Could Near Infrared Saunas Be The Best Thing For Your Skin? | SaunaSpace

Could Near Infrared Saunas Be The Best Thing For Your Skin?

skin of two women

The Skin

Human skin is truly an incredible organ and is the epitome of multitasking. The skin holds us in and provides a physical barrier against injury and infection. The skin is crucial to homeostatic temperature control, cooling the body through sweating while having an insulating capacity as well.
Sweating when the body temperature elevates as in a sauna allows the skin to act as a powerful organ of elimination, ridding the body of toxins and heavy metals encountered in our toxic world. At the same time the skin acts as an absorption route for a variety of substances.

Much of the sensory input from our environment travels to our brain from cutaneous receptors. These receptors send information to the brain along sensory nerves providing important information ranging from temperature and pain to position-movement sense or proprioception.

The skin responds to our emotional states by blushing or the formation of “goosebumps”. The skin can feel cold or hot in response to emotional states and feelings can even result in breaking out and rashes.
Exposure to sunshine allows the skin to help in the formation of vitamin D.

Skin Problems

Unfortunately many if not most people have unhealthy skin. The skin comes into contact with a great many toxins. Skin is inactivated by clothing and bathing in very hot water. Most Americans today are relatively sedentary and do not sweat enough.[1]Wilson L, MD. Skin, And Care of Your Skin . The Center For Development. March 2015.

There are also many diseases and disorders that primarily or secondarily involve the skin. Direct and indirect costs borne by our society related to these skin problems run into the billions of dollars each year.

Magic Wavelengths

Diagram Mechanism of Near Infrared LLLT
Near infrared light passes through the cell membrane and activates the cytochrome oxidase, an important photoreceptor. This initiates many beneficial, healing metabolic pathways in the cells.

Low level laser (light) therapy (LLLT), phototherapy or photobiomodulation, all refer to the use of light for altering biological activity of certain target within the human body.[2]Sawhney, MK, Hamblin, MR. Low Level Laser (Light) Therapy (LLLT) for Cosmetic Medicine and Dermatology . Wellman Center for Photomedicine, Mass. Gen. Hospital, Boston, MA & Dept. Dermatology, Harvard Med. School, Boston, MA.

An enormous amount of research over the past 10 to 15 years has discovered many beneficial applications of phototherapy in treating a variety of health problems and disorders.[3]Hamblin M, Demidova T. Mechanisms of low level light therapy . Proc. SPIE 6140, Mechanisms for Low-Light Therapy. 614001 (Feb 2006); doi:10.1117/12.646294.

LLLT uses either non-ablative low power lasers or non-coherent light sources consisting of filtered lamps such as the tungsten filament heat lamps used in near infrared lamp saunas or light-emitting diodes (LED). The main medical applications of LLLT have been reducing pain and inflammation, augmenting tissue repair and promoting regeneration of different tissues and nerves, and preventing tissue damage.

There are multiple significant variables in terms of dose parameters: wavelength, power density, pulse structure, coherence, energy, irradiation time, contact vs non-contact application, repetition regimen and more. Lower doses can result in reduced effectiveness of the treatment and higher ones can lead to tissue damage.

While treatment protocol uncertainties remain, there is one irrefutable fact of phototherapy. Virtually all LLLT research and medical applications revolve around the use of light in the visible red and near infrared spectrum. This is the same light spectrum emitted by the tungsten filament lamps in near infrared lamp saunas.

The same light is contained in sun light, in fact, over 50% of sunlight that reaches the surface of the earth is near infrared light.[4]American Society for Testing and Materials. Reference Solar Spectral Irradiance: Air Mass 1.5 . ASTM. Sep 28, 2013. Tiny receptors in our bodies called chromophores have an optical window that only absorbs and responds to near infrared light.[5]Hamblin M, Demidova T. Mechanisms of low level light therapy . Proc. SPIE 6140, Mechanisms for Low-Light Therapy. 614001 (Feb 2006); doi:10.1117/12.646294.

