaire evaluations at month-3 were assessed as "satisfactory" results. There were no adverse reactions to treatments.

CONCLUSIONS

The use of LLLT-LED bed therapy and an anti-cellulite gel demonstrated an efficient alternative in the treatment of cellulite-involved thighs/buttocks over similarly affected thighs/buttocks that were treated only with LLLT-LED bed therapy.

Comparison of the effects of 2 frequencies of application of photobiomodulation on facial rejuvenation: Controlled, randomized, and double-blind clinical trial

INTRODUCTION

Skin aging is an irreversible, slow and progressive process, mainly influenced by age, but also by external factors such as ultraviolet radiation, smoking, and alcohol, among others. It is increasingly common to look for procedures that slow down skin aging by limiting or hiding its effects on appearance. Studies have shown the benefits of photobiomodulation (PBM) for the skin, especially with the use of red light-emitting diodes. However, there is a high level of variability in the treatment parameters and frequency of application.

METHODS AND ANALYSIS

The objective of this study is to compare the effects of PBM with a light-emitting diode mask (660 nm, 6.4 mW/ cm², 8,02 J/ cm², 5.02 mW, 21 minutes) on facial rejuvenation using 2 frequency applications for 4 weeks: one group will receive PBM application on the face, twice a week and another group will receive PBM application 3 times a week. A group with simulated PBM applied twice a week for 4 weeks will be used as a control. The treatment will be performed on female participants aged between 45 and 60 years. After 4 weeks, evaluations of photographic images by specialists (Wrinkle Assessment Scale) as well as the quantitative analysis of the wrinkle size by the Image J software, the depth and width of wrinkles (assessment of face impressions by optical coherence tomography) and the level of Satisfaction with Facial Appearance Overall will be compared with data collected before the start of the study. All data will be analyzed statistically according to their distribution, seeking a level of statistical significance of 0.05.

ETHICS AND DISSEMINATION

This protocol was approved by the Research Ethics Committee of the Nove de Julho University (acceptance number: 4.365.565). This trial has been registered in ClinicalTrials.gov (ID: NCT04911140). This study is recruiting.

Photobiomodulation Reduces Periocular Wrinkle Volume by 30%: A Randomized Controlled Trial

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.

Blue light irradiation exerts anti-viral and anti-inflammatory properties against herpes simplex virus type 1 infection

The aim of this study was to investigate the antiviral and anti-inflammatory functions of blue light (BL) in cutaneous viral infections. Previously, we examined the photo-biogoverning role of 450 nm BL in SARS-CoV-2-infected cells, which showed that photo-energy could inhibit viral activation depending on the number of photons. However, the communication network between photo-energy irradiation and immune cells involved in viral infections has not been clarified. We verified viral activation, inflammatory responses, and relevant downstream cascades caused by human simplex virus type I (HSV-1) after BL irradiation. To examine the antiviral effect of BL, we further tested whether BL could disturb viral absorption or entry into host cells. The results showed that BL irradiation, but not green light (GL) exposure, specifically decreased plaque-forming activity and viral copy numbers in HSV-1-infected cells. Accumulated BL irradiation inhibited the localization of viral proteins and the RNA expression of characteristic viral genes such as UL19, UL27, and US6, thus exerting to an anti-viral effect. The results also showed that BL exposure during viral absorption interfered with viral entry or destroyed the virus, as assessed by plaque formation and quantitative PCR assays. The levels of the pro-inflammatory mediators interleukin (IL)-18 and IL-1β in M1-polarized macrophages were increased by HSV-1 infection. However, these increases were attenuated by BL irradiation. Importantly, BL irradiation decreased cGAS and STING expression, as well as downstream NF-κB p65, in M1-polarized HSV-1-infected macrophages, demonstrating anti-viral and anti-inflammatory properties. These findings suggest that BL could serve as an anti-viral and anti-inflammatory therapeutic candidate to treat HSV-1 infections.

Feasibility and Safety of Using Combined Light-Emitting Diodes Versus Intense Pulsed Light Technology for the Improvement of Facial Hypervascularization in Adult Patients

Background: Superficial facial vascular lesions can be an aesthetic problem and a symptom of different skin diseases. Objective: It was to compare the efficacy and safety profiles of Dermalux^® Tri-Wave MD, based on three combined light-emitting diodes (LEDs) technology and intense pulsed light (IPL) for reducing the excess of facial vascularization due to superficial cutaneous vascular lesions. Materials and methods: The study had a single-center, proof-of-concept, open-label, and prospective design. Two groups of adult patients were treated for facial hypervascularization, LED-Group with an LED device combining 633 and 830 nm and IPL-Group with an IPL (555-950 and 530-750 nm). Variables assessed were hemoglobin hyperconcentration (HH), hemoglobin-affected area (HAA) through Antera 3D^®, and pain using the Numeric Pain Rating Scale. Results: Twenty subjects were included, 10 by group (50% female). LED-Group: Mean age 32.1 years (range, 21-46). IPL-Group: Mean age 34.5 years (range, 25-49). HH: LED-Group 100% had a moderate improvement; in the IPL-Group, 10% was moderate, and 90% was marked. HAA: LED-Group 10% had a slight improvement, 70% moderate, and 20% marked; in the IPL-Group, 100%, the improvement was marked. Seventy percent of LED-Group patients reported no pain, 30% mild; in the IPL-Group, 100% of patients reported severe pain. Conclusions: Treatment with combined red and near-infrared LEDs effectively reduced the excess of facial vascularization with moderate outcomes compared with IPL, but without secondary effects and no pain. This treatment could represent an effective, safe, and well-tolerated approach for facial vascular lesions.

