Abstrakty využití fototerapie v dermatologii
Desmet KD, Paz DA, Corry JJ, Eells JT, Wong-Riley MT, Henry MM, Buchmann EV, Connelly MP, Dovi JV, Liang HL, Henshel DS, Yeager RL, Millsap DS, Lim J, Gould LJ, Das R, Jett M, Hodgson BD, Margolis D, Whelan HT.
Clinical and experimental applications of NIR-LED photobiomodulation.
Photomed Laser Surg. 2006 Apr;24(2):121-8.
This review presents current research on the use of far-red to near-infrared (NIR) light treatment in various in vitro and in vivo models. Low-intensity light therapy, commonly referred to as "photobiomodulation," uses light in the far-red to near-infrared region of the spectrum (630-1000 nm) and modulates numerous cellular functions. Positive effects of NIR-light-emitting diode (LED) light treatment include acceleration of wound healing, improved recovery from ischemic injury of the heart, and attenuated degeneration of injured optic nerves by improving mitochondrial energy metabolism and production. Various in vitro and in vivo models of mitochondrial dysfunction were treated with a variety of wavelengths of NIR-LED light. These studies were performed to determine the effect of NIR-LED light treatment on physiologic and pathologic processes. NIRLED light treatment stimulates the photoacceptor cytochrome c oxidase, resulting in increased energy metabolism and production. NIR-LED light treatment accelerates wound healing in ischemic rat and murine diabetic wound healing models, attenuates the retinotoxic effects of methanol-derived formic acid in rat models, and attenuates the developmental toxicity of dioxin in chicken embryos. Furthermore, NIR-LED light treatment prevents the development of oral mucositis in pediatric bone marrow transplant patients. The experimental results demonstrate that NIR-LED light treatment stimulates mitochondrial oxidative metabolism in vitro, and accelerates cell and tissue repair in vivo. NIR-LED light represents a novel, noninvasive, therapeutic intervention for the treatment of numerous diseases linked to mitochondrial dysfunction.
Belchior AC, dos Reis FA, Nicolau RA, Silva IS, Perreira DM, de Carvalho Pde T.
Influence of laser (660 nm) on functional recovery of the sciatic nerve in rats following crushing lesion.
Lasers Med Sci. 2009 Nov;24(6):893-9. Epub 2009 Feb 6.
With the aim of accelerating the regenerative processes, the objective was to study the influence of gallium-aluminum-arsenide (GaAlAs) laser (660 nm) on functional and histomorphological recovery of the sciatic nerve in rats. The sciatic nerves of 12 Wistar rats were crushed divided into two groups: control and laser therapy. For the latter, GaAlAs laser was utilized (660 nm, 4 J/cm(2), 26.3 mW and 0.63 cm(2) beam), at three equidistant points on the lesion, for 20 days. Comparison of the sciatic functional index (SFI) showed that there was a significant difference only between the pre-lesion value of the laser therapy group and that after the 21st day in the control group. It was concluded that the parameters and methods utilized demonstrated positive results regarding the SFI over the time period evaluated.
Eells JT, Wong-Riley MT, VerHoeve J, Henry M, Buchman EV, Kane MP, Gould LJ, Das R, Jett M, Hodgson BD, Margolis D, Whelan HT.
Mitochondrial signal transduction in accelerated wound and retinal healing by near-infrared light therapy.
Mitochondrion. 2004 Sep;4(5-6):559-67.
Department of Health Sciences, College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI 53201, USA. jeells@uwm.edu
Photobiomodulation by light in the red to near infrared range (630-1000 nm) using low energy lasers or light-emitting diode (LED) arrays has been shown to accelerate wound healing, improve recovery from ischemic injury in the heart and attenuate degeneration in the injured optic nerve. Recent evidence indicates that the therapeutic effects of red to near infrared light result, in part, from intracellular signaling mechanisms triggered by the interaction of NIR light with the mitochondrial photoacceptor molecule cytochrome c oxidase. We have demonstrated that NIR-LED photo-irradiation increases the production of cytochrome oxidase in cultured primary neurons and reverses the reduction of cytochrome oxidase activity produced by metabolic inhibitors. We have also shown that NIR-LED treatment prevents the development of oral mucositis in pediatric bone marrow transplant patients. Photobiomodulation improves wound healing in genetically diabetic mice by upregulating genes important in the promotion of wound healing. More recent studies have provided evidence for the therapeutic benefit of NIR-LED treatment in the survival and functional recovery of the retina and optic nerve in vivo after acute injury by the mitochondrial toxin, formic acid generated in the course of methanol intoxication. Gene discovery studies conducted using microarray technology documented a significant upregulation of gene expression in pathways involved in mitochondrial energy production and antioxidant cellular protection. These findings provide a link between the actions of red to near infrared light on mitochondrial oxidative metabolism in vitro and cell injury in vivo. Based on these findings and the strong evidence that mitochondrial dysfunction is involved in the pathogenesis of numerous diseases processes, we propose that NIR-LED photobiomodulation represents an innovative and non-invasive therapeutic approach for the treatment of tissue injury and disease processes in which mitochondrial dysfunction is postulated to play a role including diabetic retinopathy, age-related macular degeneration, Leber's hereditary optic neuropathy and Parkinson's disease.