Skin Solutions

LLLT for Skin Rejuvenation

Skin starts showing its first signs of aging in the late 20s to early 30s and it usually presents with wrinkles, dyspigmentation, telangiectasia, and loss of elasticity. Common features are reduction in the amount of collagen, fragmentation of collagen fibers, degeneration of elastic fibers, dilated and tortuous dermal vessels, and atrophy and disorientation of the epidermis. The passage of time and environmental influences are responsible for the aging process; however sun exposure seems to be one of the most important causes of these changes.[6]Takema Y, Yorimoto Y, Kawai M, Imokawa G. Age-related changes in the elastic properties and thickness of human facial skin . Br J Dermatol. 1994 Nov;131(5):641-8. [7]Kligman LH. Photoaging. Manifestations, prevention, and treatment . Clin Geriatr Med. 1989 Feb;5(1):235-51.

Illustration of Tissue Penetration Depths of Light
Near infrared light penetrates more deeply into tissue than any other type of light.

Several modalities have been developed in order to reverse the dermal and epidermal signs of photo- and chronological aging including are retinoic acid (a vitamin A derivative), dermabrasion, chemical peels, and ablative laser resurfacing.[8]Branham GH, Thomas JR. Rejuvenation of the skin surface: chemical peel and dermabrasion . Facial Plast Surg. 1996 Apr;12(2):125-33. [9]Airan LE, Hruza G. Current lasers in skin resurfacing . Facial Plast Surg Clin North Am. 2005 Feb;13(1):127-39. [10]Paasch U, Haedersdal M. Laser systems for ablative fractional resurfacing . Expert Rev Med Devices. 2011 Jan;8(1):67-83. doi: 10.1586/erd.10.74. However, these procedures require intensive post-treatment care, prolonged downtime and may lead to complications.[11]Nanni CA, Alster TS. Complications of carbon dioxide laser resurfacing. An evaluation of 500 patients . Dermatol Surg. 1998 Mar;24(3):315-20. [12]Sriprachya-Anunt S, Fitzpatrick RE, Goldman MP, Smith SR. Infections complicating pulsed carbon dioxide laser resurfacing for photoaged facial skin . Dermatol Surg. 1997 Jul;23(7):527-35; discussion 535-6. These limitations created a need for the development of alternative rejuvenation procedures that were safer, more effective, with fewer side effects.[13]Sawhney, MK, Hamblin, MR. Low Level Laser (Light) Therapy (LLLT) for Cosmetic Medicine and Dermatology . Wellman Center for Photomedicine, Mass. Gen. Hospital, Boston, MA & Dept. Dermatology, Harvard Med. School, Boston, MA.

Non-ablative skin rejuvenation aims to improve photoaged and aging skin without destroying the epidermis. LED light sources provide near infrared light for non-thermal, non-ablative skin rejuvenation shown to be effective for improving wrinkles and skin laxity. LLLT promotes collagen and elastin formation as well as wound healing. Phototherapy improves the appearance of aged and photoaged skin in a safe manner.[14]Avci P, Gupta A, Sadasivam M, Vecchio D, Pam Z, Pam N, Hamblin MR. Low-level laser (light) therapy (LLLT) in skin: stimulating, healing, restoring . Semin Cutan Med Surg. 2013 Mar;32(1):41-52. [15]Lee SY, Park KH, Choi JW, Kwon JK, Lee DR, Shin MS, Lee JS, You CE, Park MY. A prospective, randomized, placebo-controlled, double-blinded, and split-face clinical study on LED phototherapy for skin rejuvenation: clinical, profilometric, histologic, ultrastructural, and biochemical evaluations and comparison of three different treatment settings . J Photochem Photobiol B. 2007 Jul 27;88(1):51-67. Epub 2007 May 1. [16]Barolet D, Roberge CJ, Auger FA, Boucher A, Germain L. Regulation of skin collagen metabolism in vitro using a pulsed 660 nm LED light source: clinical correlation with a single-blinded study . J Invest Dermatol. 2009 Dec;129(12):2751-9. doi: 10.1038/jid.2009.186. Epub 2009 Jul 9. [17]Weiss RA, McDaniel DH, Geronemus RG, Weiss MA, Beasley KL, Munavalli GM, Bellew SG. Clinical experience with light-emitting diode (LED) photomodulation . Dermatol Surg. 2005 Sep;31(9 Pt 2):1199-205.

