Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut elit tellus, luctus nec ullamcorper mattis, pulvinar dapibus leo.

Rejuvenation by sequential treatment combining red LED, LED and infrared laser. Milta Panel.

EVERYTHING YOU WANT TO KNOW

LED & LASERS PUT THE PHOTOBIOMODULATION

AT THE HEART OF TISSUE REPAIR

Dr. Luc BENICHOU, MD

University of Paris-Est Créteil
docteurbenichou@gmail.com

SUMMARY

  • Interest in non-thermal phototherapy (Low Level Light Therapy or LLLT) has been growing steadily over the last decade in the broad field of anti-aging therapies.

  • Implemented thanks to the technological conquests of LEDs and low-power lasers, it is based on a very complex "natural" biophysical mechanism, the "photobiomodulation"..

  • Through numerous biological, biophysical and clinical studies, it opens the door to new therapeutic gestures, autonomous and/or complementary, optimized in terms of frequency, duration of exposure, power and wavelength.

  • Beyond the skin surface, the oral mucosa, muscles and joints, its field of action now extends to gynecology, ophthalmology, ENT, neurology...

LIGHT IS AT THE HEART OF PHYSICS... AND OF PHYSICAL AGENTS...

It is from the beginning of the Ultraviolet to the end of the Infrared, passing of course by the visible, that is located this part of the electromagnetic radiation which one names "light". It is however its central fraction, going from the beginning of the blue light to the very beginning of the infra-red, that we qualify as "visible".

Let's remember that:

  1. that the wavelengths of the photons, of this visible part, extend from 400 to 800nm and that the wavelengths of the photons commonly used in therapy extend from UVB (Excimer Laser at 308nm) to the beginning of the far infrared at 10.000nm (CO2 Laser).
  2. That the energy carried by light is proportional to the frequency of photons and therefore inversely proportional to wavelengths ... a blue photon carries twice as much energy as a red photon.
  3. that the energy transmitted per unit area is proportional to the number of photons delivered... this is the principle of the magnifying glass in the sun... and that of the lasers, which concentrate the photons in particular after having selected them.
  4. that a photon is a wave that can be interpreted as a particle... that has no mass!
  5. that the photons will "excite" the atoms by giving up their energy to the electrons, which will thus move away from the nucleus by changing their orbit... in doing so, they will be able to trigger chemical reactions which are, all and always, due to exchanges of electrons between the atoms.
  6. that finally if the electrons are not thus engaged in a chemical reaction they will by a phenomenon of de-excitation re-emit in one go or by intermediate stages the energy of the absorbed photon...

Consubstantial with matter, light is thus at the heart of life, between electrons and chemical reactions, an essential actor of quantum electrodynamics.

Device composed of 3 vaginal probes separating the 3 wavelength domains used in Gynecology (Blue - Red - Infrared) in the treatment of inflammatory, infectious and painful pathologies of the mucosa. Qlarity Floreo.

Probe intended for the treatment of inflammatory, infectious and painful pathologies of the vaginal mucosa associating Blue LED at 415nm, Red at 660nm, Infrared and Nanopulsed Laser at 850nm. Milta Gyneco.

...AND THE ENERGY PROVIDED BY LIGHT HAS THUS REVEALED ITS ESSENTIAL ROLE AT THE HEART OF BIOLOGY!

Let's make a quick overview, since the year 2001 when a Conference organized by NASA and the American Institute of Physics had contributed in a decisive way to promote the repair mechanisms of photons (1), highlighted at the end of the 1980s by a famous Russian biologist, Tina Karu (2) .

She had produced a remarkable work of molecular and cellular biology, identifying one of the essential steps of the electron transport chain, complex IV, i.e. Cytochrome C oxidase. This is a metalloprotein allowing electrons to pass between Copper and Iron.

By stimulating it, light accelerates the production of ATP and physiological free radicals. This demonstration has been a unique dogma for about thirty years. However, as of 2015, the work of Physicochemists has profoundly changed this dogma (4) (5) .

The two essential targets of the light turned out to be water and oxygen. The mass of a cell is indeed constituted at 70% by H2O, but that represents 99% of the molecules present! We are indeed built with 99% of water molecules! On the other hand H2O, a fundamentally polar molecule, envelops all the walls (capillary, cellular, nuclear, mitochondrial, etc.), all the structures, all the proteins, with a film 2 to 3 molecules thick (IWL for Interfacial Water Layer), and this film permanently manages the entry and exit of hydrophilic molecules (6) (7) .

