Advertisement

Current Status of Light-Emitting Diode Phototherapy in Dermatological Practice

  • R. Glen CalderheadEmail author
Chapter

Abstract

Phototherapy in its broadest sense means any kind of treatment (from the Greek therapeia ‘curing, healing,’ from therapeuein ‘to cure, treat.’) with any kind of light (from the Greek phos, photos ‘light’). The modern accepted definition of phototherapy, however, has become accepted as: “the use of low incident levels of light energy to achieve an athermal and atraumatic, but clinically useful, effect in tissue”. Under its basic original definition, phototherapy is an ancient art because the oldest light source in the world is the sun, and therapy with sunlight, or heliotherapy, has been in use for over 4000 years with the earliest recorded use being by the Ancient Egyptians (Giese, Living with our Sun’s ultraviolet rays, Springer, New York, 1976). They would treat what was probably vitiligo by rubbing the affected area with a crushed herb similar to parsley, then expose the treated area to sunlight. The photosensitizing properties of the parsley caused an intense photoreaction in the skin leading to a very nasty sunburn, which in turn hopefully led to the appearance of postinflammatory secondary hyperpigmentation, or ‘suntan’ thereby repigmenting the depigmented area. In their turn the Ancient Greeks and Romans used the healing power of the sun, and it was still being actively used in Europe in the eighteenth, nineteenth and early twentieth century, particularly red light therapy carried out with the patient placed in a room with red-tinted windows. One famous patient was King George III of Great Britain and Northern Ireland who ruled from 1760 to 1801, popularly though erroneously known as ‘Mad King George’. We now strongly suspect that he was actually suffering from the blood disease porphyria, so being shut in a room with red-draped walls and red tinted windows to treat his depression probably only served to make him even more mad, since porphyria is often associated with severe photosensitivity! Entities treated this way included the eruptive skin lesions of rubella and rubeola, and even ‘melancholia’, as was the case with King George III, now recognised as clinical depression. Hippocrates, the Father of Medicine, certainly concurred with the latter application some two millennia before King George: Hippocrates prescribed sunlight for depressive patients and believed that the Greeks were more naturally cheerier than their northern neighbors because of the greater exposure to the sun.

Keywords

LED-LLLT Photobiomodulation Collagenesis Elastinogenesis Wound healing Adenosine triphosphate Mitochondrion 

References

  1. 1.
    Giese AC. Living with our Sun’s Ultraviolet Rays. New York: Springer; 1976.CrossRefGoogle Scholar
  2. 2.
    Cox TM, Jack N, Lofthouse S, Watling J, et al. King George III and porphyria: an elemental hypothesis and investigation. Lancet. 2005;366:332–5.CrossRefGoogle Scholar
  3. 3.
    Fubini S. Influenza della luce sulla respirazione del tessuto nervoso. Annali Universali di Medicina e Chirurgia; 1897. Serie 1, 250: Fascicolo 7.Google Scholar
  4. 4.
    Finsen NR. Om de kemiske Straales skadelige Virkning paa den dyriske Organisme. Behandlung af Kopper med Udestaengning af de kemiske Straaler. Copenhagen: Hospitalstidende; 1893.Google Scholar
  5. 5.
    Zheludev N. The life and times of the LED - a 100-year history. Nat Photonics. 2007;1:189–92.CrossRefGoogle Scholar
  6. 6.
    Whelan HT, Houle JM, Whelan NT, et al. The NASA light-emitting diode medical program - progress in space flight and terrestrial applications. Space Technol Appl Int Forum. 2000;504:37–43.Google Scholar
  7. 7.
    Whelan HT, Smits RL, Buchmann EV, et al. Effect of NASA light-emitting diode (LED) irradiation on wound healing. J Clin Laser Med Surg. 2001;19:305–14.CrossRefGoogle Scholar
  8. 8.
    Ohshiro T. New classification for single-system light treatment. Laser Ther. 2011;20:11–5.CrossRefGoogle Scholar
  9. 9.
    Smith KC. The science of photobiology. Plenum Press: New York; 1977.CrossRefGoogle Scholar
  10. 10.