LLLT for Acne

Acne vulgaris is a relatively common skin disorder, with a reported prevalence of up to 90% among adolescents. Although typical acne is neither a serious nor a contagious condition, it can greatly impact the emotional and social aspects of an individual’s life. Current therapies for acne vulgaris include topical antibiotics and other topical compounds. In severe cases oral antibiotics and hormones have been used.[18]Avci P, Gupta A, Sadasivam M, Vecchio D, Pam Z, Pam N, Hamblin MR. Low-level laser (light) therapy (LLLT) in skin: stimulating, healing, restoring . Semin Cutan Med Surg. 2013 Mar;32(1):41-52. [19]Sawhney, MK, Hamblin, MR. Low Level Laser (Light) Therapy (LLLT) for Cosmetic Medicine and Dermatology . Wellman Center for Photomedicine, Mass. Gen. Hospital, Boston, MA & Dept. Dermatology, Harvard Med. School, Boston, MA.

Illustration of Treating Acne with Red and Blue Light
Illustration of acne treated with red and blue light. The sebaceous gland is colonized by bacteria, which can be killed by blue light due to the endogenous porphyrins they produce, acting as photosensitizers and forming reactive oxygen species. Red light can reduce inflammation and stimulate healing with minimal scarring.

Sunlight exposure has often been reported to have a significant impact on the treatment of acne, with a high efficacy of up to 70%.[20]Cunliffe WJ, Goulden V. Phototherapy and acne vulgaris . Br J Dermatol. 2000 May;142(5):855-6. Several studies have demonstrated the efficacy of red to near infrared (NIR) light (spectral range 630 nm to 1000 nm, and non-thermal power less than 200 mW) for the treatment of acne vulgaris. Red light maybe used alone or in combination with other modalities (in particular, blue light).[21]Posten W, Wrone DA, Dover JS, Arndt KA, Silapunt S, Alam M. Low-level laser therapy for wound healing: mechanism and efficacy . Dermatol Surg. 2005 Mar;31(3):334-40. [22]Lee SY, You CE, Park MY. Blue and red light combination LED phototherapy for acne vulgaris in patients with skin phototype IV . Lasers Surg Med. 2007 Feb;39(2):180-8. [23]Cunliffe WJ, Goulden V. Phototherapy and acne vulgaris . Br J Dermatol. 2000 May;142(5):855-6. [24]Sadick NS. Handheld LED array device in the treatment of acne vulgaris . J Drugs Dermatol. 2008 Apr;7(4):347-50. [25]Goldberg DJ, Russell BA. Combination blue (415 nm) and red (633 nm) LED phototherapy in the treatment of mild to severe acne vulgaris . J Cosmet Laser Ther. 2006 Jun;8(2):71-5. [26]Papageorgiou P, Katsambas A, Chu A. Phototherapy with blue (415 nm) and red (660 nm) light in the treatment of acne vulgaris . Br J Dermatol. 2000 May;142(5):973-8.