Evaluating the Effect of Low Power Diode Laser 806 nm on the Healing of Unilateral Cleft Lip Scar: An Open-Label Comparative Study

OBJECTIVE

To investigate the effect of laser bio-modulation irradiation therapy on the scar after surgical correction of unilateral cleft lip.

DESIGN

a comparative, open-label study.

SETTING

we conducted the study in a university based tertiary hospital that recruited early wound healers of unilateral cleft lip correction.

PATIENTS

Eighty patients were divided into two groups: In study's group, patients undergo laser bio-modulation irradiation (n = 60); in the control group, patients were followed-up without intervention (n = 20).

INTERVENTION

In the study's group, patients underwent low-power diode Laser with wavelength of 806 nm and power of 100 mw.

MAIN OUTCOME

The change in the scar of cleft lip patients, which was assessed by clinical examination and ultrasound.

RESULTS

The median pigmentation score was significantly lower in the laser group (median = 1; IQR = 1-2) than the control group (median 2; IQR 1-3), with p-value of <0.001. Likewise, the median height score was significantly lower in the laser group (median = 1; IQR = 1-1) than the control group (median 1.5; IQR 1.5-2), with p-value of 0.001. The median pliability score was significantly lower in the laser group (median = 1; IQR = 1-1) than the control group (median 2.5; IQR 1-3), with p-value of <0.001. Finally, the median vascularity score was significantly lower in the laser group (median = 1; IQR = 1-1) than the control group (median 1.5; IQR 1-2), with p-value of <0.001.

CONCLUSION

laser bio-modulation irradiation therapy demonstrates a potential efficacy in managing the hypertrophic scars after surgical repair of unilateral cleft lip.

Cutaneous Photorejuvenation of Light Emitting Diodes via the Melatonin Membrane Receptor Pathway

BACKGROUND

Melatonin receptors are present in the human skin and retina. These receptors can be stimulated by light emitting diodes (LEDs) at specific wavelengths, thereby inducing cutaneous photorejuvenation. However, the underlying mechanism remains unclear.

OBJECTIVE

To evaluate the influence of LEDs at specific wavelengths on melatonin membrane receptor (MT1) and cutaneous photorejuvenation via the MT1 pathway in vitro.

METHODS

Normal human dermal fibroblasts (HDFs) were irradiated using LEDs at different wavelengths (410~940 nm) at a dose of 1 J/cm². MT1 activity was evaluated after melatonin stimulation and LED irradiation. Thereafter, the expressions of collagen (COL) and matrix metalloproteinases (MMPs), with and without luzindole (MT1/2 receptor antagonist), were investigated via semi-quantitative reverse transcription polymerase chain reaction (PCR), real-time PCR, western blotting, and enzyme-linked immunosorbent assay.

RESULTS

In HDFs, the MT1 mRNA and protein levels increased significantly in response to melatonin (dose, 50 nM) (p<0.01) and LED irradiation at 595, 630, 850, and 940 nm (p<0.01). LED irradiation up-regulated COL type I and down-regulated MMP-1. Compared to LED irradiation without luzindole, LED irradiation with luzindole produced no significant increase in COL type I mRNA and protein levels (p<0.01).

CONCLUSION

We found that LED irradiation induces collagen synthesis and MMP-1 inhibition in HDFs via MT1 activation. Additionally, multiple LED wavelengths (595, 630, 850, and 940 nm) stimulated MT1 in HDFs, unlike in the eyes, where only blue light induced plasma melatonin suppression. This suggests the possibility of the melatoninergic pathway in photorejuvenation.

Integrative skincare trial of intense pulsed light followed by the phyto-corrective mask, phyto-corrective gel, and resveratrol BE for decreasing post-procedure downtime and improving procedure outcomes in patients with rosacea

BACKGROUND

Rosacea is a chronic inflammatory skin condition of varying severity that can significantly impact patient quality of life. Intense pulsed light (IPL) is an established treatment for rosacea-associated telangiectasia, inflammation, and erythema. This study assessed whether application of a phyto-corrective mask, gel, and resveratrol antioxidant serum after IPL treatment can improve outcomes and reduce procedure-related adverse effects.

METHODS

In a prospective, open-label, split-face, 3-month study, 10 subjects with moderate-to-severe facial rosacea underwent IPL treatment on both sides of the face. The following were applied to the right side of the face only: phyto-corrective mask once weekly starting immediately after IPL; phyto-corrective gel twice daily; and resveratrol antioxidant treatment at night. Both sides of the face were treated with sunscreen. Subjects were assessed on Day 1, 1 and 3 months after IPL by three, independent evaluators using the 5-point Global Aesthetic Improvement Scale (GAIS). All subjects rated skin redness, hydration, and overall improvement on Day 1 and completed a patient satisfaction questionnaire at the 1- and 3-month visits.