    Ohshiro T, Calderhead RG. Low level laser therapy: a practical introduction. Chichester: Wiley; 1988.Google Scholar
  11. 11.
    Asagai Y, Ueno R, Miura Y, Ohshiro T. Application of low reactive-level laser therapy (LLLT) in patients with cerebral palsy of the adult tension athetosis type. Laser Ther. 1995;7:113–8.CrossRefGoogle Scholar
  12. 12.
    Karu TI, Kolyakov SF. Exact action spectra for cellular responses relevant to phototherapy. Photomed Laser Surg. 2005;23:355–61.CrossRefGoogle Scholar
  13. 13.
    Hargate G. A randomised double-blind study comparing the effect of 1072-nm light against placebo for the treatment of herpes labialis. Clin Exp Dermatol. 2006;31:638–41.CrossRefGoogle Scholar
  14. 14.
    Karu T. Primary and secondary mechanisms of action of visible to near-IR radiation on cells. J Photochem Photobiol B. 1999;49:1–17.CrossRefGoogle Scholar
  15. 15.
    Smith KC. The photobiological basis of low level laser radiation therapy. Laser Ther. 1991;3:19–24.CrossRefGoogle Scholar
  16. 16.
    Kudo C, Inomata K, Okajima K, Motegi M, Ohshiro T. Low level laser therapy pain attenuation mechanisms, 1: Histochemical and biochemical effects of 830 nm gallium aluminium arsenide laser radiation on rat saphenous nerve Na-K-atpase activity. Laser Ther. 1988;Pilot Issue:3–6.Google Scholar
  17. 17.
    Calderhead RG. Watts a joule revisited: guest editorial. Laser Ther. 1995;7:147–9.CrossRefGoogle Scholar
  18. 18.
    Calderhead RG, Inomata K. A study on the possible haemorrhagic effects of extended infrared diode laser irradiation on encapsulated and exposed synovial membrane articular tissue in the rat. Laser Ther. 1992;4:65–8.CrossRefGoogle Scholar
  19. 19.
    Dougherty TJ. Photodynamic therapy (PDT) of malignant tumors. Crit Rev Oncol Hematol. 1984;2:83–116.CrossRefGoogle Scholar
  20. 20.
    Garcia-Zuazaga J, Cooper KD, Baron ED. Photodynamic therapy in dermatology: current concepts in the treatment of skin cancer. Expert Rev Anticancer Ther. 2005;5:791–800.CrossRefGoogle Scholar
  21. 21.
    Gold MH, Goldman MP. 5-Aminolevulinic acid photodynamic therapy: where we have been and where we are going. Dermatol Surg. 2004;30:1077–83.PubMedGoogle Scholar
  22. 22.
    Charakida A, Seaton ED, Charakida M, Mouser P, et al. Phototherapy in the treatment of acne vulgaris: what is its role? Am J Clin Dermatol. 2004;5:211–6.CrossRefGoogle Scholar
  23. 23.
    Kjeldstad B, Johnsson A. An action spectrum for blue and near ultraviolet inactivation of Propionibacterium acnes; with emphasis on a possible porphyrin photosensitization. Photochem Photobiol. 1986;43:67–70.CrossRefGoogle Scholar
  24. 24.
    Sigurdsson V, Knulst AC, van Weelden H. Phototherapy of acne vulgaris with visible light. Dermatology. 1997;194:256–60.CrossRefGoogle Scholar
  25. 25.
    Arakane K, Ryu A, Hayashi C, Masunaga T, et al. Singlet oxygen (1 delta g) generation from coproporphyrin in Propionibacterium acnes on irradiation. Biochem Biophys Res Commun. 1996;223:578–82.CrossRefGoogle Scholar
  26. 26.
    Lavi R, Shainberg A, Friedmann H, Shneyvays V, et al. Low energy visible light induces reactive oxygen species generation and stimulates an increase of intracellular calcium concentration in cardiac cells. J Biol Chem. 2003;278:40917–22.CrossRefGoogle Scholar
  27. 27.
