Journal of Clinical and Aesthetic Dermatology

FEB 2018

An evidence-based, peer-reviewed journal for practicing clinicians in the field of dermatology

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21 JCAD JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY February 2018 • Volume 11 • Number 2 R E V I E W A An increasing number of individuals are seeking noninvasive procedures for improving medical and aesthetic dermatologic conditions. Phototherapy refers to the use of nonthermal, noninvasive light to achieve a therapeutic outcome and can apply to a variety of light-emitting devices. Interest in recent advances in the use of light emitting diodes (LEDs) has led to their clinical application for a variety of medical and cosmetic uses. Depending on the target chromophore, different wavelengths of light are used. 1 Three wavelengths of light that have demonstrated several therapeutic applications are blue (415nm), red (633nm), and near-infrared (830nm). Recent publications have reignited an interest in the numerous studies performed or sponsored by a leader in the field of LED phototherapy (Omnilux™; GlobalMed Technologies, Glen Ellen, California) which clearly demonstrate the significant value of phototherapy for a range of clinical applications (Figure 1). In my private practice, LED technology is the most commonly performed procedure and is used each office day to treat a wide variety of medical and aesthetic disorders. This review will describe the broad range of clinical applications and significant results achieved for acne, wound healing, actinic keratosis, precancerous tissue, psoriasis and skin rejuvenation, and post-procedural erythema. Signed photoconsent was provided by the patients pictured herein. MEDICAL APPLICATIONS Mild-to-moderate acne vulgaris. Propionibacterium acnes (P. acnes) is a gram- positive bacterium involved in the pathogenesis of acne vulgaris. 2 In-vitro studies have demonstrated that blue light is effective for treating P. acnes because it produces the strongest photoactivation of endogenous porphyrins through a process known as endogenous photodynamic therapy (PDT). The result is free radical formation and destruction of the P. acnes cell membrane. 3 An open-label clinical study assessed the safety and efficacy of narrowband blue light on inflammatory and noninflammatory acne lesions in patients with mild-to-moderate facial acne (N=30). 4 Subjects had not used topical, oral, or systemic treatments for two weeks and had not received oral retinoids for six months. Baseline lesions were counted and recorded by lesion type. Subjects received eight 10- or 20-minute light treatments using LEDs with peak wavelengths of 409nm to 419nm (40mW/cm 2 ) over a four-week period. Lesion counts were repeated at Weeks 5, 8, and 12. A beneficial effect on inflammatory lesions was observed at Week 5, becoming significant at Weeks 8 and 12. The mean percent reduction in lesion counts at each time point was 25 percent, 53 percent (p<0.001), and 60 percent (p<0.001), respectively; however, there was little effect on noninflammatory lesions. Adverse events included mild and transient erythema, skin dryness, and pruritis. A second open-label study assessed the effects of phototherapy using LEDs emitting blue 415nm light at 48J/cm 2 to treat subjects with mild-to-moderate acne (N=45). 5 Subjects A B S T R A C T Within the field of dermatology, advances in the use of light emitting diodes (LEDs) have led to their clinical application for a variety of medical and cosmetic uses. Of note, one phototherapy device has demonstrated beneficial effects over a range of clinical applications (Omnilux™; GlobalMed Technologies, Glen Ellen, California). The study included a literature review of published studies. Using LEDs with frequencies of 415nm (blue), 633nm (red), and 830nm (infrared), this device has demonstrated significant results for the treatment of medical conditions, including mild-to-moderate acne vulgaris, wound healing, psoriasis, squamous cell carcinoma in situ (Bowen's disease), basal cell carcinoma, actinic keratosis, and cosmetic applications. Although photodynamic therapy with the photosensitizer 5-aminolevulinic acid might cause stinging and burning, phototherapy is free of adverse events. We determined that phototherapy using LEDs is beneficial for a range of medical and aesthetic conditions encountered in the dermatology practice. This treatment displays an excellent safety profile. KEYWORDS: Light-emitting diodes, phototherapy, photodynamic therapy, skin rejuvenation, acne vulgaris, periorbital wrinkles Phototherapy with Light Emitting Diodes: Treating a Broad Range of Medical and Aesthetic Conditions in Dermatology by GLYNIS ABLON, MD, FAAD Dr. Ablon is with the Ablon Skin Institute and Research Center in Manhattan Beach, California. J Clin Aesthet Dermatol. 2018;11(2):21–27 FUNDING: No funding was provided for this article. DISCLOSURES: The author has no conflicts of interest to relevant to the content of this article. CORRESPONDENCE: Glynis Ablon, MD, FAAD; Email: drablon@abloninstitute.com

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