THE SKIN AND ITS APPENDICES, THEN THE MUCOUS MEMBRANES, HAVE THUS BECOME THE FIELDS OF EXCELLENCE FOR PHOTOBIOMODULATION...

Thousands of publications testify to this. For example, here is what can be found today on Google Scholar using these keywords: "Anti-aging low level laser therapy"...000 publications and 16,900 since 2017. "Aesthetic low level laser therapy"... 300 publications and 15,800 since 2017. I highlight one for the excellence of its references and conclusions...It dates from 2013 and its title speaks for itself Low-level laser (light) therapy (LLLT) in Skin: Stimulating, Healing, Restoring.(3) The signatories are Harvard Medical School, the Departments of Dermatology at Massachusetts General Hospital and the Department of Life Sciences at the renowned M.I.T.

WHAT ARE THE PRINCIPLES OF THERAPEUTIC USE OF PHOTOBIOMODULATION IN ANTI-AGING MEDICINE?

In addition to the stimulation of the respiratory chain, it is mainly on the interfacial water films (IWL) that the light acts. It does so by modifying the related gradients of temperature, pressure, density, and therefore viscosity, and thus accelerating the movement of electrolytes and other hydrophilic molecules. Within complex IV of the respiratory chain, Cytochrome C Oxidase is a protein that does not escape this reality. This stimulates the transport of electrons. Last step of the respiratory chain, the enzyme responsible for the production of ATP, the ATPase, is a kind of engine, lubricated by the film of water which surrounds it.

Under the action of light, especially in the near infrared (800nm to 1000nm), the density of water and thus its viscosity decrease, accelerating the speed of rotation of the ATPase and thus the production of ATP (7) .

On the other hand, at the level of the same complex IV, the light, especially in the red and especially around 635nmThis is done by exciting the "ordinary" form of oxygen, the "triplet" oxygen, to transform it into the infinitely more reactive "singlet" oxygen. It does this by exciting the "ordinary" form of oxygen, the "triplet" oxygen, to transform it into "singlet" oxygen, which is infinitely more reactive (8) 

All in all, it is the cellular and therefore tissue energy balance that is improved by the action of light, with the main consequences being a rationalization of the inflammatory response, a rapid and prolonged analgesic effect, and an acceleration of cellular synthesis and mobility (9)(10) (11)

Finally, we must take into account very broad anti-infectious effects of blue light (from 415nm to 470nm)(12)

They concern bacteria as well as yeasts, which are very present on mucous membranes, and parasites. In this respect, the skin covering, especially on the face, is a habitat for proprionibacterium acnes and for the demodex mite very frequently present in rosacea.

WHAT ARE THE RULES OF USE?

In all cases, the light source should be placed as close as possible to the area to be treated. Depending on the power delivered by the device used, the duration of treatment using sequentially one or more wavelengths, may vary from 3′ to 10′. As a rule 5′ will suffice.

The red and especially the infrared wavelengths will always be used, the anti-infectious role of blue being circumstantial and therefore limited. When the skin condition is not optimal before a surgical operation or an aggressive act, it is recommended to perform a pre-operative stimulation session 1 to 3 days before...

A short session of about 3 minutes is desirable in post-operative or post-aggressive care, immediately before dressing.

Another session will be performed after the dressing change or during the control visit. Finally, it is sometimes advisable to perform one or two maintenance sessions per month or every two months.

ILLUSTRATIONS OF THE USES OF PHOTOBIOMODULATION IN THE HUMAN CLINIC.

  1. Helmet adapted to scalp treatment by sequential LED and laser treatment using alternately Blue, Red and Infrared (LED and nanopulsed laser). Milta Helmet.
  2. Treatment of rosacea and acne using mostly blue light sources (470nm LED). Milta Panel.
  3. Treatment of abdominal stretch marks by red LED and Infrared. Milta Panel.
  4. Rejuvenation by sequential treatment combining red LED, LED and infrared laser. Milta Panel.
  5. Treatment of dry eye syndrome and palpebral rosacea by blue LED. Prototype used in a pilot study (Closed eyelid and eye protection). MiltaPod.
  6. Prototype device intended for otitis externa (treatment of the auricle and the external auditory canal). Qlarity.
  7. Device composed of 3 vaginal probes separating the 3 wavelength domains used in Gynecology (Blue - Red - Infrared) in the treatment of inflammatory, infectious and painful pathologies of the mucosa. Qlarity Floreo.