    Morton CA, Whitehurst C, Moseley H, et al. Development of an alternative light source to lasers for photodynamic therapy. Clinical evaluation in the treatment of pre-malignant non-melanoma skin cancer. Lasers Med Sci. 1995;10:165–71.CrossRefGoogle Scholar
  28. 28.
    Babilas P, Kohl E, Maisch T, Backer B, et al. In vitro and in vivo comparison of two different light sources for topical photodynamic therapy. Br J Derm. 2006;154:712–8.Google Scholar
  29. 29.
    Pollock B, Turner D, Stringer M, Bojar RA, et al. Topical aminolaevulinic acid-photodynamic therapy for the treatment of acne vulgaris: a study of clinical efficacy and mechanism of action. Br J Dermatol. 2004;151:616–22.CrossRefGoogle Scholar
  30. 30.
    Hong SB, Lee MH. Topical aminolevulinic acid-photodynamic therapy for the treatment of acne vulgaris. Photodermatol Photoimmunol Photomed. 2005;21:322–5.CrossRefGoogle Scholar
  31. 31.
    Omi T, Bjerring P, Sato S, Kawada S, et al. 420 nm intense continuous light therapy for acne. J Cosmet Laser Ther. 2004;6:156–62.CrossRefGoogle Scholar
  32. 32.
    Webber J, Luo Y, Crilly R, Fromm D, Kessel D. An apoptotic response to photodynamic therapy with endogenous protoporphyrin in vivo. J Photochem Photobiol B. 1996;35:209–11.CrossRefGoogle Scholar
  33. 33.
    Nitzan Y, Kauffman M. Endogenous porphyrin production in bacteria by δ-aminolevulinic acid and subsequent bacterial photoeradication. Lasers Med Sci. 1999;14:269–77.CrossRefGoogle Scholar
  34. 34.
    Zouboulis CC. Acne as a chronic systemic disease. Clin Dermatol. 2014;32:389–96.CrossRefGoogle Scholar
  35. 35.
    Papageorgiou P, Katsambas A, Chu A. Phototherapy with blue (415 nm) and red (660 nm) light in the treatment of acne vulgaris. Br J Dermatol. 2000;142:973–8.CrossRefGoogle Scholar
  36. 36.
    Goldberg DG, Russell B. Combination blue (415 nm) and red (633 nm) LED phototherapy in the treatment of mild to severe acne vulgaris. J Cosmet Laser Ther. 2004;8:71–5.CrossRefGoogle Scholar
  37. 37.
    Lee SY, You CE, Park MY. Blue and red light combination LED phototherapy for acne vulgaris in patients with skin phototype IV. Lasers Surg Med. 2007;39:180–8.CrossRefGoogle Scholar
  38. 38.
    Trelles MA, Allones I, Luna R. Facial rejuvenation with a nonablative 1320 nm Nd:YAG laser: a preliminary clinical and histologic evaluation. Dermatol Surg. 2001;27:111–6.PubMedGoogle Scholar
  39. 39.
    Nikolaou VA, Stratigos AJ, Dover JS. Nonablative skin rejuvenation. J Cosmet Dermatol. 2005;4:301–7.CrossRefGoogle Scholar
  40. 40.
    Orringer JS, Voorhees JJ, Hamilton T, Hammerberg C, et al. Dermal matrix remodeling after nonablative laser therapy. J Am Acad Dermatol. 2005;53:775–82.CrossRefGoogle Scholar
  41. 41.
    Rahman Z, Alam M, Dover JS. Fractional laser treatment for pigmentation and texture improvement. Skin Therapy Lett. 2006;11:7–11.PubMedGoogle Scholar
  42. 42.
    Wanner M, Tanzi EL, Alster TS. Fractional photothermolysis of facial and nonfacial cutaneous photodamage with a 1,550-nm erbium-doped fiber laser. Dermatol Surg. 2007;33:23–8.PubMedGoogle Scholar
  43. 43.
    Lowe NJ, Lowe P. Pilot study to determine the efficacy of ALA-PDT photo-rejuvenation for the treatment of facial ageing. J Cosmet Laser Ther. 2005;7:159–62.CrossRefGoogle Scholar
  44. 44.
