24TH Annual Meeting Illuminating Medical Aesthetics: Shining a Light on Low-Level Light Therapy In the Medical Esthetic Practice Sam Shatkin, MD Upon completion of this presentation, the participants will self-report an increase in knowledge about: A. The science of LLLT and how to effectively integrate LLLT into their medical practice. Disclosure: Nothing to Disclose
Slide 1 Illuminating Medical Esthetics Shining a Light on Low-Level Light Therapy in the Medical Aesthetic Practice Skin Care 2018-SPSSCS New York, NY Dr. Samuel Shatkin Jr. MD FACS Member ASPS, ASAPS, A4M, ASLSM Assistant Professor SUNY@Buffalo Slide 2 Nothing to Disclose Slide 3
Slide 4 Today s Agenda 1. Understanding Light Therapy The science, what it is and how it works 2. Why LED Light Therapy? Benefits 3. Application in Aesthetic Medicine Uses Slide 5 Slide 6 The Art
Slide 7 The Science Slide 8 Science-Light Slide 9 LLLT Low Level Light Therapy
Slide 10 Introduction to LLLT The day may not be far off when most homes will have a light source (most likely a LED device) to be used for aches, pains, cuts, bruises, joints, and which can also be applied to the hair and even transcranially to the brain. Boston s Mass General Hospital, the Harvard School of Medicine and the Harvard-MIT Division of Health & Sciences (Annals of Biomedical Engineering, Feb 2012. The Nuts & Bolts of Low Level Laser (Light) Therapy) Slide 11 Burns 3 Clinical Applications for Light Therapy Muscle Pain Joint Stiffness 1 Muscle Spasms Pain Mgmt Joint Pain Muscle Stiffness Micro Circulation Contusions Trauma Recovery Wound Care Post- Surgery Recovery Accelerated Cellular Healing Hair Skin Growth Care? Diabetic Lesions Decubitus Ulcers Kill P. Acnes Skin Elasticity Reduce Wrinkles & Fine Lines Skin Care Skin Texture Fat Skin Reduction Care? Stimulate Collagen Production Skin Pigment Slide 12 What is Low Level Light Therapy? The application of specific wavelengths of light to tissue to obtain therapeutic benefits Category: Low Level Light Therapy Includes LED & Cold LASER (under 1W power) Adjunctive Therapy to LASER Variety of applications across many medical fields
Slide 13 What is LLLT? Think of it as a battery charger for compromised cells... Light source emits photons Photons absorbed by mitochondria and cell membranes Causing elevation of ATP synthesis Increased ATP causes metabolic events Nitric Oxide-relaxed muscle in vessels Increased circulation Slide 14 Electro Magnetic Spectrum 13 Slide 15 Shining Light on Skin
Slide 16 Non-Invasive Penetration Blue Red Near- IR Slide 17 Requirements for Efficacy 1. Specific Wavelengths 3. Treatment Time Therapeutic Effect 2. Energy Delivered 4. Proximity to Skin Slide 18 Emissions Proximity Inverse Square Law: Distance doubled from the skin, absorption of the light energy is diminished by 4 times. 17
Slide 19 Structural Change Collagen Elastin No LED LED Fig. 8 No LED LED Clinics in Plastic Surgery 2016 43, 541-550DOI: (10.1016/j.cps.2016.03.011) Copyright 2016 Elsevier Inc. Terms and Conditions 18 Slide 20 Wound Healing 1/2 Healing Time Clinics in Plastic Surgery 2016 43, 541-550DOI: (10.1016/j.cps.2016.03.011) Copyright 2016 Elsevier Inc. Terms and Conditions Fig. 9 19 Slide 21 Cells Affected by LED P. acnes bacteria: Blue Bacteriocidal Fibroblast Cells: Red, a little IR Promote Collagen and Elastin Fibers Keratinocytes: Red and IR equally Structural strength and skin clarity, tone, texture Mast Cells: Red, near IR Inflammatory reactions. Neutrophil Cells: (leukocytes) Little red, mostly IR Defense in the inflammatory process. Macrophage Cells: (leukocytes) Red and IR Activates specific immune responses.