LLLT for Herpes Virus Lesions

herpes on lipOne of the most common virus infections is caused by herpes simplex virus (HSV). HSV is chronic and lasts one’s entire life. The exposure of the host to physical or emotional stresses such as fever, exposure to UV light, and immune suppression causes virus reactivation eruption of “cold sores”.[27]Avci P, Gupta A, Sadasivam M, Vecchio D, Pam Z, Pam N, Hamblin MR. Low-level laser (light) therapy (LLLT) in skin: stimulating, healing, restoring . Semin Cutan Med Surg. 2013 Mar;32(1):41-52. Anti-viral drugs have been only partially effective.
LLLT has been suggested as an alternative to current medications for accelerated healing, reducing symptoms and influencing the length of the recurrence period.[28]Eduardo Cde P, Bezinelli LM, Eduardo Fde P, da Graça Lopes RM, Ramalho KM, Bello-Silva MS, Esteves-Oliveira M. Prevention of recurrent herpes labialis outbreaks through low-intensity laser therapy: a clinical protocol with 3-year follow-up . Lasers Med Sci. 2012 Sep;27(5):1077-83. doi: 10.1007/s10103-011-1019-6. Epub 2011 Nov 16. [29]Muñoz Sanchez PJ, Capote Femenías JL, Díaz Tejeda A, Tunér J. The effect of 670-nm low laser therapy on herpes simplex type 1 . Photomed Laser Surg. 2012 Jan;30(1):37-40. doi: 10.1089/pho.2011.3076. Epub 2011 Nov 2. [30]Bello-Silva MS, de Freitas PM, Aranha AC, Lage-Marques JL, Simões A, de Paula Eduardo C. Low- and high-intensity lasers in the treatment of herpes simplex virus 1 infection . Photomed Laser Surg. 2010 Feb;28(1):135-9. doi: 10.1089/pho.2008.2458. [31]Schindl A, Neumann R. Low-intensity laser therapy is an effective treatment for recurrent herpes simplex infection. Results from a randomized double-blind placebo-controlled study . J Invest Dermatol. 1999 Aug;113(2):221-3. [32]Landthaler M, Haina D, Waidelich W. Treatment of zoster, post-zoster pain and herpes simplex recidivans in loco with laser light [Article in German] . Fortschr Med. 1983 Jun 9;101(22):1039-41.

LLLT for Vitiligo

woman suffering from vitiligoVitiligo is an acquired pigmentary disorder characterized by depigmentation of the skin and hair. The underlying mechanism of how the depigmentation occurs is uncertain. Therefore, stimulation of these epidermal and dermal cells may be a possible treatment option. Treatment of vitiligo has generally been unsatisfactory.[33]Avci P, Gupta A, Sadasivam M, Vecchio D, Pam Z, Pam N, Hamblin MR. Low-level laser (light) therapy (LLLT) in skin: stimulating, healing, restoring . Semin Cutan Med Surg. 2013 Mar;32(1):41-52.
LLLT has been suggested as an alternative effective treatment option for patients with vitiligo. Phototherapy has been shown to improve pigmentation.[34]Yu HS, Wu CS, Yu CL, Kao YH, Chiou MH. Helium-neon laser irradiation stimulates migration and proliferation in melanocytes and induces repigmentation in segmental-type vitiligo . J Invest Dermatol. 2003 Jan;120(1):56-64. [35]Lan CC, Wu CS, Chiou MH, Chiang TY, Yu HS. Low-energy helium-neon laser induces melanocyte proliferation via interaction with type IV collagen: visible light as a therapeutic option for vitiligo . Br J Dermatol. 2009 Aug;161(2):273-80. doi: 10.1111/j.1365-2133.2009.09152.x. Epub 2009 Apr 30. [36]Lan CC, Wu CS, Chiou MH, Hsieh PC, Yu HS. Low-energy helium-neon laser induces locomotion of the immature melanoblasts and promotes melanogenesis of the more differentiated melanoblasts: recapitulation of vitiligo repigmentation in vitro . J Invest Dermatol. 2006 Sep;126(9):2119-26. Epub 2006 May 11.