    Alster TS, Surin-Lord SS. Photodynamic therapy: practical cosmetic applications. J Drugs Dermatol. 2006;5:764–8.PubMedGoogle Scholar
  45. 45.
    Christiansen K, Peter Bjerring P, Troilius A. 5-ALA for photodynamic photorejuvenation - optimization of treatment regime based on normal-skin fluorescence measurements. Lasers Surg Med. 2007;39:302–10.CrossRefGoogle Scholar
  46. 46.
    Weiss RA, Weiss MA, Geronemus RG, McDaniel DH. A novel non-thermal non-ablative full panel LED photomodulation device for reversal of photoaging: digital microscopic and clinical results in various skin types. J Drugs Dermatol. 2004;3:605–10.PubMedGoogle Scholar
  47. 47.
    Russell BA, Kellett N, Reilly LR. A study to determine the efficacy of combination LED light therapy (633 nm and 830 nm) in facial skin rejuvenation. J Cosmet Laser Ther. 2005;7:196–200.CrossRefGoogle Scholar
  48. 48.
    Goldberg DJ, Amin S, Russell BA, Phelps R, et al. Combined 633-nm and 830-nm led treatment of photoaging skin. J Drugs Dermatol. 2006;5:748–53.PubMedGoogle Scholar
  49. 49.
    Lee SY, Park KH, Choi JW, Kwon JK, et al. 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. J Photochem Photobiol B. 2007;88:51–67.CrossRefGoogle Scholar
  50. 50.
    Trelles M, Mordon S, Calderhead RG, Goldberg D. (Viewpoint 3 and comment 3) How best to halt and/or revert UV-induced skin ageing: strategies, facts and fiction. Exp Dermatol. 2008;17:228–40.CrossRefGoogle Scholar
  51. 51.
    Kim WS, Calderhead RG. Is light-emitting diode phototherapy (LED-LLLT) really effective? Laser Ther. 2011;20:206–15.Google Scholar
  52. 52.
    Min PK, Goo BCL. 830 nm light-emitting diode low level light therapy (LED-LLLT) enhances wound healing: a preliminary study. Laser Ther. 2013;22:43–9.CrossRefGoogle Scholar
  53. 53.
    Calderhead RG, Kim WS, Ohshiro T, Trelles MA, Vasily DB. Adjunctive 830 nm light-emitting diode therapy can improve the results following aesthetic procedures. Laser Ther. 2015;24:277–89.CrossRefGoogle Scholar
  54. 54.
    Calderhead RG, Vasily DB. Low level light therapy with light-emitting diodes for the aging face. Clin Plast Surg. 2016;43:541–50.CrossRefGoogle Scholar
  55. 55.
    Rigau J, Trelles MA, Calderhead RG, Mayayo E. Changes in fibroblast proliferation and metabolism following in vitro helium-neon laser irradiation. Laser Ther. 1991;3:25–34.CrossRefGoogle Scholar
  56. 56.
    Takezaki S, Omi T, Sato S, Kawana S. Ultrastructural observations of human skin following irradiation with visible red light-emitting diodes (LEDs): a preliminary in vivo report. Laser Ther. 2005;14:153–60.CrossRefGoogle Scholar
  57. 57.
    Karu T. Identification of the photoreceptors. In:Ten lectures on basic science of laser phototherapy. Grangesberg, Sweden: Prima Books AB; 2007.Google Scholar
  58. 58.
    Trelles MA, Rigau J, Velez M. LLLT in vivo effects on mast cells. In: Simunovic Z, editor. Lasers in medicine and dentistry (Part 1). Switzerland: LaserMedico; 2002. p. 169–86.Google Scholar
  59. 59.
    Trelles MA. Phototherapy in anti-aging and its photobiologic basics: a new approach to skin rejuvenation. J Cosmet Dermatol. 2006;5:87–91.CrossRefGoogle Scholar
  60. 60.
