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Journal of Photochemistry and Photobiology B: Biology 88 (2007) 51–67 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 Seung Yoon Lee a,*, Ki-Ho Park b, Jung-Woo Choi c, Jung-Kyun Kwon d, Doo Rak Lee a, Mi Sun Shin a, Jee Sung Lee e, Chung Eui You a, Mi Youn Park a a Department of Dermatology, National Medical Center, 18-79, Euljiro 6-ga, Jung-ku, Seoul, Republic of Korea b Quantitative Real-Time PCR Lab, Clinical Research Institute, Seoul National University Hospital, 28, Yeongun-dong, Jongno-ku, Seoul, Republic of Korea c Department of Pathology, Korea University Hospital, 126-1, Anam-dong 5-ga, Seongbuk-ku, Seoul, Republic of Korea d Department of Electron Microscope Laboratory, College of Medicine, Hanyang University, 17, Haengdang-dong, Seongdong-ku, Seoul, Republic of Korea e Division of Biostatistics, Graduate School of Public Health, Korea University, 126-1, Anam-dong 5-ga, Seongbuk-ku, Seoul, Republic of Korea Received 8 January 2007; received in revised form 10 April 2007; accepted 11 April 2007 Available online 1 May 2007 Abstract Light-emitting diodes (LEDs) are considered to be effective in skin rejuvenation. We investigated the clinical efficacy of LED photo- therapy 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 quasi- monochromatic LED devices on the right half of their faces. All subjects were randomly divided into four groups treated with either 830 nm alone, 633 nm alone, a combination of 830 and 633 nm, or a sham treatment light, twice a week for four weeks. Serial photo- graphy, 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-a, ICAM-1, IL-6 and connexin 43 (Cx43), by utilizing specific stains, TEM, immu- nohistochemistry, and real-time RT-PCR, respectively. In the results, objectively measured data showed significant reductions of wrin- kles (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. Ultrastruc- tural 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-a, 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 633 nm LED phototherapy is an effective approach for skin rejuvenation. Ó 2007 Elsevier B.V. All rights reserved. Keywords: Light-emitting diodes; Light therapy; Phototherapy; Photorejuvenation; Skin rejuvenation; Non-ablative rejuvenation 1. Introduction * Corresponding author. Tel.: +82 2 2260 7315; fax: +82 2 2277 0915. Aging skin presents various unpleasant-looking mor- E-mail address: drlsy96@hotmail.com (S.Y. Lee). phologic changes such as wrinkles, dyspigmentation, telan- 1011-1344/$ - see front matter Ó 2007 Elsevier B.V. All rights reserved. doi:10.1016/j.jphotobiol.2007.04.008 www.elsevier.com/locate/jphotobiolPDF Image | LED phototherapy for skin rejuvenation
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