LLLT for Hypertrophic Scars and Keloids

belly scar with keloidsHypertrophic scars and keloids are benign skin tumors that usually form following surgery, trauma, or acne and are difficult to eradicate. The use of LLLT as a prophylactic method to alter the wound healing process to avoid or attenuate the formation of hypertrophic scars or keloids has been investigated. Near infrared (NIR) LED therapy has been shown to improve scar formation without adverse effects.[37]Avci P, Gupta A, Sadasivam M, Vecchio D, Pam Z, Pam N, Hamblin MR. Low-level laser (light) therapy (LLLT) in skin: stimulating, healing, restoring . Semin Cutan Med Surg. 2013 Mar;32(1):41-52. [38]Sawhney, MK, Hamblin, MR. Low Level Laser (Light) Therapy (LLLT) for Cosmetic Medicine and Dermatology . Wellman Center for Photomedicine, Mass. Gen. Hospital, Boston, MA & Dept. Dermatology, Harvard Med. School, Boston, MA. [39]Liu W, Wang DR, Cao YL. TGF-beta: a fibrotic factor in wound scarring and a potential target for anti-scarring gene therapy . Curr Gene Ther. 2004 Mar;4(1):123-36. [40]Barolet D, Boucher A. Prophylactic low-level light therapy for the treatment of hypertrophic scars and keloids: a case series . Lasers Surg Med. 2010 Aug;42(6):597-601. doi: 10.1002/lsm.20952. [41]Hamblin M, Demidova T. Mechanisms of low level light therapy . Proc. SPIE 6140, Mechanisms for Low-Light Therapy. 614001 (Feb 2006); doi:10.1117/12.646294.

LLLT for Burns

sunburnt skin on backPatients treated with NIR LED showed decreased symptoms of burning, redness, swelling, and peeling after acute sunburn. People that receive laser therapy may suffer devastating burns. LED treated laser burns have demonstrated accelerated healing.[42]Avci P, Gupta A, Sadasivam M, Vecchio D, Pam Z, Pam N, Hamblin MR. Low-level laser (light) therapy (LLLT) in skin: stimulating, healing, restoring . Semin Cutan Med Surg. 2013 Mar;32(1):41-52. [43]Sawhney, MK, Hamblin, MR. Low Level Laser (Light) Therapy (LLLT) for Cosmetic Medicine and Dermatology . Wellman Center for Photomedicine, Mass. Gen. Hospital, Boston, MA & Dept. Dermatology, Harvard Med. School, Boston, MA. [44]Weiss RA, McDaniel DH, Geronemus RG, Weiss MA, Beasley KL, Munavalli GM, Bellew SG. Clinical experience with light-emitting diode (LED) photomodulation . Dermatol Surg. 2005 Sep;31(9 Pt 2):1199-205.

LLLT for Psoriasis

Psoriasis on torso and armsMore recently LLLT has been considered for treatment of plaque psoriasis. A recent preliminary study showed no adverse side effects and a resolution of psoriasis. The limitation of this study was the small number of patients enrolled, however the results observed encourage future investigations for use of LLLT in treating psoriasis.[45]Ablon G. Combination 830-nm and 633-nm light-emitting diode phototherapy shows promise in the treatment of recalcitrant psoriasis: preliminary findings . Photomed Laser Surg. 2010 Feb;28(1):141-6. doi: 10.1089/pho.2009.2484.

LLLT for Photoprotection

The UV range (< 400 nm) exposure is responsible for almost all damaging photo-induced effects on human skin.[46]Sinha RP, Häder DP. UV-induced DNA damage and repair: a review . Photochem Photobiol Sci. 2002 Apr;1(4):225-36. [47]Calles C, Schneider M, Macaluso F, Benesova T, Krutmann J, Schroeder P. Infrared A radiation influences the skin fibroblast transcriptome: mechanisms and consequences . J Invest Dermatol. 2010 Jun;130(6):1524-36. doi: 10.1038/jid.2010.9. Epub 2010 Feb 4. [48]Schroeder P, Calles C, Benesova T, Macaluso F, Krutmann J. Photoprotection beyond ultraviolet radiation–effective sun protection has to include protection against infrared A radiation-induced skin damage . Skin Pharmacol Physiol. 2010;23(1):15-7. doi: 10.1159/000257259. Epub 2010 Jan 14. Existing solutions to prevent UV damage are based on either avoidance of sun exposure or by use of sunscreens. Sun avoidance might be hard to implement, especially for the people involved in outdoor occupations or activities. Topical sunscreens have their own limitations as well.