RESULTS

Ten women were enrolled, aged 44-72 years old, with moderate (n = 6) to severe (n = 4) rosacea. IPL was effective at reducing symptoms with rosacea classified as absent in five women and mild in five at the final 3-month visit. GAIS scores also revealed improvements on both sides of the face, but the skincare treated side showed continuous improvement over 3 months with all patients remaining at least "Improved", whereas there appeared to be a waning effect after 1 month with IPL alone. On Day 1 after IPL, all women reported less redness, improved hydration, and improved skin appearance on the right side of the face. Patient satisfaction was consistently rated higher on the right side of the face.

CONCLUSION

Application of a phyto-corrective mask, gel, and resveratrol antioxidant serum may complement IPL treatment for rosacea by enhancing treatment outcomes and reducing procedure-related symptoms.

Physiotherapeutic Reduction of Orofacial Pain Using Extremely Low-Frequency Electromagnetic Field and Light-Emitting Diode Therapy—A Pilot Study

Introduction. Pain is a natural response of the body to injury and one of the symptoms defining an inflammatory reaction. It is almost always present after orthognathic surgeries (OGS), but its severity is subjective in each patient. Postoperative care of the patient is aimed at minimizing of postoperative pain relief orofacial region. Options of physiotherapy include extremely low-frequency electromagnetic field (ELF EMF) and high-energy light-emitting diode (LED). Aim of the Study. The aim of this study was to evaluate the effects of physiotherapy combining ELF EMF and LED to reduce pain of the orofacial region in patients after OGS. Material and Methods. The study was conducted in thirty-two patients who underwent OGS to treat morphological defects. The participants were randomly divided into two groups: Physiotherapy group (PT) and Control group (CG). In both groups, patients were prescribed Paracetamol and nonsteroidal analgesics (NSAID—ibuprofen). Patients from the PT group additionally received postoperative physiotherapy immediately after leaving the surgical clinic in the form of ELF EMF and LED therapy. Physiotherapeutic treatments were performed for 10 days, three applications a day, at no cost to the patient. Pain intensity was assessed using the visual analogue scale (VAS), which is a reliable instrument for the measurement of pain intensity self-reported by the patient. Results. Faster reduction of pain was the major observation made in patients who received physiotherapy treatments. In all subjects, after 5 days of therapy, the pain intensity was reduced by about 50% or resolved completely. Effects of therapy were measured with the relative changes in the pain intensity score, showing what fraction of the initial pain was eliminated at the first stage and throughout the whole therapy. The analysis of relative changes instead of absolute changes allowed us, among other things, to eliminate the bias of the higher initial pain intensity in the CG group compared to the PT group. Conclusions. The conducted research revealed that the combined use of ELF EMF and LED is beneficial in the reduction of pain of patients after OGS. The analgesic effects of physiotherapy in the treatment after OGS are necessary to continue research in this area and analyze the possibility of extending the indications for its use in other surgically treated maxillofacial diseases.

Photodynamic effect of light emitting diodes on E. coli and human skin cells induced by a graphene-based ternary composite

In this paper, the photodynamic effect of a ternary nanocomposite (TiO₂-Ag/graphene) on Escherichia coli bacteria and two human cell lines: A375 (melanoma) and HaCaT (keratinocyte) after exposure to different wavelength domains (blue, green or red-Light Emitting Diode, LED) was analyzed. The results obtained through bioassays were correlated with the morphological, structural and spectral data obtained through FT-IR, XPS and UV-Vis spectroscopy, powder X-Ray diffractometry (XRD) and STEM/EDX techniques, leading to conclusions that showed different photodynamic activation mechanisms and effects on bacteria and human cells, depending on the wavelength. The nanocomposite proved a therapeutic potential for blue light-activated antibacterial treatment and revealed a keratinocyte cytotoxic effect under blue and green LEDs. The red light-nanocomposite duo gave a metabolic boost to normal keratinocytes and induced stasis to melanoma cells. The light and nanocomposite combination could be a potential therapy for bacterial keratosis or for skin tumors.

Treatment with LEDs at a wavelength of 642 nm enhances skin tumor proliferation in a mouse model

Photobiomodulation (PBM) is attracting increased attention in the fields of dermatology and cosmetics. PBM with a variety of light parameters has been used widely in skin care, but can cause certain types of unwanted cells to proliferate in the skin; this can lead to skin tumors, such as papillomas and cancers. We constructed a mouse model of human skin tumors using DMBA as an initiator and TPA as a promoter, and confirmed that LEDs with a wavelength of 642 nm (red light) increased tumor size, epidermal thickness, and systemic proinflammatory cytokine levels. These results indicated that skin tumor cell proliferation may result from the use of 642 nm LEDs, suggesting the need for regulation of skin care based on LED light therapy.

Optimal Fluence and Duration of Low-Level Laser Therapy for Efficient Wound Healing in Mice

Background

Low-level laser (light) therapy is a promising technology that stimulates healing, relieves pain and inflammation, and restores function in injured body parts. However, few studies have compared the effects of light-emitting diodes of different fluence levels or different treatment durations.

Objective

Here, we investigated the effects of various fluence levels and treatment durations on wound closure in mice.