Barolet D., Boucher A.
LED photoprevention: Reduced MED response following multiple LED exposures
Preclinical Report Lesers Surg. Med. 40:106-112, 2008.
As photoprotection with traditional sunscreen presents some limitations, the use of non-traditional treatments to increase skin resistance to ultraviolet (UV) induced damage would prove particularly appealing. The purpose of this pilot study was to test the potential of non-thermal pulsed light-emitting diode (LED) treatments (660 nm) prior to UV exposure in the induction of a state of cellular resistance against UV-induced erythema.
Study Design/Materials and Methods
Thirteen healthy subjects and two patients with polymorphous light eruption (PLE) were exposed to 5, 6, or 10 LED treatments (660 nm) on an EXPERIMENTAL anterior thigh region. Individual baseline minimal erythema doses (MED) were then determined. UV radiation was thereafter performed on the LED EXPERIMENTAL and CONTROL anterior thigh areas. Finally, 24 hours post-UV irradiation, LED pre-treated MED responses were compared to the non-treated sites.
Results
Reduction of erythema was considered significant when erythema was reduced by >50% on the LED-treated side as opposed to CONTROL side. A significant LED treatment reduction in UV-B induced erythema reaction was observed in at least one occasion in 85% of subjects, including patients suffering from PLE. Moreover, there was evidence of a dose-related pattern in results. Finally, a sun protection factor SPF-15-like effect and a reduction in post-inflammatory hyperpigmentation were observed on the LED pre-treated side.
Conclusions
Results suggest that LED based therapy prior to UV exposure provided significant protection against UV-B induced erythema. The induction of cellular resistance to UV insults may possibly be explained by the induction of a state a natural resistance to the skin via specific cell signaling pathways and without the drawbacks and limitations of traditional sunscreens. These results represent an encouraging step towards expanding the potential applications of LED therapy and could be useful in the treatment of patients with anomalous reactions to sunlight.
Caetano KS, Frade MA, Minatel DG, Santana LA, Enwemeka CS.
Phototherapy Improves Healing of Chronic Venous Ulcers.
Photomed Laser Surg. 2009 Jan 16. [Epub ahead of print]
Abstract Objective: We tested the hypothesis that LED phototherapy with combined 660-nm and 890-nm light will promote healing of venous ulcers that failed to respond to other forms of treatment. Background Data: A variety of dressings, growth factors, and adjunct therapies are used to treat venous ulcers, but none seems to yield satisfactory results. Materials and Methods: We used a randomized placebo-controlled double-blind study to compare a total of 20 patients divided with 32 chronic ulcers into three groups. In group 1 the ulcers were cleaned, dressed with 1% silver sulfadiazine (SDZ) cream, and treated with placebo phototherapy (<.03 J/cm(-3)) using a Dynatron Solaris 705((R)) phototherapy research device. In group 2 the ulcers were treated similarly but received real phototherapy (3 J/cm(-2)) instead of placebo. In group 3 (controls), the ulcers were simply cleaned and dressed with SDZ without phototherapy. The ulcers were evaluated with digital photography and computer image analysis over 90 d or until full healing was attained. Results: Ulcers treated with phototherapy healed significantly faster than controls when compared at day 30 (p < 0.01), day 60 (p < 0.05), and day 90 (p < 0.001), and similarly healed faster than the placebo-treated ulcers at days 30 and 90 (p < 0.01), but not at day 60. The beneficial effect of phototherapy was more pronounced when the confounding effect of small-sized ulcers was removed from the analysis. Medium- and large-sized ulcers healed significantly faster with treatment (>/=40% rate of healing per month) than placebo or control ulcers (p < 0.05). Conclusion: Phototherapy promotes healing of chronic venous ulcers, particularly large recalcitrant ulcers that do not respond to conventional treatment.