BIBLIOGRAPHY

1- Harry T. Whelan, Ellen V. Buchmann, Noel T. Whelan, Scott G. Turner, Vita Cevenini, Helen Stinson, Ron Ignatius, Todd Martin, Joan Cwiklinski, Glenn A. Meyer, Brian Hodgson, Lisa Gould, Mary Kane, Gina Chen and James Caviness. NASA light emitting diode medical applications from deep space to deep sea. AIP Conference Proceedings 552, 35 (2001).

2- Karu TI A suitable model for wound healing: how many times are we tostumble over the same block? Lasers in Surgery and Medicine, (01 Jan 1999), 25(4):283-284

3- Avci P, Gupta A, Sadasivam M, et al. Low-level laser (light) therapy (LLLT) in skin: stimulating, healing, restoring. Semin Cutan Med Surg.2013;32(1):41-52.

4- Sommer AP, Schemmer P, Pavláth AE, Försterling HD, Mester ÁR, Trelles MA. Quantum biology in low level light therapy: death of a dogma. Ann Transl Med 2020; 8(7):440. doi: 10.21037/atm.2020.03.159

5- Andrei P. Sommer Mitochondrial cytochrome c oxidase is not the primary acceptor for near infrared light-it is mitochondrial bound water: the principles of low-level light therapy Annals of Translational Medicine Vol 7, Supplement 1 (March 2019).

6- Andrei P. Sommer. Photobiomodulation, Photomedicine, and Laser Surgery. Revisiting the photon/cell interaction Jun 2019.336-341.

7- Sommer, A., Haddad, M. & Fecht, H. Light Effect on Water Viscosity: Implication for ATP Biosynthesis. Sci Rep 5, 12029 (2015).

8- A Blázquez-Castro - Direct 102 optical excitation: A tool for redox biology Elsevier 2017.

9- Nicoleta Herascu, Bogdan Velciu, Mihaela Calin, Dan Savastru, and Camelia Talianu. Low Level Laser Therapy (LLLT) Efficacy in Postoperative Wounds. Photomedicine and Laser Surgery. Feb 2005.70-73. Published in Volume: 23 Issue 1: March 1, 2005.

10- de Holanda Araujo, A.M.P., de Sena, K.R.R., da Silva Filho, E.M. etal. Low-level laser therapy improves pain in post-cesarean section: a randomized clinical trial. Lasers Med Sci 35, 1095-1102 (2020).

11- Ezzati K, Fekrazad R, Raoufi Z. The Effects of Photobiomodulation Therapy on Post-Surgical Pain. J Lasers Med Sci. 2019;10(2):79-85. doi:10.15171/jlms.2019.

12- Raquel Ferrer-Espada, Ying Wang, Xueping Sharon Goh, Tianhong Dai. Antimicrobial Blue Light Inactivation of Microbial Isolates in Biofilms. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

13- Vinh Van Tran, Minhe Chae, Ju-Young Moon, Young-Chul Lee, Light emitting diodes technology-based photobiomodulation therapy (PBMT)for dermatology and aesthetics: Recent applications, challenges, and perspectives, Optics & Laser Technology, Volume 135, 2021.

14- S Moskvin - "Western School" vs "Eastern School" Journal of Lasers in Medical Sciences, Vol. 12, Oct. 2021, p. e66, https://journals.sbmu.ac.ir/jlms/article/view/34501.

15- Zhu, Qin et al. "Near Infrared (NIR) Light Therapy of Eye Diseases: A Review." International journal of medical sciences vol. 18,1 109-119. 1 Jan. 2021,

16- Amanda Rodrigues Scheffer, Maria Fernanda Capoani GM, Renata da Silva Cardoso RT. Photobiomodulation Therapy in Hearing Related Aspects: an Integrative Bibliometric Study. Int Tinnitus Journal. 2021;25(1):59-65.

17- Salehpour, Farzad, Gholipour-Khalili, Sevda, Farajdokht, Fereshteh, Kamari, Farzin, Walski, Tomasz, Hamblin, Michael R., DiDuro, Joseph O. and Cassano, Paolo. "Therapeutic potential of intranasal photobiomodulation therapy for neurological and neuropsychiatric disorders: a narrative review." Rev Neurosci. 2020 Apr 28; 31(3): 269-286.

Rejuvenation by sequential treatment combining red LED, LED and infrared laser. Milta Panel.

en_US