Slide 22 Why Use LED Therapy Aging, illness and injury to the body. Alternative Medicine is becoming a focus. Convenient and Safe Use Economic Market / Financial Benefits 21 Slide 23 LED Practice Benefits Features Benefits Minimal Investment Increase Services Practice Differentiation Non-Attended Modality Tx Many Conditions Quick Return Enhances Bottom Line Competitive Advantage Efficient Versatile Resale? Generate additional $$ Adjunct to other treatments Slide 24 Clinical Use in the Plastic Surgery Practice Stand Alone for Facial Rejuvenation Acne Pre Surgery/Post Surgery Post Laser Microneedling/Peels Wound Healing Hair Regrowth Fat Reduction With PDTx New Tx? 23
Slide 25 Anti-Aging Sun Damage 4 years later with skin protection and therapy Slide 26 Anti-Aging Sun Damage 4 years later with skin protection and therapy Slide 27 Anti-Aging Therapy Before LED Tx 3 x weekly for 4 weeks 12 weeks after final treatment
Slide 28 Anti-Aging Therapy Before LED Therapy 3 x weekly for 4 weeks Just before start of last treatment Slide 29 Anti-Aging Therapy Before LED Therapy Then: 3 x weekly for 4 weeks Just before start of last treatment Slide 30 Anti-Aging Therapy Before LED Therapy Then: 3 x weekly for 4 weeks Just before start of last treatment
Slide 31 Acne Therapy Before LED Therapy 5 weeks later 2 x weekly No other modalities used Slide 32 Acne Therapy Before LED Therapy 8 weeks later 2 x weekly No other modalities used Slide 33 Post Laser Therapy Immediately after Fractional Laser 1-30 Min. LED Therapy 32
Slide 34 Post Laser Therapy Immediately after Ablative Laser 6 Days Later after 2-30min LED sessions 33 Slide 35 Post Laser Therapy Before Ablative Laser 30 Days Later after 4-30min LED 34 sessions Slide 36 Post Laser Therapy Before Ablative Laser 30 Days Later after 4-30min LED 35 sessions
Slide 37 Post MicroNeedling After Microneedling After 30 Minute LED Treatment 36 Slide 38 Post MicroNeedling After Microneedling After 30 Minute LLLT 37 Slide 39 Wound Healing Bruise before LED Treatment Bruise after one 30 min. LED 38 treatment
Slide 40 Hair Regrowth Efficacy and Safety of a Low-level Laser Device in the Treatment of Male and Female Patter n Hair Loss: A Multicenter, Randomized, Sham Device -controlled, Double-blind Study- Am J Clin Dermatol 2014; 15(2): 115 127 39 Slide 41 Optimizing Results Clinical outcomes are affected by: Frequency of use Total number of treatments Proximity to the light source Inherent health of cells being treated Compliance to protocol Slide 42 Aesthetic Protocols Treatments Acne Skin Rejuvenation Post Laser, RF, Microneedling Hair Regrowth Post Surgical
Slide 43 Acne Treatments- Blue Wavelength IPL and/or Peel with facial 1-30 min treatment 2 tx per week for 4 weeks Home skin care regimen Slide 44 Skin Rejuvenation Treatments- Red and near IR Skin tx-peel, Microneedling, RF 1-30 min treatment 3 tx per week for 4 weeks Home skin care regimen Slide 45 Post Ablative Laser Treatments- Red and near IR Immediately 1-30 min treatment Each PO visit- 1-30 min treatment Day 2 and Day 6
Slide 46 Post Surgery Pain- near IR During PO visit 1-30 min treatment Swelling/Redness- Red and near IR During PO visits 1-30 min treatment 2-30 min tx per week for 2 weeks Slide 47 Conclusion Understanding Light Therapy Why LED Light Therapy? Application in Plastic Surgery Practice Sound Scientific and Clinical Evidence Expanding Applications Clinical Outcomes Financial Benefits Low Cost SETS YOUR PRACTICE APART! Slide 48 Questions?