Kim KH, Geronemus RG.
Nonablative [Non-wounding] laser and light therapies for skin rejuvenation
Arch Facial Plast Surg. 2004 Nov-Dec;6(6):398-409
BACKGROUND: Multiple modalities have been described for skin rejuvenation, including ablative and nonablative therapies. Because of the prolonged recovery period associated with ablative procedures that injure the epidermis, nonablative skin treatments have grown increasingly popular. Various laser- and light-based systems have been designed or applied for promoting skin remodeling without damage to the epidermis.
METHODS: Studies investigating the use of nonablative procedures for facial rhytids [wrinkles] or acne scarring with clinical, histological, and objective quantitative measurements are systematically reviewed.
RESULTS: Nonablative treatments are associated with clinical and objective improvements for the treatment of facial rhytids and acne scarring. Dermal remodeling seems to occur as a result of thermal injury, leading to dermal fibrosis without epidermal disruption.
CONCLUSIONS: Although results are not as impressive as those of ablative treatments, nonablative procedures are effective in the treatment of photoaging and acne scarring. As technology in nonablative therapies continues to evolve, future laser and light sources may yield even more favorable results.
Oh, J Kim, N Seo, S Kim, IH
Alteration of extracellular matrix modulators after nonablative laser therapy in skin rejuvenation.
BACKGROUND: Nonablative laser therapy is widely practised for skin rejuvenation, which stimulates collagen production and dermal matrix remodelling. Matrix remodelling is primarily modulated by a coordinated action of matrix metalloproteinases (MMPs) and their inhibitors, but the effects of nonablative lasers on these matrix modulators are not fully investigated.
OBJECTIVES: To evaluate the changes in matrix modulators, such as MMP-1, MMP-2, MMP-3, MMP-9 and MT1-MMP, and their inhibitors (TIMP-1, TIMP-2 and RECK in particular), after nonablative laser treatments of human facial skin.
METHODS: Twenty-four adult volunteers received a series of four nonablative laser treatments separated by 3-week intervals on facial skin. Two-millimetre skin punch biopsies were obtained at baseline and 3 weeks after the last treatment.
RESULTS: Nonablative laser treatments led to a robust increase in two major dermal matrix components, type I collagen and tropoelastin. Among MMPs tested, levels of MMP-2 mRNA were statistically significantly increased, but the amount of active MMP-2 was rather reduced. More importantly, the expression level of RECK was significantly enhanced by laser treatments.
CONCLUSIONS: Clinical outcomes following nonablative laser treatments may result not only from increased biosynthesis but also from decreased degradation, via an induction of RECK expression, of matrix proteins.
Na JI, Suh DH
Red light phototherapy alone is effective for acne vulgaris: randomized, single-blinded clinical trial
BACKGROUND: Recently, a demand for safe and effective treatment of acne has been increasing. Although visible light has attracted attention as a new option, the effect of red light alone has not yet been evaluated.
OBJECTIVES: The objective was to assess the efficacy of red light phototherapy with a portable device in acne vulgaris.
METHODS: Twenty-eight volunteers with mild to moderate acne were treated with portable red light-emitting devices in this split-face randomized trial. The right or left side of the face was randomized to treatment side and phototherapy was performed for 15 minutes twice a day for 8 weeks. Clinical photographs, lesion counts, and a visual analog scale (VAS) were used to assess each side of the face at baseline and Weeks 1, 2, 4, and 8, and a split-face comparison was performed.
RESULTS: The percent improvement in noninflammatory and inflammatory lesion counts of the treated side was significant compared to the control side (p<.005). VAS decreased from 3.9 to 1.9 on the treatment side and the difference between the treatment and control sides was significant at Week 8 (p<.005).
CONCLUSIONS: This study shows that red light phototherapy alone can be a new therapeutic option for acne vulgaris.
