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Avci et al. Page 10 significant increase in NGF release from keratinocytes was reported. 66 Additionally, the medium from HeNe laser irradiated keratinocytes stimulated [3H]thymidine uptake and proliferation of cultured melanocytes. Another study by Lan et al. demonstrated that the HeNe laser (632.8 nm, 1 J/cm2 and 10 mW) stimulates melanocyte proliferation through enhanced α2β1 integrin expression88 and induces melanocyte growth through upregulation of the expression of phosphorylated cyclic-AMP response element binding protein (CREB) which is an important regulator of melanocyte growth.88 ECM molecules are also important elements of the pigmentation process due to their regulatory roles for physiological functions of pigment cells including morphology, migration, tyrosinase activity and proliferation.99–101 Type IV collagen is present in the basement membrane and is known to have an intricate relationship with melanocytes in the epidermis such as increasing melanocyte mobility.89 Following, HeNe irradiation, the attachment of melanocytes to type IV collagen was found to be significantly enhanced which also indicated modulation of melanocyte physiological function by HeNe laser irradiation.88 Furthermore, among various ECM proteins found in the dermis, fibronectin was shown to have significant effects on both differentiation and migration of cultured melanoblasts and melanocytes.102,103 In 1983, Gibson et al. demonstrated that the physical distribution of fibronectin in vivo was closely associated with the migration path undertaken by melanoblasts during the repigmentation process of vitiligo.104 Based on Lan at al.’s findings, an immature melanoblast cell line (NCCmelb4) showed significant decrease in the attachment to fibronectin following HeNe laser treatment while the attachment of a more differentiated melanoblast cell line (NCCmelan5) to fibronectin increased about 20% following 1 J/cm2, 10 mW HeNe laser treatment.89 Lastly, expression of integrin a5b1 which mediate locomotion of pigment cells was found to be enhanced on NCCmelb4 cells.89 LLLT for Producing Depigmentation Most studies carried out for vitiligo show the stimulatory effects of LLLT on pigmentation; however in a previously mentioned study, while testing effects of blue and red laser for acne treatment, an interesting and unexpected result was found for the first time.49 Combining both blue (415 +−5 nm, irradiance 40 mW/cm2, 48 J/cm2 ) and red (633 +- 6 nm, 80 mW/cm2, 96 J/cm2 ) light produced an overall decrease in the melanin level. Instrumental measurement results showed that melanin level increased by 6.7 (the median of differences between the melanin level before and after one treatment session) after blue light irradiation without a statistical significance (P > .1), whereas it decreased by 15.5 with statistical significance (P < .005) after red light irradiation. This finding may have some relationship with the laser’s brightening effect of the skin tone, which 14 out of 24 patients spontaneously reported after the treatment period. However as of today, no other studies investigated or reported similar decrease in melanin levels following red light irradiation. Considering that different parameters are used for vitiligo and acne treatment, different effects of red light on the same tissue might be due to the biphasic effects of LLLT.18,19 LLLT for Hypertrophic Scars and Keloids Hypertrophic scars and keloids are benign skin tumors that usually form following surgery, trauma, or acne and are difficult to eradicate. Fibroblastic proliferation and excess collagen Semin Cutan Med Surg. Author manuscript; available in PMC 2014 August 08. NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author ManuscriptPDF Image | Low-level laser (light) therapy (LLLT) in skin: stimulating, healing, restoring
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