    Calderhead RG, Kubota J, Trelles MA, Ohshiro T. One mechanism behind LED phototherapy for wound healing and skin rejuvenation: key role of the mast cell. Laser Ther.  https://doi.org/10.5978/islsm.17.141.CrossRefGoogle Scholar
  61. 61.
    Young S, Bolton P, Dyson M, Harvey W, Diamantopoulos C. Macrophage responsiveness to light therapy. Lasers Surg Med. 1989;9:497–505.CrossRefGoogle Scholar
  62. 62.
    Osanai T, Shiroto C, Mikami Y, Kudou E, et al. Measurement of GaAlAs diode laser action on phagocytic activity of human neutrophils as a possible therapeutic dosimetry determinant. Laser Ther. 1990;2:123–34.CrossRefGoogle Scholar
  63. 63.
    Dima VF, Suzuki K, Liu Q, Koie T, et al. Laser and neutrophil serum opsonic activity. Roum Arch Microbiol Immunol. 1996;55(4):277–83.PubMedGoogle Scholar
  64. 64.
    Samoilova KA, Bogacheva ON, Obolenskaya KD, Blinova MI, et al. Enhancement of the blood growth promoting activity after exposure of volunteers to visible and infrared polarized light. Part I: Stimulation of human keratinocyte proliferation in vitro. Photochem Photobiol Sci. 2004;3(1):96–101.CrossRefGoogle Scholar
  65. 65.
    Kim JW, Lee JO. Low level laser therapy and phototherapy assisted hydrogel dressing in burn wound healing: light guided epithelial stem cell biomodulation. In: Eisenmann-Klein M, Neuhann-Lorenz C, editors. Innovations in plastic and aesthetic surgery. Berlin: Springer; 2007. p. 36–42.Google Scholar
  66. 66.
    Trelles MA, Allones I, Mayo E. Combined visible light and infrared light-emitting diode (LED) therapy enhances wound healing after laser ablative resurfacing of photodamaged facial skin. Med Laser App. 2006;21:165–75.CrossRefGoogle Scholar
  67. 67.
    Trelles MA, Allones I. Red light-emitting diode (LED) therapy accelerates wound healing post-blepharoplasty and periocular laser ablative resurfacing. J Cosmet Laser Ther. 2006;8:39–42.CrossRefGoogle Scholar
  68. 68.
    Trelles MA, Allones I, Mayo E. Er:YAG laser ablation of plantar verrucae with red LED therapy-assisted healing. Photomed Laser Surg. 2006;24:494–8.CrossRefGoogle Scholar
  69. 69.
    Ablon G. Combination 830-nm and 633-nm light-emitting diode phototherapy shows promise in the treatment of recalcitrant psoriasis: preliminary findings. Photomed Laser Surg. 2010;28:141–6.CrossRefGoogle Scholar
  70. 70.
    Park KY, Han TY, Kim IS, Yeo IK, Kim BJ, Kim MN. The effects of 830 nm light-emitting diode therapy on acute herpes zoster ophthalmicus: a pilot study. Ann Dermatol. 2013;25:163–7.CrossRefGoogle Scholar
  71. 71.
    Mester E, Szende B, Spiry T, Scher A. Stimulation of wound healing by laser rays. Acta Chir Acad Sci Hung. 1972;13:315–24.PubMedGoogle Scholar
  72. 72.
    Lee GY, Kim WS. The systemic effect of 830-nm LED phototherapy on the wound healing of burn injuries: a controlled study in mouse and rat models. J Cosmet Laser Ther. 2012;14:107–10.CrossRefGoogle Scholar
  73. 73.
    Kubota J. Defocused diode laser therapy (830 nm) in the treatment of unresponsive skin ulcers: a preliminary trial. J Cosmet Laser Ther. 2004;6:96–102.CrossRefGoogle Scholar
  74. 74.
    Glinkowski W. Delayed union healing with diode laser therapy (LLLT). Case report and review of literature. Laser Ther. 1990;2:107–10.CrossRefGoogle Scholar
  75. 75.
    Pretel H, Lizarelli RF, Ramalho LT. Effect of low-level laser therapy on bone repair: histological study in rats. Lasers Surg Med. 2007;39(10):788–96.CrossRefGoogle Scholar
  76. 76.