It has recently been suggested that infrared (IR) exposure might have protective effects against UV-induced skin damage mainly by triggering protective/repair responses to UV irradiation.[49]Barolet D, Boucher A. LED photoprevention: reduced MED response following multiple LED exposures . Lasers Surg Med. 2008 Feb;40(2):106-12. doi: 10.1002/lsm.20615. [50]Frank S, Oliver L, Lebreton-De Coster C, Moreau C, Lecabellec MT, Michel L, Vallette FM, Dubertret L, Coulomb B. Infrared radiation affects the mitochondrial pathway of apoptosis in human fibroblasts . J Invest Dermatol. 2004 Nov;123(5):823-31. [51]Applegate LA, Scaletta C, Panizzon R, Frenk E, Hohlfeld P, Schwarzkopf S. Induction of the putative protective protein ferritin by infrared radiation: implications in skin repair . Int J Mol Med. 2000 Mar;5(3):247-51.

LLLT for Treatment of Hair Loss

balding manAndrogenetic alopecia (AGA) is the most common form of hair loss in men, affecting almost 50% of the male population.[52]Otberg N, Finner AM, Shapiro J. Androgenetic alopecia . Endocrinol Metab Clin North Am. 2007 Jun;36(2):379-98. Several other forms of hair loss also exist such as telogen effluvium (TE), alopecia areata (AA), and alopecia induced via chemotherapy.[53]Sawhney, MK, Hamblin, MR. Low Level Laser (Light) Therapy (LLLT) for Cosmetic Medicine and Dermatology . Wellman Center for Photomedicine, Mass. Gen. Hospital, Boston, MA & Dept. Dermatology, Harvard Med. School, Boston, MA.

In 2007, the FDA approved LLLT as a possible treatment modality for hair loss.[54]Wikramanayake TC, Rodriguez R, Choudhary S, Mauro LM, Nouri K, Schachner LA, Jimenez JJ. Effects of the Lexington LaserComb on hair regrowth in the C3H/HeJ mouse model of alopecia areata . Lasers Med Sci. 2012 Mar;27(2):431-6. doi: 10.1007/s10103-011-0953-7. Epub 2011 Jul 9.
Multiple studies have shown LLLT to be beneficial in treating hair loss. In male pattern baldness (AGA) patients described significant improvements in overall hair regrowth, a decreased rate of hair loss, thicker feeling hair, improved scalp health and hair shine. About 65% of the patients that receive chemotherapy for cancer develop alopecia. In an animal model hair regrowth proceeded more rapidly after LLLT.[55]Castex-Rizzi N, Lachgar S, Charvéron M, Gall Y. Implication of VEGF, steroid hormones and neuropeptides in hair follicle cell responses [Article in French] . Ann Dermatol Venereol. 2002 May;129(5 Pt 2):783-6. [56]Leavitt M, Charles G, Heyman E, Michaels D. HairMax LaserComb laser phototherapy device in the treatment of male androgenetic alopecia: A randomized, double-blind, sham device-controlled, multicentre trial . Clin Drug Investig. 2009;29(5):283-92. doi: 10.2165/00044011-200929050-00001. [57]Meneguzzo DT, Lopes LA, Pallota R, Soares-Ferreira L, Lopes-Martins RÁ, Ribeiro MS. Prevention and treatment of mice paw edema by near-infrared low-level laser therapy on lymph nodes . Lasers Med Sci. 2013 May;28(3):973-80. doi: 10.1007/s10103-012-1163-7. Epub 2012 Aug 23. [58]Satino JL, Markou M. Hair Regrowth and Increased Hair Tensile Strength Using the HairMax LaserComb for Low-Level Laser Therapy . International Journal of Cosmetic Surgery and Aesthetic Dermatology. August 2003, 5(2): 113-117. doi:10.1089/153082003769591209. [59]Shukla S, Sahu K, Verma Y, Rao KD, Dube A, Gupta PK. Effect of helium-neon laser irradiation on hair follicle growth cycle of Swiss albino mice . Skin Pharmacol Physiol. 2010;23(2):79-85. doi: 10.1159/000265678. Epub 2009 Dec 14. [60]Weiss RA, McDaniel DH, Geronemus RG, Weiss MA, Beasley KL, Munavalli GM, Bellew SG. Clinical experience with light-emitting diode (LED) photomodulation . Dermatol Surg. 2005 Sep;31(9 Pt 2):1199-205.