Methods

Full-thickness wounds were created on the dorsal skin using an 8-mm diameter punch, and the wounds were irradiated at 1, 4, or 40 J/cm² for 5 consecutive days starting on day 1. To determine the optimal irradiation duration, wounds were irradiated at the most potent fluence of previous study for 5, 10, or 15 days. Photographic documentation, skin biopsies, and wound measurements were performed to compare the effects of different treatment parameters.

Results

The most effective fluence level was 40 J/cm² at day 5, as determined by monitoring wound closure. There were no statistically significant differences in wound healing with different durations.

Conclusion

We have shown that repeated exposure to low levels of light significantly stimulates wound healing in mice and demonstrated more efficient wound closure with certain fluences of 830 nm irradiation.

Photobiomodulation: The Clinical Applications of Low-Level Light Therapy

BACKGROUND

Low-level light therapy (LLLT) is a recent addition to the pantheon of light-based therapeutic interventions. The absorption of red/near-infrared light energy, a process termed "photobiomodulation," enhances mitochondrial ATP production, cell signaling, and growth factor synthesis, and attenuates oxidative stress. Photobiomodulation is now highly commercialized with devices marketed directly to the consumer. In the gray area between the commercial and therapeutic sectors, harnessing the clinical potential in reproducible and scientifically measurable ways remains challenging.

OBJECTIVES

The aim of this article was to summarize the clinical evidence for photobiomodulation and discuss the regulatory framework for this therapy.

METHODS

A review of the clinical literature pertaining to the use of LLLT for skin rejuvenation (facial rhytids and dyschromias), acne vulgaris, wound healing, body contouring, and androgenic alopecia was performed.

RESULTS

A reasonable body of clinical trial evidence exists to support the role of low-energy red/near-infrared light as a safe and effective method of skin rejuvenation, treatment of acne vulgaris and alopecia, and, especially, body contouring. Methodologic flaws, small patient cohorts, and industry funding mean there is ample scope to improve the quality of evidence. It remains unclear if light-emitting diode sources induce physiologic effects of compararable nature and magnitude to those of the laser-based systems used in most of the higher-quality studies.

CONCLUSIONS

LLLT is here to stay. However, its ubiquity and commercial success have outpaced empirical approaches on which solid clinical evidence is established. Thus, the challenge is to prove its therapeutic utility in retrospect. Well-designed, adequately powered, independent clinical trials will help us answer some of the unresolved questions and enable the potential of this therapy to be realized.

Efficacy of Intense Pulsed Light Treatment for Moderate to Severe Acute Blepharitis or Blepharoconjunctivitis: A Retrospective Case Series

Objectives:

We aimed to evaluate the efficacy of periocular intense pulsed light (IPL) therapy in the treatment of moderate to severe acute blepharitis or blepharoconjunctivitis.

Materials and Methods:

This was a retrospective study performed in one institution. Eleven patients who received bilateral periocular IPL therapy using an IPL device (E>Eye, ESwin, Paris, France) were retrospectively evaluated. The following findings obtained at baseline and 10 weeks after the treatment were recorded: slit-lamp examinations; symptom scores of the Compression of the Eyelid (COTE) grading system and Ocular Surface Disease Index (OSDI); ocular surface staining with Oxford grading scale (OXFORD) scores; lipid layer thickness (LLT); and non-invasive tear meniscus test (TMH), non-invasive break up time measurement (NIBUT), and meibography performed by using I.C.P. Ocular Surface Analyzer (SBM System, Turin, Italy).

Results:

Significant improvements in OSDI symptom scores (p<0.0001), LLT (p<0.0001), and meibography (p<0.0001) were obtained at 10 weeks after bilateral periocular IPL therapy. COTE and ocular surface staining scores decreased by 59.72% and 57.14% respectively, while NIBUT and TMH increased by 47.34% and 22.16%, respectively. In parallel to the improvement in OSDI, LLT, and meibography, findings of acute blepharitis or blepharoconjunctivitis improved in slit-lamp examination. There were no adverse effects.

Conclusion:

Serial IPL therapy improves the clinical signs and symptoms of moderate to severe acute blepharitis or blepharoconjunctivitis, meibomian gland morphology, and secretion quality.

Role of Photo-Biomodulation Therapy in Facial Rejuvenation and Facial Plastic Surgery

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.

Assessment of Human Gingival Fibroblast Proliferation after Laser Stimulation In Vitro Using Different Laser Types and Wavelengths (1064, 980, 635, 450, and 405 nm)-Preliminary Report

Purpose: to assess the effect of photobiomodulation (PBM) on human gingival fibroblast proliferation. Methods: The study was conducted using the primary cell cultures of human fibroblasts collected from systemically healthy donors. Three different laser types, Nd:YAG (1064 nm), infrared diode laser (980 nm), and prototype led laser emitting 405, 450, and 635 nm were used to irradiate the fibroblasts. Due to the patented structure of that laser, it was possible to irradiate fibroblasts with a beam combining two or three wavelengths. The energy density was 3 J/cm², 25 J/cm², 64 J/cm². The viability and proliferation of cells were determined using the (Thiazolyl Blue Tetrazolium Blue) (MTT) test conducted 24, 48, and 72 h after laser irradiation. Results: The highest percentage of mitochondrial activity (MA = 122.1%) was observed in the group irradiated with the 635 nm laser, with an energy density of 64 J/cm² after 48 h. The lowest percentage of MA (94.0%) was observed in the group simultaneously irradiated with three wavelengths (405 + 450 + 635 nm). The use of the 405 nm laser at 25 J/cm² gave similar results to the 635 nm laser. Conclusions: The application of the 635 nm and 405 nm irradiation caused a statistically significant increase in the proliferation of gingival fibroblasts.