    Karu T. Irradiation effects are detectable in the cells of subsequent generations. In:Ten lectures on basic science of laser phototherapy. Grangesberg, Sweden: Prima Books AB; 2007.Google Scholar
  77. 77.
    Kubota J. Effects of diode laser therapy on blood flow in axial pattern flaps in the rat model. Lasers Med Sci. 2002;17:146–53.CrossRefGoogle Scholar
  78. 78.
    Niinikoski J. Current concepts of the role of oxygen in wound healing. Ann Chir Gynaecol. 2001;90(Suppl 215):9–11.PubMedGoogle Scholar
  79. 79.
    Kim YD, Kim SS, Hwang DS, Kim SG, et al. Effect of low-level laser treatment after installation of dental titanium implant-immunohistochemical study of RANKL, RANK, OPG: an experimental study in rats. Lasers Surg Med. 2007;39:441–50.CrossRefGoogle Scholar
  80. 80.
    Nagasawa A, Kato K, Negishi A. Bone regeneration effect of low level lasers. Laser Ther. 1991;3:59–62.CrossRefGoogle Scholar
  81. 81.
    Naeser MA, Saltmarche A, Krengel MH, Hamblin MR, Knight JA. Improved cognitive function after transcranial, light-emitting diode treatments in chronic, traumatic brain injury: two case reports. Photomed Laser Surg. 2011;29:351–8.CrossRefGoogle Scholar
  82. 82.
    Nawashiro H, Wada K, Nakai K, Sato S. Focal increase in cerebral blood flow after treatment with near-infrared light to the forehead in a patient in a persistent vegetative state. Photomed Laser Surg. 2012;30:231–3. ReviewCrossRefGoogle Scholar
  83. 83.
    Naeser MA, Zafonte R, Krengel MH, Martin PI, Frazier J, et al. Significant improvements in cognitive performance post-transcranial, red/near-infrared light-emitting diode treatments in chronic, mild traumatic brain injury: open-protocol study. J Neurotrauma. 2014;31:1008–17.CrossRefGoogle Scholar
  84. 84.
    Gratton E, Toronov V, Wolf U, Wolf M, Webb A. Measurement of brain activity by near-infrared light. J Biomed Opt. 2005;10:1100–8.CrossRefGoogle Scholar
  85. 85.
    Yu G, Durduran T, Furuya D, Greenberg JH, Yodh AG. Frequency-domain multiplexing system for in vivo diffuse light measurements of rapid cerebral hemodynamics. Appl Opt. 2003;42:2931–9.CrossRefGoogle Scholar
  86. 86.
    Dima VF, Ionescu MD. Ultrastructural changes induced in Walker carcinosarcoma by treatment with dihematoporphyrin ester and light in animals with diabetes mellitus. Roum Arch Microbiol Immunol. 2000;59:119–30.PubMedGoogle Scholar
  87. 87.
    Skobelkin OK, Michailov VA, Zakharov SD. Preoperative activation of the immune system by low reactive level laser therapy (LLLT) in oncologic patients: a preliminary report. Laser Ther. 1991;3:169–76.CrossRefGoogle Scholar
  88. 88.
    Simpson S. Chakras for starters. 2nd ed. Nevada City, CA: Crystal Clarity; 2002.Google Scholar
  89. 89.
    Carey SC. A beginner’s guide to scientific method. 2nd ed. London: Wadsworth Publishing Inc; 2004.Google Scholar
  90. 90.
    Almeida-Lopes L, Rigau J, Zângaro RA, Guidugli-Neto J, Jaeger MM. Comparison of the low level laser therapy effects on cultured human gingival fibroblasts proliferation using different irradiance and same fluence. Lasers Surg Med. 2001;29:179–84.CrossRefGoogle Scholar
  91. 91.
    Karu T. Ten lectures on basic science of laser phototherapy. Grangesberg, Sweden: Prima Books AB; 2007.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Research Division, VP Medicoscientific AffairsClinique LGoyang-shiSouth Korea

Personalised recommendations