LEDs: A TECHNOLOGICAL BREAKTHROUGH

LED lights are now  part of our everyday lives. A LED, or Light Emitting Diode, is a semiconductor which produces light when electric current passes through it. The first LEDs, which were red, yellow and green, were developed in 1962. Nowadays, blue, purple and white LEDs are available.
Over time, scientists have managed to design LEDs capable of producing higher light output than that of incandescent light bulbs and compact fluorescent lamps. For example, LEDs are used in computer  or television screens. They are gradually replacing both fragile and expensive video projector lamps and car headlights. Diodes are also used to light up road edges and walls. The most powerful LEDs are used to light up sea buoys.

LED manufacturers offer a range of wavelengths ranging from 400 to 700 nm.
Unlike conventional lamps, LEDs do not emit UV light. These characteristics are especially important in dermatology. Practitioners can use a wide range of colours and wavelengths to provide appropriate treatments.
In addition to their power, LED lights have a life span ranging from 50 to 100,000 hours (i.e. 20 years). This makes them ten times better than fluorescent lamps and one hundred times better than incandescent light bulbs. LEDs require very little energy in order to work, which can lead to significant energy savings.
Another asset is that standard LEDs barely produce any heat, i.e. they do not burn fingers or skin. This cold light can be used in a variety of skin treatments without any risk of burning or other such risks.

LEDs AND HEALTH

Today, LEDs are being used for medical purposes. Researchers from NASA have discovered that skin which is poorly exposed to natural light does not regenerate so well and, as such, healing is difficult. They came up with the idea of using diodes with wavelengths capable of simulating human cell regeneration mechanisms. American scientists were inspired by the treatments developed around fifteen years ago by Russian researchers who were treating inflammation and healing wounds using a low-powered helium-neon laser.
The use of cold light was thus established.
It was first implemented around ten years ago. Practitioners started to treat actinic keratosis and cancerous skin lesions by exposing them to a combination of white light and a photosensitive topical remedy. The results were extremely convincing and the treatment left no scars. This kind of treatment has come into general use.

The equipment is designed by Biophoton and distributed by Medicaloo for medical and paramedical applications.
For over twenty years, these two players specialising in applying light to health problems have boasted a reputation in the medical world which is second to none.
Some of their patents are exploited by such world-class manufacturers as Matsushita, in Japan.
Their expertise covers the development and manufacture of laser equipment and, of course, LEDs.
Today, Biophoton and Medicaloo manufacture and market Triwings^® and Hydroled^® which revolutionise the use of LED technology. These two pieces of equipment are unique in the world for the way in which they combine different yellow, red and blue light.

• Time programming: 1 to 99 minutes or seconds
• Frequency programming: continuous or pulsed
• Mode: continuous or pulsed light
• Digital display of all settings - Preview of treatment area
• Power supply: 90 to 250V, 50/60 Hz
• Consumption: Hydro 4 kW, LEDs 1.5 kW
• Emitting panels can be oriented in all directions
• Wavelengths: 470 nm, 590 nm, 630 nm, 850 nm
• Adjustable optical power: 3 values
• Power density: up to 100 mW/cm² depending on wavelength
• Wavelengths are mixable
• Device dimensions: 2400x1200x1600 cm Unloaded weight: 280 kgs; water loaded: 770 kgs
• Panel dimensions: 11 panels 85 mm by 210 mm
• Max. height of person: 200 cm

INTERVIEWS WITH DR MICHELE PELLETIER-AOUIZERATE, DERMATOLOGIST AT TOULON SUR MER.

"We are at the start of a revolution". For four years, Dr Michèle Pelletier-Aouizerate has been using LED lamps to treat her patients.
She has been using a Triwings^® lamp for 18 months to take advantage of the power produced by mixing several colours.
Dr Pelletier-Aouizerarte is therefore one of the pioneers of this technology in France.
In several speeches, she has presented the fruit of her experience to her colleagues. And estimates what still has to be done.

When did you do your first work?
I spoke at a conference of the Dermatological Surgery Discussion Group on 6 September 2008. My speech was entitled "The various sources of energy used for skin rejuvenation treatment". It seems to me that, apart from the sources already well identified, such as nutrition or hot light such as lasers and lamps, it is essential to include cold light sources which appear only in the field of these energy sources.
We are only at the beginning of the story. Medical equipment using LED diodes has only been marketed for barely seven years. And still today, the Triwings^® lamp is the only one capable of mixing several colours so that we can benefit from the combined power of several wavelengths. I ended my speech with the question: "Is cold light the dark side of light?"

What are the bases for your observations and experiments?
The first treatments concerned actinic keratosis and cancerous lesions caused by the combined action of aging and exposure to the sun.
Practitioners used the principles of dynamic phototherapy by coating the affected areas with a product before exposing them to LED radiation. The results were very positive. The lesions formed scabs, which fell off without leaving scars. In fact, this treatment is becoming fairly routine. I therefore judged that light action could be used with other treatments.
This year I gave a speech entitled "From colour to care: cell respiration". I considered that after studying the effect of heat, it was time to look at vibration, i.e. wavelength and hence the coloured light produced by these diodes.
Indeed, light is the corollary of colour: No light, no colour; which is defined by its shade, saturation (more or less pure) and its brilliance or luminosity.