Safety and efficacy of a novel home-use device for light-potentiated (LED) skin treatment

Skin structure and function results from a dynamic interplay between dermal and epidermal cell types. Optimizing skin health through an effective and long-lasting skin care regime therefore requires a global approach, encompassing various mechanisms to stimulate this interplay beyond the action scope of a classical topical solution. This study evaluates the impact of a novel home-use device combining a topical serum, light-emitting diodes and massage on the clinical signs of extrinsic skin aging. The innovative principle relies on potentiating the effect of active ingredients contained in the topical serum with visible and near infra-red photons to prevent extracellular matrix degradation and promote its reconstruction. After in vitro and ex vivo investigations, a clinical study assessed the safety and efficacy of a daily treatment with the home-use device for 28 days. A significant increases in skin density and radiance while reducing the wrinkles was obtained with no side effects.

Various biological effects of solar radiation on skin and their mechanisms: implications for phototherapy

The skin protects our body from various external factors, such as chemical and physical stimuli, microorganisms, and sunlight. Sunlight is a representative environmental factor that considerably influences the physiological activity of our bodies. The molecular mechanisms and detrimental effects of ultraviolet rays (UVR) on skin have been thoroughly investigated. Chronic exposure to UVR generally causes skin damage and eventually induces wrinkle formation and reduced elasticity of the skin. Several studies have shown that infrared rays (IR) also lead to the breakdown of collagen fibers in the skin. However, several reports have demonstrated that the appropriate use of UVR or IR can have beneficial effects on skin-related diseases. Additionally, it has been revealed that visible light of different wavelengths has various biological effects on the skin. Interestingly, several recent studies have reported that photoreceptors are also expressed in the skin, similar to those in the eyes.

Based on these data, I discuss the various physiological effects of sunlight on the skin and provide insights on the use of phototherapy, which uses a specific wavelength of sunlight as a non-invasive method, to improve skin-related disorders.

Synergistic effects of using novel home-use 660- and 850-nm light-emitting diode mask in combination with hyaluronic acid ampoule on photoaged Asian skin: A prospective, controlled study

BACKGROUND

Recently, light-emitting diode (LED) devices are among those mostly preferred for esthetic application because they improve the appearance of photoaged skin characterized by wrinkles, sagginess, pigmented lesions, and others. In addition, the use of hyaluronic acid (HA) for skin rejuvenation is already well proven.

AIMS

This study aims to evaluate the synergistic effects of using home-use LED mask device with HA ampoule.

METHODS

The total number of recruited subjects was 48:24 in Group A treated with both home-use LED mask device and HA ampoule and 24 in Group B treated with HA ampoule only, for 4 weeks. To assess the efficacy of the treatment, the following were used: Antera 3D CS, EOS 800D with Image-Pro Plus, DUB-USB, VisioFace Quick, and Visioscan VC98.

RESULTS

After treatment, the volume measurement (mm³ ) for prejowl sulci and nasolabial fold flattening as well as the area measurement (pixel) for lower chin firmness improvement was significantly reduced, and the number of pores (ea) for enlarged pores as well as the desquamation index (%) for the amount of corneocytes significantly decreased in both Group A and Group B. Moreover, the percentage of skin density significantly improved. Furthermore, Group A showed a significantly faster and higher rate of improvement than Group B.

CONCLUSION

The use of 660- and 850-nm home-use LED mask device can generate synergistic effects on home-use topical applications like HA on photoaged face, and such device can be safely and efficiently used daily in personal environments.

Efficacy of home-use light-emitting diode device at 637 and 854-nm for facial rejuvenation: A split-face pilot study

BACKGROUND

The use of light-emitting diode (LED) in combination wavelength for facial rejuvenation has been previously reported. Nowadays, there has been a growing market for home-use cosmetic devices because of its low cost and convenience.

AIMS

To evaluate the efficacy and safety of home-use LED device on facial rejuvenation.

METHODS

This was a prospective split-face clinical trial with a total of 24 subjects, who presented with photo aging skin. All subjects were treated with the home-use LED device on the left side of their face, twice a week for 8 weeks. Primary outcomes measured in the study were the changes in the biophysical properties of the skin assessed with the following parameters: skin elasticity, skin hydration, texture, and wrinkles. Evaluations were done at baseline, 2-, 4-, 6-, and 8-week follow-up. Subjects' self-improvement scores and adverse reactions were also recorded.

RESULTS

All 24 subjects completed the study and attended all follow-up. Skin elasticity was significantly higher in the LED group compared to the control during the 6- and 8-week follow-up (P < .05). In the LED group, an image of the treated skin captured using Visioscan^® showed improvement of the skin texture at 8-week follow-up. Majority of the subjects in the LED group scored good improvement on all follow-ups (37.5%, 41.7%, 58.3%, and 62.5%) when compared to the baseline. No adverse reactions or pain were recorded in the study.

