Phototherapy using light-emitting diode (LED) lights appears to show much promise not only for rejuvenating the skin, but also for treating medical conditions outside of the cosmetic arena, including Parkinson's disease and loss of eyesight, according to one expert.
"In the cosmetic field, LED photomodulation might really be thought of as the concept of 'light as a drug' rather than light as a selective photothermal destructive device. It is also very complimentary in that it can negate some of the collateral damage from the other modern cosmetic treatments," says David McDaniel, M.D., assistant professor of clinical dermatology and plastic surgery, Eastern Virginia Medical School, and director of Laser Skin & Vein Center of Virginia, Virginia Beach, Va.
"Using LED photomodulation, you show a net increase that is greater than if you were just stimulating the collagen alone," Dr. McDaniel explains.
According to Dr. McDaniel, depending on the photomodulation code, vascular endothelial growth factor (VEGF) can be up-regulated in the skin to speed wound healing. It can also be down-regulated and assist in the treatment of macular degeneration, among other diseases and conditions dependant upon the selected parameters. In some cases, one can achieve a positive or a negative effect on the gene expression for the same gene.
"The photomodulation codes (the combination of treatment parameters) are very important in LED phototherapy and include several variables such as the wavelengths, ratios, colors, energy parameters, and whether the LED is pulsed continuously or not, as well as the pulsing characteristics. This is why every time you change a parameter in the code in clinical studies, you need to repeat the studies, a daunting and painstaking task," Dr. McDaniel says.
"Not all LED devices are created equal, and I believe that the skin effects of the Gentle Waves device as well as a few other LED devices have been well-documented scientifically in both clinical and/or laboratory studies. However, more research and data like those studies is needed for many of the other LED devices, because, unfortunately, many devices have little or no scientific or clinical data to support their claims," he adds.
GENTLE WAVES The Gentle Waves device has a 595 nm/810 nm dual wavelength, which can effectively regulate cell activity without a thermal effect. The primary goal of nonablative thermal skin rejuvenation is the stimulation of new collagen and dermal extracellular matrix substance, which visibly improves the appearance of wrinkles without damaging the epidermis. In order to maximize cosmetic outcomes, Dr. McDaniel often uses Gentle Waves in conjunction with other procedures that cause thermal injury or damage to the epidermis, such as dermabrasion, a chemical peel or IPL therapy, because of the device's anti-inflammatory-type effect.
Depending on the model of the device and the target surface area, treatments can take anywhere from 35 seconds to a few minutes. A typical treatment schedule for the face, neck and décolletage can be applications twice a week for four weeks, for a total of eight treatments. However, the protocol that is used more commonly involves one treatment every one to two weeks, for a total of eight to 12 treatments. According to Dr. McDaniel, patients may choose to just treat themselves at home, or may choose to have the initial series of treatments in the office and then use a home-based unit for maintenance.
"This is one of the major differences between Gentle Waves and some other similar LED devices. Some devices have very long exposure times, so it is one thing to do the treatment in an office setting or in a medical spa efficiently using a large-surface-area LED array panel, but quite another to do the treatment at home using a small LED device," Dr. McDaniel says.
The Gentle Waves procedure is safe (including eye-safe) and painless, and the LEDs are durable as far as handling and vibration (compared to lasers and many other light sources). The LEDs also require low voltage, so electrical hazards and electromagnetic radiation (EMR) issues are not usually a problem.
ADDITIONAL INDICATIONS According to Dr. McDaniel, there is good evidence indicating that LED therapy can disrupt or potentially reverse apoptosis in various cells. The value of this application could turn out to be much more significant than that of current LED use in the cosmetic arena.
Future therapeutic indications with photomodulation can potentially span all medical fields and could include medical applications for burns and wound healing and, potentially, retinal diseases, acute strokes and cardiac events. Other applications could include internal therapy, performed by affixing an LED to an endoscope, or even an implantable LED device that could be activated remotely. This could be used in the pancreas for the treatment of diabetes, or as a device that could potentially trans-illuminate across the cribriform plate and reach the part of the brain responsible for Parkinson's disease.
Disclosures: Dr. McDaniel is listed as an inventor on patents related to LED photomodulation but does not receive any royalties. He has performed LED research and/or consulting in the past for Light BioScience, Gentle Waves and SkinCeuticals. He reports some equity in Light BioScience and Gentle Waves.