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TABLE 1. Parameters of different wavelengths of LED light and their clinical applications BLUE YELLOW RED IR COMBINED Wavelength (nm) 400–470 570–590 630–700 800–1200 Variable Depth of LED light penetration <1mm 0.5–2mm 2–3mm 5–10mm Variable Deepest target Epidermis Papillary dermis Adnexa Adnexa and reticular dermis Variable Studied therapeutic uses • Acne • Combination therapy • Photoaging • Post laser and IPL recovery • Wound healing • Radiation dermatitis • Post-surgical recovery • Post-laser recovery • Skin rejuvenation • Photodynamic therapy • Photodynamic therapy with injection of sensitizer • Sunburn protection • Mucositis • Wound healing • Ulcers • Photorejuvenation • Combination therapy • Acne • Photorejuvenation • Post-procedure recovery • Reduction in skin melanin considered as an alternative treatment for isolated lesions. Light Bioscience of Virginia Beach, Virginia, manufactures a yellow light device, GentleWaves® LED Photomodulation® (590nm). It delivers a 35-second treatment in a patented 102ms pulsed cycle. While pulsed light has been shown to be efficacious during testing, continuous delivery of light was not shown to be efficacious during initial testing of the device.6 Anodyne Therapy, LLC, of Tampa, Florida, markets the MIRE therapy system (890nm). The device is marketed for improving circulation and decreasing pain, stiffness, and muscle spasm. RED LIGHT-EMITTING DIODES Red LEDs have the deepest tissue penetration of the visible wavelengths and are therefore used to target dermal structures, such as adnexa and fibroblasts.13 Red LEDs have been studied for a wide variety of uses, including wound healing, photodamage, the treatment of NMSCs, precancers, warts, and the prevention of oral mucositis in cancer patients. A split-face study of red LED (633nm) in patients who had undergone blepharoplasty and periocular resurfacing demonstrated a statistically significant improvement of edema, erythema, bruising, and pain on the treated side of the face.14 Red LED (633nm) following erbium-doped yttrium aluminum garnet (Er:YAG) ablation of palmoplantar verrucae has been shown to speed recovery.15 A retrospective blinded study by Sakamoto et al16 found aminolevulinic acid (ALA) or methylester aminolevulinic acid (MAL) combined with red LED to statistically improve scar appearance after two or more treatments. In 2011, a prospective, split-face, double-blind, randomized, controlled trial by Sanclemente et al17 found that MAL combined with red LED demonstrated superior efficacy in treatment of global facial photodamage compared with placebo and red LED based on Dover’s modified global photodamage score. The treatment was well-tolerated and resulted in high patient satisfaction in 80.4 percent of subjects.17 A similar prospective randomized trial of MAL- PDT with red light also found global clinical improvement in 10 of 14 patients and histologically found increased collagen fibers and decreased elastic fibers.18 Red LED light appears to be a promising treatment option for premalignant and malignant lesions. Successful treatment of NMSC with red LED was demonstrated by Calzavara-Pinton et al19 who used two MAL-PDT sessions to treat 112 biopsy-proven Bowen’s disease (BD) lesions. The complete response rates were 73.2 percent at three months and 53.6 percent at 24 months post-treatment. They found that the best clinical response was in well-differentiated (Broders’ scores I and II) BD lesions and worst in nodular, invasive, and/or poorly differentiated (Broders’ scores III and IV) BD lesions.19 NMSC with red LED PDT was demonstrated by Wong et al20 who used a red (630nm) custom-made LED array in conjunction with 2% ALA to 38 [June 2015 • Volume 8 • Number 6] 38PDF Image | Light-emitting Diodes A Brief Review and Clinical Experience
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