Albertini R, Villaverde AB, Aimbire F, Salgado MA, Bjordal JM, Alves LP, Munin E, Costa MS
Anti-inflammatory effects of low-level laser therapy (LLLT) with two different red wavelengths (660nm and 684nm) in carrageenan-induced rat paw edema
It has been suggested that low-level laser therapy (LLLT) can modulate inflammatory processes. The aim of this experiment was to investigate what effects red laser irradiation with two different wavelengths (660nm and 684nm) on carrageenan-induced rat paw edema and histology. Thirty two male Wistar rats were randomly divided into four groups. One group received a sterile saline injection, while inflammation was induced by a sub-plantar injection of carrageenan (1mg/paw) in the three other groups. After 1h, LLLT was administered to the paw in two of the carrageenan-injected groups. Continuous wave 660nm and 684nm red lasers respectively with mean optical outputs of 30mW and doses of 7.5J/cm(2) were used. The 660nm and 684nm laser groups developed significantly (p<0.01) less edema (0.58ml [SE+/-0.17] ml and 0.76ml [SE+/-0.10] respectively) than the control group (1.67ml [SE+/-0.19]) at 4h after injections. Similarly, both laser groups showed a significantly lower number of inflammatory cells in the muscular and conjunctive sub-plantar tissues than the control group. We conclude that both 660nm and 684nm red wavelengths of LLLT are effective in reducing edema formation and inflammatory cell migration when a dose of 7.5J/cm(2) is used.
Meireles GC, Santos JN, Chagas PO, Moura AP, Pinheiro AL
Effectiveness of laser photobiomodulation at 660 or 780 nanometers on the repair of third-degree burns in diabetic rats
OBJECTIVE: The aim of this investigation was to compare by light microscopy the effects of laser photobiomodulation (LPBM) at lambda = 660 nm and lambda = 780 nm on third-degree burns in diabetic Wistar rats. BACKGROUND DATA: Burns are severe injuries that result in fluid loss, tissue destruction, infection, and shock, that may result in death. Diabetes is a disease that reduces the body\'s ability to heal properly. LPBM has been suggested as an effective method of improving wound healing.
MATERIALS AND METHODS: A third-degree burn measuring 1.5 x 1.5 cm was created in the dorsum of each of 55 animals, and they were divided into three groups that were or were not treated with LPBM (lambda = 660 nm or lambda = 780 nm, 35 mW, varphi = 2 mm, 20 J/cm(2)). The treatments were started immediately post-burn at four points within the burned area (5 J/cm(2)) and were repeated at 24-hour intervals over 21 d. The animals were humanely killed after 3, 5, 7, 14, and 21 d by an overdose of intraperitoneal general anesthetic. The specimens were routinely cut and stained and analyzed by light microscopy.
RESULTS: We found that healing in the animals receiving 660-nm laser energy was more apparent at early stages, with positive effects on inflammation, the amount and quality of granulation tissue, fibroblast proliferation, and on collagen deposition and organization. Epithelialization and local microcirculation were also positively affected by the treatment.
CONCLUSION: The use of 780-nm laser energy was not as effective as 660-nm energy, but it had positive effects at early stages on the onset and development of inflammation. At the end of the experimental period the primary effect seen was on the amount and quality of the granulation tissue. The 660-nm laser at 20 J/cm(2), when used on a daily basis, was more effective than the 780-nm laser for improving the healing of third-degree burns in the diabetic rats beginning at the early stages post-burn.
Houk LD, Humphreys T
Lasers to magic bullets: an updated history of lasers in dermatology
Laser therapy is one of the fastest expanding and most exciting fields in dermatology. From its theoretical beginnings in Einstein's imagination, lasers have come to be used in treatments for conditions ranging from skin malignancy and acne to hirsutism and photoaging. We will briefly review the evolution of laser treatment, with a focus on the recent developments surrounding the new millennium.
Sami NA, Attia AT, Badawi AM.
Phototherapy in the treatment of acne vulgaris.
J Drugs Dermatol. 2008 Jul;7(7):627-32.