CONCLUSION

The home-use LED device, with a combination wavelength of 637 and 854 nm, is safe and can be used as an adjunctive treatment for self-administered facial rejuvenation.

Photochemical Retinopathy induced by blue light emitted from a light-emitting diode Face Mask: A case report and literature review

RATIONALE

Skin photobiomodulation involves the use of low doses of light of a specific wavelength to reduce skin inflammation and promote tissue repair. Recently, a face mask using a light-emitting diode (LED) to induce photobiomodulation has been widely introduced in the market. However, a short wavelength of high-energy blue light can cause retinal damage. We would like to report a rare case of photochemical retinopathy after using a blue LED face mask.

PATIENT CONCERNS

A 37-year-old woman presented with complaints of distorted vision. The patient was exposed to blue light from an LED face mask 1 month before presentation.

DIAGNOSIS

Color fundus photography revealed a yellowish chorioretinal lesion and optical coherence tomography revealed retinal pigment epithelium destruction in the parafoveal area. Fluorescein angiography revealed leakage from the lesion at the parafovea. The patient was diagnosed with blue LED-induced photochemical retinopathy.

INTERVENTIONS

Intravitreal bevacizumab was injected in the right eye.

OUTCOMES

After 4 weeks, dysmorphopsia was improved.

LESSONS

This case report demonstrates that retinal damage can occur in humans due to prolonged exposure to blue light. Therefore, it is important to be wary of eye exposure and ensure the eyes are covered during LED face mask use.

Study on injection molding analysis of glasses-type wearable device for facial skin care

BACKGROUND:

With the improvement in the standard of living, there has been increasing interest in facial skin care. In particular, it has been observed that people pay extra attention to eye-skin when they visit skin care parlors for special treatment and care.

OBJECTIVE:

There is a need for skin care devices that would enable convenient skin care anywhere, including at home and on the move. In this research, we developed a prototype of a glasses-type skin care device with a LED (Light-Emitting Diode) irradiation function and performed injection molding analysis of the skin care device model for mass production.

METHODS:

First, the product was designed using a universal design to improve the wearability of the glasses-type skin care device. The first prototype of the skin care device was produced using an integrated LED optical module capable of irradiating at three LED wavelengths to investigate the structural function of the product. The prototype was classified into three mechanisms and injection molding analysis was performed. The fill time, temperature at flow front, injection pressure, clamp force, and deflection values were analyzed according to the appropriate number and location of gates into which the PC + PBT (Polycarbonate + Polybutylene terephthalate) resin was introduced.

RESULTS:

We found that all the other parts except the temple section of the device were inferior in moldability.

CONCLUSION:

In further studies, the 3D prototype will be modified to enhance moldability, and injection molding analysis with other materials as well as with PC + PBT resin will be performed.

Intended Human Exposure to Non-ionizing Radiation for Cosmetic Purposes

Cosmetic devices using non-ionizing radiation (NIR) are increasingly available for people who wish to modify their appearance for aesthetic purposes. There are a wide range of NIR modalities used for cosmetic procedures, including devices that use optical radiation (laser, intense pulsed light, and light-emitting diode), electromagnetic fields, and ultrasound. Common procedures involving the application of NIR include epilation, skin rejuvenation, body sculpting and contouring, treatment of vascular and skin lesions, tattoo removal, and scar reduction. The majority of research on the use of NIR cosmetic devices has focused on the efficacy of the treatment rather than adverse effects or complications. Studies that assessed safety consisted mostly of case reports and small case series. Common adverse effects on the skin reported include mild and transient pain, erythema, swelling, and changes in pigmentation. Less common, more severe side effects include burns, blisters, scarring, persisting erythema, altered pigmentation, and eye damage. Some of the latter may have resulted from treatment errors. Particular groups of people that may be at greater risk from optical radiation include people with dark skin, with high sun exposure, and taking photosensitizing medications or supplements. There is lack of evidence for the safety profile of cosmetic NIR procedures during pregnancy. Reports of injuries to workers administering treatments with cosmetic NIR devices are rare, but inadvertent damage to the eye from optical devices may occur. Randomized controlled trials are required to fully assess potential adverse effects from the use of NIR cosmetic devices. Regulation varies worldwide and some regions apply the same safety classification and guidance as for medical devices. In order to reduce harm associated with the use of cosmetic devices, ICNIRP considers it important that regulations that cover all types and frequencies of cosmetic NIR devices are adopted worldwide and that there is greater oversight regarding their use.

