Denise Baker, MD Denise Baker, MD The following potential conflict of interest relationships are germane to my presentation. Speakers Bureau: Sciton Laser, Johnson & Johnson Light Emitting Diodes reserved. 1
LED Categories Yellow 580-600nm Blue 410-417nm Red 600-660nm Mixture Red LEDs 630-660nm NASA Studies on Wound Healing Vasodilation Blood Flow Oxygenation PDT with ALA Blue LEDs 412-417nm ACNE Suppression FDA Cleared 15-20 Minutes Exposure Multiple Treatments PDT With ALA/Levulan reserved. 2
Yellow LEDs 590nm 35 second Pulsed Technology Light Activation of Fibroblasts Collagen stimulation Collagenase/MMP Suppression FDA Cleared for wrinkle reduction and Skin Rejuvenation The Theory of The use of low intensity light therapy to non-thermally modulate the activity of living cells Using LED light energies but modulating various settings, Photomodulation can: Photo activate cells to produce collagen Photo inhibit cells to suppress collagenase reserved. 3
Photoactivation of Cells Promotes Collagen & Elastin Photoinhibition of Cells Suppresses Collagenase & MMPs 35 Second Treatment Code Required for Non-Thermal Light Activation 590nm Pulsing Yellow LED Arrays Key to Photomodulation LED Mechanisms of Action Mitochondria O 2 H + cyst c Fe Cu Heme Ligand ADP+P i ATP H + Mitochondrial Inner Membrane H 2 O reserved. 4
The Human Cell The Factory Human Fibroblast Cell Mitochondria The Power Plant Collagen Vs. Collagenase Structural Support of the Skin Adds to Elasticity of the Skin Thickens & Strengthens Skin Essential for Skin Fitness MMP Enzyme dissolves & transports Damaged Collagen UV Sun Exposure & Smoking will Trigger Collagenase Production Non-Ablative Thermal Injury Stimulates Collagen & Collagenase LED photomodulation post Laser will slow collagenase production LED photomodulation can decrease all MMPs Collagenase Damage/Aging 59-yo identical twins: one did not smoke Smoker Non-Smoker Photo credit: Dermatology Times (February 2000) reserved. 5
Photomodulation vs. Current Laser Therapies PHOTOMODULATION PHOTOTHERMOLYSIS Non-Ablative Very Low Level Non-Ablative Lower Level Energy Ablative Higher Level Energy Photomodulation Non-ablative Selective Photobiochemical Photothermal Photothermal Non- Selective Photothermal Laser vs. LED Lasers & Intense Pulsed Light Thermal (photothermolysis) Discomfort Injury/wound to skin Slower treatment time High energy LED Photomodulation Non-thermal (photomodulation) No discomfort No injury Faster treatment times Low energy reserved. 6
Benefits Softer, Smoother Skin Better Skin Appearance, Less Dull Creamy Looking Skin Softens Skin Redness Reduction of Fine Lines and Wrinkles Better Skin Tone & Texture GLOBAL SKIN IMPROVEMENT Protocol Series of 8 to 10 treatments Once a week to get skin looking & feeling great Clean Dry Skin Critical Exfoliation before allows better light penetration Monthly maintenance to keep skin looking & feeling great When Will You See Improvement? 4-8 Treatments Smoother Softer Better Looking Skin Decreased Erythema 2-3 months post 8-10 Treatments Wrinkle Reduction Pore Size Reduction Collagen takes 60-90 days to remodel reserved. 7
(LED device alone) POST reserved. 8
(LED device alone) POST (LED device alone) POST (LED device alone) POST reserved. 9
(LED device alone) POST Progressive Improvement 1, 8, 16, 24 weeks post tx Histopathology Results Collagen I POST MMP-9 POST reserved. 10
Histopathology Results (LED device alone) POST (1 week) Immunofluorescence microscopy - MMP-3 Primos Digital Surface Profilometry (LED device alone) POST (57-year-old photoaged female) Pre treatment 1 month post 8 treatments David H. McDaniel, M.D. High resolution ultrasound skin imaging (Dermascan) David H. McDaniel, M.D. reserved. 11
Histopathology Results IL-6 - Marker showing decreased inflammation in the skin POST (4 months) Progressive Improvement % change improvement from 1 week 2 months and from 2 months 4 months Periorbital 100% 90% 80% 70% % Improvement 60% 50% 40% 30% 20% 10% 0% Global Pores Redness 1 week post 2 months post 4 months post Reverses Acute UV Induced Matrix Enzyme Expression Robert Weiss, MD David H. McDaniel, MD Roy Geronemus, MD Margaret Weiss, MD John Newman, MD April 2004 ASLMS Annual Meeting Dallas reserved. 12
Sunburn R Right side treated with post UV exposure (RT-PCR) 3 UVA 1 UVA 1 MMP-1 I 2 Relative Expression 1 0-1 II I II -2-3 1 hr 4 hr Human Fibroblasts Combination Therapy LED can be used as a stand-alone treatment OR in combination with other regimens LED + Photofacial Turns on collagen; Turns off collagenase & inflammation Speeds recovery and increases results from photofacial LED + Lasers Quenches thermal injury Decreases edema & erythema to enhance laser procedures LED + Botox Diminishes fine lines & wrinkles Smoothes and refreshes skin LED + Microdermabrasion Treats all layers of the skin with exfoliation & dermal remodeling LED + Chemical Peels Stimulates dermis, while peels remove damaged outer layers to improve tone & texture reserved. 13
30 20 Combined with IPL Collagen I MMP-1 % of Skin Biopsy Staining for: 10 IPL+GW Collagen I 0 IPL A lone IPL A lone MMP-1 IPL+GW -10-20 -30 Change in % Tissue Stained 1 st Peer Review Published Article June 2003 reserved. 14
Features & Benefits of LEDs No side effects, downtime or pain Remarkably safe and effective for all skin types Non-invasive, non-ablative and non-thermal so there is no injury to the skin surface Fast and convenient - takes less than 5 minutes Treats large areas such as the entire face or chest No aftercare is needed reserved. 15
Benefits Softer, Smoother Skin Better Skin Appearance, Less Dull Softens Skin Redness Reduction of Fine Lines and Wrinkles Better Skin Tone & Texture Global Skin Improvement Summary Safe Simple Risk Free Treatments Painless Patient Friendly Protocols Affordable & Noticeable Benefits Anti-Sun Device Perfect Compliment to Laser/IPL Botox Treatments reserved. 16