BACKGROUND: Achieving an effective management of acne vulgaris with minimal complications remains a difficult challenge for physicians. Moreover, the rise in antibiotic-resistant strains reduce the future usefulness of current mainstay therapies, and accordingly, the need for alternative therapies is mandatory. Phototherapy has been shown to be an effective treatment for acne, and there has been a renewed interest in photodynamic therapy as a treatment modality for this condition. OBJECTIVES: To evaluate the effectiveness of pulsed dye laser (PDL), intense pulsed light (IPL) and light-emitting diode (LED) phototherapy for the treatment of moderate to severe acne vulgaris. METHODS: Forty-five patients with moderate to severe acne were randomly divided into 3 equal groups. Group 1 was treated with a PDL, group 2 was treated with IPL, and group 3 was treated with a blue-red combination LED. Treatment was continued until a > or = 90% clearance of patient lesions was achieved. Clinical assessments were conducted before starting treatment, at 1 month as a midpoint evaluation, and after the final treatment session. RESULTS: Patients treated with the PDL reached a > or = 90% clearance of their inflammatory lesions after a mean of 4.1 +/- 1.39 sessions, while patients treated with IPL required a mean of 6 +/- 2.05 sessions. Patients treated with the LED required a mean of 10 +/- 3.34 sessions. At the mid-point evaluation, the percent reduction in acne lesions treated with the PDL was 90% or more, in cases of IPL and the LED, the percent reductions were 41.7% and 35.3%, respectively. Laser and light phototherapy sessions were well tolerated with minimal adverse events experienced as being mild and usually self-limiting. CONCLUSIONS: The encouraging results of the present study contributes evidence of phototherapy as useful therapeutic option for treatment of moderate to severe acne, and validates further studies to evaluate treatments with a larger number of patients and for a longer period of follow-up.
Lee SY, Park KH, Choi JW, Kwon JK, Lee DR, Shin MS, Lee JS, You CE, Park MY.
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 Jul 27;88(1):51-67. Epub 2007 May 1.
Light-emitting diodes (LEDs) are considered to be effective in skin rejuvenation. We investigated the clinical efficacy of LED phototherapy for skin rejuvenation through the comparison with three different treatment parameters and a control, and also examined the LED-induced histological, ultrastructural, and biochemical changes. Seventy-six patients with facial wrinkles were treated with quasimonochromatic LED devices on the right half of their faces. All subjects were randomly divided into four groups treated with either 830nm alone, 633nm alone, a combination of 830 and 633nm, or a sham treatment light, twice a week for four weeks. Serial photography, profilometry, and objective measurements of the skin elasticity and melanin were performed during the treatment period with a three-month follow-up period. The subject's and investigator's assessments were double-blinded. Skin specimens were evaluated for the histologic and ultrastructural changes, alteration in the status of matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs), and the changes in the mRNA levels of IL-1ss, TNF-alpha, ICAM-1, IL-6 and connexin 43 (Cx43), by utilizing specific stains, TEM, immunohistochemistry, and real-time RT-PCR, respectively. In the results, objectively measured data showed significant reductions of wrinkles (maximum: 36%) and increases of skin elasticity (maximum: 19%) compared to baseline on the treated face in the three treatment groups. Histologically, a marked increase in the amount of collagen and elastic fibers in all treatment groups was observed. Ultrastructural examination demonstrated highly activated fibroblasts, surrounded by abundant elastic and collagen fibers. Immunohistochemistry showed an increase of TIMP-1 and 2. RT-PCR results showed the mRNA levels of IL-1ss, TNF-alpha, ICAM-1, and Cx43 increased after LED phototherapy whereas that of IL-6 decreased. This therapy was well-tolerated by all patients with no adverse effects. We concluded that 830 and 633nm LED phototherapy is an effective approach for skin rejuvenation.
Khoury JG, Goldman MP.
Use of light-emitting diode photomodulation to reduce erythema and discomfort after intense pulsed light treatment of photodamage.
J Cosmet Dermatol. 2008 Mar;7(1):30-4.
OBJECTIVES: This study evaluates the use of light-emitting diode (LED) photomodulation therapy to accelerate resolution of post-intense pulsed light (IPL) erythema. METHODS: In this split-face study, 15 subjects were randomized to receive LED treatment to one side of the face as determined by computer-generated randomization numbers. All 15 subjects received a single IPL treatment for facial photodamage. Immediately after IPL treatment, one side of the face was treated for 35 s with the LED device. The other side was not treated. Subjects returned 24 h later for a second LED treatment on the same side of the face. Posttreatment erythema was rated on both sides of the face by the blinded investigator and by subjects immediately after IPL treatment, 24 h later, and 1 week later on a scale of 0% (no erythema) to 100% (severe erythema). Patients commented on posttreatment discomfort immediately after IPL treatment. RESULTS: Mean erythema scores on the first visit were significantly higher (P = 0.0054) on the side not treated with LED (52.7 +/- 24.6) than on the LED-treated side (43.3 +/- 21.9). Visit 2 data showed a similar trend (P = 0.0281). The subjects reported similar findings with mean erythema scores on the first visit on the LED-treated side (46.7 +/- 25.3) compared with the untreated side (60.0 +/- 23.3); the difference was significant (P = 0.0382). On the second visit, the mean erythema scores trended lower on the LED-treated side (24.3 +/- 22.1) than on the untreated side (27.9 +/- 25.8), but the difference did not reach statistical significance (P = 0.1365). Erythema scores on both facial sides were 0 for all subjects 1 week after IPL treatment. Four patients commented that posttreatment discomfort was considerably less on the LED-treated side immediately after treatment. CONCLUSION: LED photomodulation treatment may accelerate the resolution of erythema and reduce posttreatment discomfort in IPL-treated patients with photodamage.