The Effects of Photobiomodulation on Vocal Fold Wound Healing: In Vivo and In Vitro Studies

Background: Photobiomodulation (PBM) is increasingly used in dermatology and dentistry due to its benefit of promoting wound healing and relieving pain; however, there is no corresponding research report on the application of PBM to vocal fold wound healing. Objective: To assess the potential wound-healing effects of PBM on the vocal folds via in vivo and in vitro experiments. Materials and methods: In in vitro study, vocal fold fibroblasts (VFFs) were irradiated under a diode laser with wavelength of 635 nm at energy density of 8 J/cm². The Cell Counting Kit-8 (CCK-8) assay was used to study the viability of VFFs, and the gene expressions of COL1A2, COL3A1, IL-6, HAS2, and COX-2 were investigated by real-time polymerase chain reaction (RT-PCR). In in vivo study, 15 rabbits were used. Lamina propria of the left vocal folds of 12 rabbits was unilaterally stripped, and 6 of them were treated with PBM. The remaining three rabbits served as normal controls. After 3 months, all animals were sacrificed to obtain histological results. We used laryngoscope to record images of the healing phase. Results: Irradiation with energy density of 8 J/cm² resulted in a 2.8% increase in cell proliferation (p < 0.05). However, the difference between the experimental and the control group became larger after 48 and 72 h of subsequent irradiation. RT-PCR results showed that the expression of COL1A2, COL3A1, and HAS2 was higher, and the expression of IL-6 and COX-2 was lower. Histological examination showed that, compared with the injury group, hyaluronic acid (HA) increased significantly, collagen deposition decreased, and the configuration of collagen was more organized after PBM treatment. Conclusions: PBM can inhibit inflammatory reaction and promote the secretion of HA to decrease the deposition of collagen and regenerate vocal fold tissue without scar.

Intense Pulsed Light for Meibomian Gland Disease: A Report by the American Academy of Ophthalmology

PURPOSE

To review the literature on the efficacy of intense pulsed light (IPL) on the eyelids in the management of meibomian gland disease (MGD) and meibomian gland-related ocular surface disease.

METHODS

A literature search was last conducted on May 15, 2019, in the PubMed and Cochrane Library databases for English-language original research that assessed the effect of IPL on MGD in adult patients. Thirty-three articles were identified, and 12 studies were determined to be relevant to the criteria outlined for assessment. The panel methodologist (V.K.A.) assigned a level of evidence rating to each study; 4 studies were rated level II, and 8 studies were rated level III. Five studies had potential conflicts of interest and design limitations that affected interpretation of results.

RESULTS

All studies documented improvement in clinically meaningful metrics, including tear breakup time (TBUT), corneal staining and eyelid margin measurements, meibum quality, meibomian gland expressability, ocular surface disease index (OSDI), and standard patient evaluation of eye dryness (SPEED) questionnaire scores. Side effects were relatively uncommon but included discomfort, cutaneous erythema, blistering, eyelash loss, and floaters; these were uniformly self-limited.

CONCLUSIONS

Although methodological limitations and potential conflicts of interest in some studies raised concern, the existing body of literature demonstrates improvements in the signs and symptoms of MGD after IPL therapy.

Lichen Planopilaris and Low-Level Light Therapy: Four Case Reports and Review of the Literature About Low-Level Light Therapy and Lichenoid Dermatosis

Lichen planopilaris (LPP) is a cell-mediated scarring alopecia that causes inflammation of the scalp and the eventual destruction of hair follicles in affected areas. Current literature on treatment of LPP remains limited with no definitive treatment approach being recognized, although a combination of topical/intralesional steroids and orally administered hydroxychloroquine remains the most utilized option. Low-level light therapy (LLLT) is an expanding technology shown to be effective in a variety of dermatologic conditions. We report here four patients with LPP who show a dramatic response to LLLT, including a reduction of inflammation, disappearance of symptoms, and evident hair regrowth with no side effects. We review the possible role of LLLT in LPP and other lichenoid conditions.

Efficacy and Tolerability of Phototherapy With Light-Emitting Diodes for Sensitive Skin: A Pilot Study

Sensitive skin (SS) syndrome is defined by the occurrence of unpleasant sensations in response to stimuli that should normally not induce such sensations. It affects ~50% of women and 40% of men and can impact the quality of life. There is no consensus on therapeutic management. Phototherapy by light-emitting diodes (LEDs) is increasingly being used in dermatology for various inflammatory skin disorders with significant reduction in SS-10 and good tolerability. A Korean study suggested its efficacy in alleviating SS symptoms associated with other facial diseases. Our objective is to obtain preliminary data on the efficacy of phototherapy with LEDs for alleviating SS symptoms and increasing tolerance in subjects with SS that is not associated with other facial skin disorders. This monocentric pilot study included 30 subjects with SS who had a Sensitive Scale-10 score ≥40. The treatment consisted of red LED light exposure twice a week until significant reduction in SS-10 with a maximal treatment length of 8 weeks. The primary outcome was defined by a 60% decrease in the SS-10 score compared to the baseline.

Results: Thirty subjects were included; 83% were women, and the mean age was 28.9 years. Two participants were considered lost to follow-up. The cheeks (90%) and the nose (70%) were the most frequently involved parts of the face. Cold, heat, temperature variation, water and sun were the most frequent triggering factors. Twenty-eight subjects (93.3%, 95% CI 77.9 to 99.2%) achieved the primary outcome. Significant reduction in SS-10 was achieved in 77% of subjects in six sessions or fewer. The mean (SD) SS-10 scores were 54.7 (12.1) at inclusion, 14.4 (6.0) at the last session and 13.9 (7.5) 2 months after the last session, suggesting that the benefits persist for a few weeks. Two side effects were reported: both were allergic reactions to the nickel contained in the protective goggles. This pilot study had a small sample size and no control group. LEDs were effective in treating SS in all 28 subjects who completed the study in accordance with the protocol, and the benefits persisted for 2 months after the last LED therapy session.

