©Sharon McQuillan, MD. All rights reserved. 1

LED Photomodulation

Denise Baker, MD

LED Photomodulation

Denise Baker, MD

The following potential conflict of interest relationships are germane to my presentation.

Speakers Bureau: Sciton Laser, Johnson & Johnson

LED Photomodulation

•  Light •  Emitting •  Diodes

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LED Categories

•  Yellow 580-600nm •  Blue 410-417nm •  Red 600-660nm • Mixture

Red LEDs 630-660nm

•  NASA Studies on Wound Healing

•  Vasodilation •  Blood Flow •  Oxygenation •  PDT with ALA

Blue LEDs 412-417nm

•  ACNE Suppression •  FDA Cleared •  15-20 Minutes Exposure • Multiple Treatments •  PDT With ALA/Levulan

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Yellow LEDs 590nm •  LED Photomodulation •  35 second Pulsed Technology •  Light Activation of Fibroblasts •  Collagen stimulation •  Collagenase/MMP Suppression •  FDA Cleared for wrinkle reduction

and Skin Rejuvenation

The Theory of LED Photomodulation

The use of low intensity light therapy to non-thermally modulate the activity of living cells

  Using LED light energies but modulating various settings, Photomodulation can:

•  Photo activate cells to produce collagen •  Photo inhibit cells to suppress collagenase

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LED Photomodulation

•  Photoactivation of Cells Promotes Collagen & Elastin •  Photoinhibition of Cells

Suppresses Collagenase & MMPs •  35 Second Treatment Code

Required for Non-Thermal Light Activation •  590nm Pulsing Yellow LED Arrays

Key to Photomodulation

Mechanisms of Action

H2O

O2

H+

Fe—Cu Heme Ligand

ADP+Pi ATP H+

cyst c Mitochondrial

Inner Membrane

Mitochondria

LED

LED Photomodulation

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Mitochondria

The Human Cell

Human Fibroblast Cell

“The Factory”

“The Power Plant”

Collagen

•  Structural Support of the Skin

•  Adds to Elasticity of the Skin

•  Thickens & Strengthens Skin

•  Essential for Skin Fitness

Collagenase •  MMP Enzyme dissolves &

transports Damaged Collagen •  UV Sun Exposure & Smoking

will Trigger Collagenase Production

•  Non-Ablative Thermal Injury Stimulates Collagen & Collagenase

Vs.

  LED photomodulation post Laser will slow collagenase production

  LED photomodulation can decrease all MMPs

Smoker Non-Smoker

Collagenase Damage/Aging

59-yo identical twins: one did not smoke

Photo credit: Dermatology Times (February 2000)

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Photomodulation vs. Current Laser Therapies

PHOTOMODULATION PHOTOTHERMOLYSIS

Photomodulation Photobiochemical

“Very Low Level”

Non-Ablative

“Lower Level Energy”

Non-ablative Photothermal

Non-Ablative

Selective Photothermal

Non- Selective Photothermal

“Higher Level Energy”

Ablative

Laser vs. LED

Lasers & Intense Pulsed Light •  Thermal

(photothermolysis) •  Discomfort •  Injury/wound to skin •  Slower treatment time •  High energy

LED Photomodulation •  Non-thermal

(photomodulation) •  No discomfort •  No injury •  Faster treatment times •  Low energy

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LED Photomodulation Benefits

•  Softer, Smoother Skin •  Better Skin Appearance, Less Dull •  Creamy Looking Skin •  Softens Skin Redness •  Reduction of Fine Lines and Wrinkles •  Better Skin Tone & Texture “GLOBAL SKIN IMPROVEMENT”

LED Photomodulation Protocol

•  Series of 8 to 10 treatments •  Once a week to get skin looking &

feeling great •  Clean Dry Skin Critical •  Exfoliation before allows better light

penetration •  Monthly maintenance to keep skin

looking & feeling great

When Will You See Improvement?

•  4-8 Treatments –  Smoother –  Softer –  Better Looking Skin –  Decreased Erythema

•  2-3 months post 8-10 Treatments –  Wrinkle Reduction –  Pore Size Reduction –  Collagen takes 60-90 days to remodel

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PRE

POST

LED Photomodulation (LED device alone)

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PRE

POST

LED Photomodulation (LED device alone)

PRE

POST

LED Photomodulation (LED device alone)

PRE

POST

LED Photomodulation (LED device alone)

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PRE

POST

LED Photomodulation (LED device alone)

Progressive Improvement 1, 8, 16, 24 weeks post tx

Histopathology Results Collagen I

MMP-9

PRE

PRE

POST

POST

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Immunofluorescence microscopy - MMP-3

Histopathology Results (LED device alone)

PRE POST (1 week)

Primos Digital Surface Profilometry (LED device alone)

PRE

POST

LED Photomodulation (57-year-old photoaged female)

Pre treatment 1 month post 8 treatments

High resolution ultrasound skin imaging (Dermascan) David H. McDaniel, M.D. David H. McDaniel, M.D.

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Histopathology Results IL-6 - Marker showing decreased inflammation in the skin

PRE POST (4 months)

Progressive Improvement

Periorbital

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Global Pores Redness

% I

mpr

ovem

ent

1 week post 2 months post 4 months post

% change improvement from 1 week → 2 months and from 2 months → 4 months

LED Photomodulation Reverses Acute UV Induced Matrix Enzyme

Expression Robert Weiss, MD

David H. McDaniel, MD Roy Geronemus, MD Margaret Weiss, MD John Newman, MD

April 2004 ASLMS

Annual Meeting Dallas

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Sunburn LED Photomodulation

Right side treated with LED Photomodulation

R

MMP-1

-3

-2

-1

0

1

2

3

Rela

tive

Expr

essio

n

1 hr 4 hr

LED Photomodulation post UV exposure (RT-PCR)

UVA 1 UVA 1

I

I

II II

Human Fibroblasts

Combination Therapy •  LED can be used as a stand-alone treatment OR in

combination with other regimens

•  LED + Photofacial –  Turns on collagen; Turns off collagenase & inflammation –  Speeds recovery and increases results from photofacial

•  LED + Lasers –  Quenches thermal injury –  Decreases edema & erythema to enhance laser procedures

•  LED + Botox –  Diminishes fine lines & wrinkles –  Smoothes and refreshes skin

•  LED + Microdermabrasion –  Treats all layers of the skin with exfoliation & dermal remodeling

•  LED + Chemical Peels –  Stimulates dermis, while peels remove damaged outer layers to improve

tone & texture

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LED Photomodulation Combined with IPL

-30

-20

-10

0

10

20

30

Collagen I

MMP-1

Collagen I MMP-1

IPL+GW

IPL A loneIPL A lone

IPL+GW

% of Skin Biopsy Staining for:

Change in % Tissue Stained

1st Peer Review Published Article

June 2003

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Features & Benefits of LEDs •  No side effects, downtime or pain •  Remarkably safe and effective for all skin types •  Non-invasive, non-ablative and non-thermal so

there is no injury to the skin surface •  Fast and convenient - takes less than 5 minutes •  Treats large areas such as the entire face or chest •  No aftercare is needed

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LED Photomodulation Benefits •  Softer, Smoother Skin •  Better Skin Appearance, Less Dull •  Softens Skin Redness •  Reduction of Fine Lines and Wrinkles •  Better Skin Tone & Texture •  Global Skin Improvement

LED Photomodulation Summary •  Safe Simple Risk Free Treatments •  Painless Patient Friendly Protocols •  Affordable & Noticeable Benefits •  Anti-Sun Device •  Perfect Compliment to Laser/IPL Botox

Treatments