Baez F, Reilly LR.
The use of light-emitting diode therapy in the treatment of photoaged skin.
J Cosmet Dermatol. 2007 Sep;6(3):189-94.
BACKGROUND: Light-emitting diode (LED) therapy is an increasingly popular methodology for the treatment of sun damage. Combination use of light wavelengths reported to stimulate collagen synthesis and accelerate fibroblast-myofibroblast transformation may display a composite rejuvenative effect. OBJECTIVE: To clinically assess reduction in sun damage signs following a 5-week course of LED therapy and to assess subject's perception of the treatment. METHODS: Thirteen subjects with wrinkles or fine lines in the periorbital and nasolabial region and those presenting Glogau scale photodamage grade II-III received nine 20-min duration light treatments using the Omnilux LED system. The treatments combined wavelengths of 633 and 830 nm at fluences of 126 and 66 J/cm(2), respectively. Sun-damage reduction was assessed at 6, 9, and 12 weeks by clinical photography and patient satisfaction scores. RESULTS: The majority of subjects displayed "moderate" (50%) or "slight" (25%) response to treatment at investigator assessment. Treatment of the periorbital region was reported more effective than the nasolabial region. At 12-week follow-up, 91% of subjects reported improved skin tone, and 82% reported enhanced smoothness of skin in the treatment area. CONCLUSION: Good response to LED therapy has been shown in this modest sample. Larger trials are needed to assess optimum frequency of light treatments and overall treatment time.
Trelles MA.
Phototherapy in anti-aging and its photobiologic basics: a new approach to skin rejuvenation.
J Cosmet Dermatol. 2006 Mar;5(1):87-91.
Intrinsic aging and photoaging of the face are constantly ongoing, and eventually result in the typical "aged" face, with visible lines and wrinkles at rest, a variety of dyschromia and a tired, dull and lax epidermis over poorly organized elastotic dermal architecture characterized by many interfibrillary spaces. Both ablative and nonablative resurfacing have been reported as solutions, the former providing excellent results, but a long patient downtime, and the latter giving little or no downtime, but less-than-ideal results. In ablative resurfacing, the epidermis is removed and replaced with a "new" epidermis, whereas in the nonablative approach the epidermis is spared through some form of cooling. In both approaches, however, the goal is to create controlled amounts of thermal damage in the dermis to stimulate the wound healing process, thus generating a tighter, better organized, "younger" dermal matrix. A better approach might be to apply prevention, rather than the cure, and to treat subjects in their very early 20s, before even fine lines have begun to appear. This "photoanti-aging" approach could be achieved with the use of very low incident levels of photon energy to stimulate the skin cells, both epidermal and dermal, at cell-specific wavelengths based on the photobiological findings of the literature over the past two decades or so, in order to increase their resistance to the effects of chronological and photoaging. Lasers and IPL systems could be used, but are extremely expensive and therapist-intensive. A new generation of light-emitting diodes (LEDs) has appeared as the result of a spin-off from the US NASA Space Medicine Program, which are much more powerful than the previous generation with quasimonochromatic outputs. These LEDs can offer target specificity to achieve photobiomodulated enhanced action potentials of the skin cells, in particular mast cells, macrophages, endotheliocytes, and fibroblasts, plus increases in local blood and lymphatic flow, in a noninvasive, athermal manner. New phototherapeutic LED-based systems have appeared to meet the need for a less-expensive but clinically useful light source to enable photoantiaging as a reality in clinical practice. Some studies proving the efficacy of LED therapy have already appeared, and based on their results LED therapy represents a potential new approach to prevention in anti-aging, so that further studies are warranted to prove its efficacy.
