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Figure 3. Evaluation of rosacea in a 44-year-old patient with rosacea for 15 years who received nine total treatments on the nose and left and right malar cheeks PDT, and IR therapies have been shown to have the REFERENCES response rate suggesting that it not be used as first-line therapy. The authors’ own experience with photomodulated yellow LED studied a small number of patients and does not allow for any definitive statements to be made about the yellow LED device. Nevertheless, the mixed results, they believe, are more a function of the energy settings used than a reflection on the technology as a whole. Indeed, the beneficial use of LED for phototherapy exists, but improved data in fluence parameter use must be explored. The authors also suggest that additional randomized, controlled, blinded trials be completed with red, yellow, blue, and IR LED in order for definitive practice guidelines to be made. As LED device use expands and their indications become better defined, more efficacious treatments will be available. This is an exciting field that has yet to reach its full potential. greatest success as dermatologic therapies for acne, 1. photodamage, wrinkles, and scar appearance. The double- blind, randomized, control trial by Kwon et al59 has shown 2. effective treatment of mild-to-moderate acne using combination blue-red LED phototherapy. In treating global 3. photodamage, fine lines, mottled pigmentation, tactile roughness, sallowness, erythema, and telangiectasia, a prospective, split-face, double-blind, randomized, placebo- controlled trial by Sanclemente et al17 on 48 patients found 4. that MAL-red PDT had superior efficacy compared to placebo. A similar prospective, randomized trial also found global clinical improvement of photodamage treated with MAL-red PDT.18 Wrinkle severity was statistically 5. significantly reduced by red LED, IR, and a combination of both in a prospective, placebo-controlled, double-blind, split-face trial by Lee et al.50 6. Scar appearance has been shown to have statistically significant improvement as determined by three board- certified dermatologists after ALA/MAL-PDT treatments based on the retrospective study of 21 patients by 7. Sakamoto et al.16 Although these studies have demonstrated some of the beneficial uses of LED therapy, there are other randomized, controlled trials that have shown the ineffectiveness of LED 8. therapies. For example, yellow LED alone has been shown in a randomized, controlled, double-blind study to not prevent radiation dermatitis in patients with breast cancer.38 A retrospective study by Berking et al29 on the treatment of necrobiosis lipoidica with MAL/ALA-PDT showed a low 9. Calderhead RG. The photobiological basics behind light-emitting diode (LED) phototherapy. Laser Therapy. 2007;16:97–108. Barolet, DB. Light-emitting diodes (LEDs) in dermatology. Semin Cutan Med Surg. 2008;27:227–238. Barolet D, Roberge C, Auger F, et al. Regulation of skin collagen metabolism in vitro using a pulsed 660 nm LED light source: clinical correlation with a single-blinded study. J Invest Dermatol. 2009;129:2751–2759. Almeida Issa MC, Piñeiro-Maceira J, et al. Immunohistochemical expression of matrix metalloproteinases in photodamaged skin by photodynamic therapy. Br J Dermatol. 2009;161:647–653. McDaniel DH, Weiss RA, Geronemus R. Light-tissue interactions I: photothermolysis vs photomodulation laboratory findings. Lasers Surg Med. 2002;14:25. Weiss RA, McDaniel DH, Geronemus RG, et al. Clinical experience with light-emitting diode (LED) photomodulation. Dermatol Surg. 2005;31(9 Pt 2):1199– 1205. McDaniel DH, Weiss RA, Geronemus RG, Mazur C, Wilson S, Weiss MA. Varying ratios of wavelengths in dual wavelength LED photomodulation alters gene expression profiles in human skin fibroblasts. Lasers Surg Med. 2010;42:540–545. Weiss RA, Weiss MA, Geronemus RG, McDaniel DH. A novel non-thermal non-ablative full panel LED photomodulation device for reversal of photoaging: digital microscopic and clinical results in various skin types. J Drugs Dermatol. 2004;3:605–610. Shnitkind E, Yaping E, Geen S, et al. Anti-inflammatory 42 [June 2015 • Volume 8 • Number 6]PDF Image | Light-emitting Diodes A Brief Review and Clinical Experience
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