LLLT for Fat Reduction and Cellulite Treatment

Cellulite on thighObesity is a nearly universal problem today and up to 85% of women suffer from cellulite, a significant cosmetic concern.

LLLT with near infrared light has been efficacious in decreasing body fat and specifically cellulite formation.

Conclusion

Low level light or laser therapy (LLLT)  is a form of light therapy. Light therapy is used interchangeably with phototherapy or photobiomodulation. Non-ablative lasers, LED’s, and near infrared lamps are used in a wide variety of applications in the management of skin problems and disorders. They provide a safe, user friendly, and effective alternative to traditional treatments which are often expensive, problematic and of limited effectiveness.

The large and rapidly growing body of research in this field does not specifically address the use of near infrared lamp saunas but one fact bears repeating. Virtually all research and actual application of phototherapy involves near infrared light. Every wavelength utilized in research and clinical use is contained in the light emitted by the tungsten filament bulbs in a near infrared lamp sauna. Use of near infrared saunas will only increase as awareness of this powerful tool grows in the public mind.

(Featured image courtesy of Olivier Valsecchi)

References   [ + ]

1.Wilson L, MD. Skin, And Care of Your Skin . The Center For Development. March 2015.
2, 13, 19, 38, 43, 53.Sawhney, MK, Hamblin, MR. Low Level Laser (Light) Therapy (LLLT) for Cosmetic Medicine and Dermatology . Wellman Center for Photomedicine, Mass. Gen. Hospital, Boston, MA & Dept. Dermatology, Harvard Med. School, Boston, MA.
3, 5, 41.Hamblin M, Demidova T. Mechanisms of low level light therapy . Proc. SPIE 6140, Mechanisms for Low-Light Therapy. 614001 (Feb 2006); doi:10.1117/12.646294.
4.American Society for Testing and Materials. Reference Solar Spectral Irradiance: Air Mass 1.5 . ASTM. Sep 28, 2013.
6.Takema Y, Yorimoto Y, Kawai M, Imokawa G. Age-related changes in the elastic properties and thickness of human facial skin . Br J Dermatol. 1994 Nov;131(5):641-8.
7.Kligman LH. Photoaging. Manifestations, prevention, and treatment . Clin Geriatr Med. 1989 Feb;5(1):235-51.
8.Branham GH, Thomas JR. Rejuvenation of the skin surface: chemical peel and dermabrasion . Facial Plast Surg. 1996 Apr;12(2):125-33.
9.Airan LE, Hruza G. Current lasers in skin resurfacing . Facial Plast Surg Clin North Am. 2005 Feb;13(1):127-39.
10.Paasch U, Haedersdal M. Laser systems for ablative fractional resurfacing . Expert Rev Med Devices. 2011 Jan;8(1):67-83. doi: 10.1586/erd.10.74.
11.Nanni CA, Alster TS. Complications of carbon dioxide laser resurfacing. An evaluation of 500 patients . Dermatol Surg. 1998 Mar;24(3):315-20.
12.Sriprachya-Anunt S, Fitzpatrick RE, Goldman MP, Smith SR. Infections complicating pulsed carbon dioxide laser resurfacing for photoaged facial skin . Dermatol Surg. 1997 Jul;23(7):527-35; discussion 535-6.
14, 18, 27, 33, 37, 42.Avci P, Gupta A, Sadasivam M, Vecchio D, Pam Z, Pam N, Hamblin MR. Low-level laser (light) therapy (LLLT) in skin: stimulating, healing, restoring . Semin Cutan Med Surg. 2013 Mar;32(1):41-52.