Which clinical cases did you present and how was your speech received?
My presentation left the audience rather doubtful. Nevertheless, I presented significant clinical cases, backed up with photographs taken before and after treatment.
During my speech, I presented several cases of treatment of ulcers, scars, stretch marks, jellyfish stings, treatment of acne and burns. But the message is hard to put across. I think that even physicians find it hard to understand the revolution that this method implies. You literally have to think differently. With light, you can treat a scar without using cream, resorb acne spots without antibiotic, just through the effect of light vibration on the skin.
Our work is going to evolve a great deal. With light, the physician becomes a sort of orchestra leader, who must coordinate many factors (wavelengths, vibrations...) in order to obtain harmonious clinical results.
This work requires the ability to analyse and diagnose problems, combined with a real knowledge of colours. We are at the start of a process. Major studies are in progress.
We shall acquire in-depth knowledge, improve protocols and expand our toolkit. Today we are working with only three colours (yellow, red and blue). Tomorrow, we shall work with all the colours in the rainbow.

INTERVIEWS WITH DR LINDA FOUQUE, DERMATOLOGIST IN NICE.

Established in Nice, Dr Linda Fouque has been using a Triwings^® lamp for more than a year for treating cancerous lesions and skin rejuvenation.
Until then, she had been using another device but it only produced a single, yellow light.
Looking for more powerful equipment, which could mix several colours, Dr Fouque tried a Triwings^® lamp for dynamic phototherapy, particularly for treating cancerous or precancerous skin lesions.
"I noticed that the skin lightened under the effect of the LEDs" Dr Fouque explained. Wanting to validate this empirical observation, the dermatologist asked five volunteers to come twice a week for two months to expose their forearms to cold light.
The experiment was backed by Vincience, a research centre specialising in extracting and evaluation for the cosmetics industry. Based in Sofia Antipolis, Vincience lent the dermatologist a special microscope, the VivaScope, which could be used to examine the epidermis without breaking the skin.
The VivaScope studies were performed at Vincience by a specialist team, and the LED part at Dr Fouque's office. "With this sort of big magnifier, we could measure the skin pigmentation" Dr Fouque explained. The volunteers were given one month of treatment with two sessions per week. The results were compelling two months after the end of treatment. The practitioner noted significant effects on the homogenisation of the skin’s pigmentation.
The treatment can therefore be used to combat skin aging. Indeed, with age, skin pigments are distributed less evenly. "After the treatment, I noted a distinct improvement in the radiance of the complexion" said Linda Fouque. The microscopic examination proved the effects of LED treatment on the basement membrane which forms a junction between the dermis and the epidermis. This membrane becomes flattened with age. The LEDs gave the basement membrane the scalloped aspect characteristic of young skin. "The cold light stimulated the blood vessels to reform", Dr Fouque described. The blood circulates better. The skin is better irrigated and better oxygenated.
The effects are obvious: the complexion is more luminous and the look less tired." According to the dermatologist, if the patient wishes to benefit from the effects of this rejuvenation over a longer period, a monthly session is recommended.
* Dr Fouque's work is being published in the American journal "Investigative Dermatology"

INTERVEWS WITH DR SYLVIE BOISNIC, DERMATOLOGIST AND RESEARCH DIRECTOR AT GREDECO.
(Dermatology and Cosmetology Research Group)

A promising research theme
Dr Sylvie Boisnic is director of research at the Dermatology and Cosmetology Research Group (GREDECO). This independent unit performs a great deal of research for industry or manufacturers. GREDECO has developed an innovative research method: keeping alive human skin obtained from surgical operations and placed in a culture medium. "This method, standardised with the aim of restoring the metabolic conditions existing in vivo, is used to maintain cell viability and preserve epithelial differentiation, explained Dr Boisnic. So we can rapidly analyse the efficacy and tolerance of an active substance, a complex product or radiation such as that from a laser or LED diode, using histology, immunohistochemistry, biochemistry and electron microscopy." The laboratory can thus work directly on tissues without the need for all the precautions necessary for testing on live volunteers. Dr Boisnic has been studying cold light for six years. "At first", she explained, with soft lasers. All the work I have studied, was effective and free of burns."
 
Two studies in parallel
GREDECO wanted to study the effect of the LEDs in a Triwings^® lamp on the production of collagen by skin cells. The skin kept alive underwent accelerated aging with ultraviolet light, to make it uniform at around the age of 80. The researchers also wanted to work on skin which was altered, as if it had been permanently exposed to sunlight for years. They performed eight sessions of exposure to the radiation of LED lamps for 20 minutes at a time, ten minutes of continuous light and ten in pulsed mode. They also compared the skin with stretch marks (untreated) and others treated with a lamp. After treatment, it was noted that the network of elastic fibres in the skin was denser with longer fibres. The scientists also observed the reorganisation of collagen bundles which became thicker and there was an increase in collagen synthesis by the fibroblasts in the experimentally aged skin or the stretch marks. GREDECO then exposed five people to LED radiation from a Triwings^® lamp to treat stretch marks. They observed a "statistically significant improvement in the stretch marks: 46% reduction of the folded aspect, 58% in depth and 57% in skin extensibility in the region of the stretch marks." "Overall, the study tells us that the satisfaction scored by the subjects and the physician was roughly identical at around 60%." According to Dr Boisnic, it seems that cold light is all the more effective if it used very early on recent lesions. The laboratory judges that it is "particularly pertinent to be able to evaluate the curative role of this type of treatment on very recent stretch marks. The results may be distinctly superior."