Low level light therapy for the treatment of recalcitrant chalazia: a sample case summary

Purpose

To evaluate the effects of low-level light therapy (LLLT) on the resolution of recalcitrant chalazia.

Patients and Methods

This was a single-site retrospective chart review of patients with chalazia, all of whom were unresponsive to previous pharmaceutical therapy or surgical intervention, who received a 15 min LLLT treatment in conjunction with a standard pharmaceutical regimen. A second treatment was applied 24 hrs to as late as 2 months if there was no evidence of progression of resolution in appearance.

Results

A total of 26 eyes of 22 patients with relevant history and treatment were reviewed, all with a history of prior pharmaceutical treatment for their chalazia. After a single 15 min LLLT treatment, followed by a standard pharmaceutical regimen, 46% of eyes (12/26) showed resolution of their chalazia. Resolution was noted from 3 days to one-month post-treatment. With a second treatment, the chalazia resolved in 92% of eyes (24/26). Only two eyes of the 26 (8%) required incision and curettage after LLLT treatment.

Conclusion

The use of LLLT for the treatment of recalcitrant chalazia appears to be beneficial in patients who have failed topical and/or systemic therapy, significantly reducing the likelihood of requiring surgical intervention.

The Rationale for Photobiomodulation Therapy of Vaginal Tissue for Treatment of Genitourinary Syndrome of Menopause: An Analysis of Its Mechanism of Action, and Current Clinical Outcomes

Objective: Light, particularly in the visible to far-infrared spectrum, has been applied to the female genital tract with lasers and other devices for nearly 50 years. These have included procedures on both normal and neoplastic tissues, management of condylomata, endometriosis, and menometrorrhagia, and, more recently, a number of fractional laser devices have been applied for the management of genitourinary syndrome of menopause (GSM) and stress urinary incontinence (SUI), and to achieve so-called vaginal rejuvenation. Photobiomodulation therapy (PBMT) has been proposed as an alternative for use in managing GSM and SUI.

Methods: This article reviews the biological basis, symptoms, and management of GSM, and investigates the current status and rationale for the use of PBMT.

Results and conclusions: Based on the preliminary evidence available, PBMT is safe and appears to be efficacious in treating GSM.

Wound-healing effects of 635-nm low-level laser therapy on primary human vocal fold epithelial cells: an in vitro study

Low-level laser therapy (LLLT) has been promoted for its beneficial effects on tissue healing and pain relief for skin and oral applications. However, there is no corresponding literature reporting on vocal fold wound healing. Our purpose was to assess the potential wound-healing effects of LLLT on primary human vocal fold epithelial cells (VFECs). In this study, normal vocal fold tissue was obtained from a 58-year-old male patient who was diagnosed with postcricoid carcinoma without involvement of the vocal folds and underwent total laryngectomy. Primary VFECs were then cultured. Cells were irradiated at a wavelength of 635 nm with fluences of 1, 4, 8, 12, 16, and 20 J/cm² (50 mW/cm²), which correspond to irradiation times of 20, 80, 160, 240, 320, and 400 s, respectively. Cell viability of VFECs in response to varying doses of LLLT was investigated by the Cell Counting Kit-8 (CCK-8) method. The most effective irradiation dose was selected to evaluate the cell migration capacity by using the scratch wound-healing assay. Real-time polymerase chain reaction (RT-PCR) was used to detect the gene expression of TGF-β1, TGF-β3, EGF, IL-6, and IL-10. Irradiation with doses of 8 J/cm² resulted in 4% increases in cell proliferation differing significantly from the control group (p < 0.05). With subsequent doses at 48 and 72 h after irradiation, the differences between the experimental and the control groups became greater, up to 9.8% (p < 0.001) and 19.5% (p < 0.001), respectively. It also increased cell migration and the expression of some genes, such as EGF, TGF-β1, TGF-β3, and IL-10, involved in the tissue healing process. This study concludes that LLLT at the preset parameters was capable of stimulating the proliferation and migration of human vocal fold epithelial cells in culture as well as increase the expression of some genes involved in tissue healing process. Additionally, successive laser treatments at 24 h intervals have an additive beneficial effect on the healing of injured tissues.

The Management of Melasma on Skin Types V and VI Using Light Emitting Diode Treatment

OBJECTIVE

This study investigated light emitting diode (LED) treatment for patients with melasma on darker skin types.

BACKGROUND

Melasma is a common disfiguring skin condition in women which is difficult to treat and is refractory. The cause of melasma remains unclear.

METHODS

In this study, 60 female participants aged between 25 and 60 years, who presented with melasma, were enrolled (n = 39.85). They were purposely assigned to two groups according to their skin types. Both groups received a total of 36 LED light treatments over a period of 9 months.

RESULTS

Both subjective and objective results indicated a significant improvement of melasma. Statistical analyses revealed significant improvements in both groups.

CONCLUSIONS

The results of this study suggest that LED is effective in managing melasma. These results will provide a basis for future therapeutic use of phototherapy to improve melasma.

Photodynamic and photobiological effects of light-emitting diode (LED) therapy in dermatological disease: an update

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.