15.Lee SY, Park KH, Choi JW, Kwon JK, Lee DR, Shin MS, Lee JS, You CE, Park MY. A prospective, randomized, placebo-controlled, double-blinded, and split-face clinical study on LED phototherapy for skin rejuvenation: clinical, profilometric, histologic, ultrastructural, and biochemical evaluations and comparison of three different treatment settings . J Photochem Photobiol B. 2007 Jul 27;88(1):51-67. Epub 2007 May 1.
16.Barolet D, Roberge CJ, Auger FA, Boucher A, Germain L. Regulation of skin collagen metabolism in vitro using a pulsed 660 nm LED light source: clinical correlation with a single-blinded study . J Invest Dermatol. 2009 Dec;129(12):2751-9. doi: 10.1038/jid.2009.186. Epub 2009 Jul 9.
17, 44, 60.Weiss RA, McDaniel DH, Geronemus RG, Weiss MA, Beasley KL, Munavalli GM, Bellew SG. Clinical experience with light-emitting diode (LED) photomodulation . Dermatol Surg. 2005 Sep;31(9 Pt 2):1199-205.
20, 23.Cunliffe WJ, Goulden V. Phototherapy and acne vulgaris . Br J Dermatol. 2000 May;142(5):855-6.
21.Posten W, Wrone DA, Dover JS, Arndt KA, Silapunt S, Alam M. Low-level laser therapy for wound healing: mechanism and efficacy . Dermatol Surg. 2005 Mar;31(3):334-40.
22.Lee SY, You CE, Park MY. Blue and red light combination LED phototherapy for acne vulgaris in patients with skin phototype IV . Lasers Surg Med. 2007 Feb;39(2):180-8.
24.Sadick NS. Handheld LED array device in the treatment of acne vulgaris . J Drugs Dermatol. 2008 Apr;7(4):347-50.
25.Goldberg DJ, Russell BA. Combination blue (415 nm) and red (633 nm) LED phototherapy in the treatment of mild to severe acne vulgaris . J Cosmet Laser Ther. 2006 Jun;8(2):71-5.
26.Papageorgiou P, Katsambas A, Chu A. Phototherapy with blue (415 nm) and red (660 nm) light in the treatment of acne vulgaris . Br J Dermatol. 2000 May;142(5):973-8.
28.Eduardo Cde P, Bezinelli LM, Eduardo Fde P, da Graça Lopes RM, Ramalho KM, Bello-Silva MS, Esteves-Oliveira M. Prevention of recurrent herpes labialis outbreaks through low-intensity laser therapy: a clinical protocol with 3-year follow-up . Lasers Med Sci. 2012 Sep;27(5):1077-83. doi: 10.1007/s10103-011-1019-6. Epub 2011 Nov 16.
29.Muñoz Sanchez PJ, Capote Femenías JL, Díaz Tejeda A, Tunér J. The effect of 670-nm low laser therapy on herpes simplex type 1 . Photomed Laser Surg. 2012 Jan;30(1):37-40. doi: 10.1089/pho.2011.3076. Epub 2011 Nov 2.
30.Bello-Silva MS, de Freitas PM, Aranha AC, Lage-Marques JL, Simões A, de Paula Eduardo C. Low- and high-intensity lasers in the treatment of herpes simplex virus 1 infection . Photomed Laser Surg. 2010 Feb;28(1):135-9. doi: 10.1089/pho.2008.2458.
31.Schindl A, Neumann R. Low-intensity laser therapy is an effective treatment for recurrent herpes simplex infection. Results from a randomized double-blind placebo-controlled study . J Invest Dermatol. 1999 Aug;113(2):221-3.
32.Landthaler M, Haina D, Waidelich W. Treatment of zoster, post-zoster pain and herpes simplex recidivans in loco with laser light [Article in German] . Fortschr Med. 1983 Jun 9;101(22):1039-41.
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