A newly filed patent contains a proposed rosacea treatment using small bands of infrared radiation between 790nm and 900nm with a power between 1 and 100 mW/cm^2. The unit proposed could be a LED device, used from twice a day to every 10 days. An energy density between 3 and 180 Joules/cm^2 is proposed.

Infrared Light is in the invisible spectrum below red, with wavelengths from 700nm to 2,000nm. We know that infrared light penetrates skin tissue more effectively than visible light.

An example device described is the OMNILUX Plus, which is promoted as “(Infra-red) works as a combination therapy with the Revive (red) head for even better skin rejuvenation, ideal for deeper lines and wrinkles”. OMNILUX Plus is based on a matrix of Infra Red LEDs, which provide narrowband 830nm light. This device is not currently promoted as a treatment for rosacea, so it seems that this patent covers using an existing treatment method for a new condition – rosacea.

The example treatment regime used an OMNILUX Plus unit at 830nm (+/- 0.5nm), using 55 mW/cm^2 at a distance of 1-10cm from the skin for 20 minutes with a power of 66 Joules/cm^2, twice a week for four weeks. Goggles were used and the unit was further placed 3-5cm from the patient’s nose.

The patent says that the patient enjoyed substantially reduced telangiectasia and reduced inflammatory papules.

Treating erythematotelangiectatic rosacea or papulopustular rosacea with narrow-band infrared light radiation and radiation kits therefor

United States Patent Application 20090270847, Lee; Seung Yoon, October 29, 2009

A method of treating erythematotelangiectatic rosacea or papulopustular rosacea in a subject comprises exposing the subject’s skin in need thereof to narrow-band infrared radiation at a wavelength(s) in a range of between 790 nm and 900 nm and having a band width of between 0 nm and 20 nm, in an effective dose to treat erythematotelangiectatic rosacea or papulopustular rosacea and essentially not to cause photothermolysis of the skin. Alternatively, a method of treating erythematotelangiectatic rosacea or papulopustular rosacea in a subject comprises exposing the subject’s skin in need thereof to narrow-band infrared radiation at a wavelength(s) in a range of between 790 nm and 900 nm and having a band width of between 0.1 nm and 20 nm, in an effective dose to treat erythematotelangiectatic rosacea or papulopustular rosacea. A kit for such methods comprises a radiation source generating narrow-band infrared radiation at a wavelength(s) in a range of between 790 nm and 900 nm, the narrow-band infrared radiation having a band width of between 0 nm and 20 nm and having a power density of between 1 mW/cm^2 and 100 mW/cm^2, and a manual instructing a user how to use the narrow-band infrared radiation for treating erythematotelangiectatic rosacea or papulopustular rosacea.

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This paper is a further confirmation of the benefits of LED therapy post laser treatments.

More directly relevant to rosacea sufferers is a 2008 paper in Cosmetic Dermatology that also showed that LED helps recovery after IPL and reduces redness.

Further, this is building on the encouraging comments from the interview with laser and light therapy expert Dr. David Goldberg Combining Light-Based Treatments and Topicals for Rosacea.

The effect of IPL and LED appears to be additive. That is, the combination works better than each one separately. Papules & pustules are generally best treated with oral and/or topical agents. Inflammation or swelling is best treated with a combination of IPL and yellow/red LED. This group also is treated with near-infrared LED.

Here is the new abstract;

Improvement of Postfractional Laser Erythema with Light-Emitting Diode Photomodulation, Dermatol Surg. 2009 Apr 2, Alster TS, Wanitphakdeedecha R., Washington Institute of Dermatologic Laser Surgery, Washington, District of Columbia.

BACKGROUND The most common side effects of fractional laser skin treatment are erythema and edema. Low-level light therapy and light-emitting diode (LED) devices have been used to stimulate fibroblast activity and hasten wound healing.

OBJECTIVE To determine whether LED treatment immediately after fractional laser skin resurfacing affects the severity and duration of postoperative eythema.

MATERIALS AND METHODS Twenty patients received treatment with a 590-nm wavelength LED array to randomly selected facial halves immediately after undergoing full-face fractional laser skin resurfacing with a 1,550-nm erbium-doped fiber laser. Differences in erythema between LED-treated and untreated facial halves were recorded at 24, 48, and 96 hours post-treatment.

RESULTS The LED-treated facial halves were less erythematous in all 20 patients 24 hours postoperatively. The six patients who received the highest mean energy densities during fractional laser treatment continued to exhibit decreased erythema in the LED-treated areas at 48 hours. At 96 hours post-treatment, no discernible differences between facial halves were observed in any patient.

CONCLUSIONS Photomodulation with a 590-nm-wavelength LED array can decrease the intensity and duration of postfractional laser treatment erythema. The authors have indicated no significant interest with commercial supporters.

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Has anyone had their laser or IPL practitioner suggest LED as a post treatment therapy ? I wonder how long it will be before this form of recovery therapy will become the norm.

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Synergistic effect: Combining LED devices with PDL or IPL optimizes rosacea treatment

Combination laser and light-based treatments for rosacea have a synergistic effect and are now being studied, according to David J. Goldberg, M.D., a board-certified dermatologist in practice since 1985 at Skin Laser & Surgery Specialists of New York and New Jersey.

…

“Recently, we have started to look at trying to do something new that decreases the inflammation of rosacea in a totally different way. We have begun to combine the light-emitting diode (LED) devices — which have a totally different mechanism — with either PDL or IPL to optimize outcomes for treatment of rosacea,” says Dr. Goldberg, also clinical professor of dermatology and director of laser research, Mount Sinai School of Medicine, New York.

“We have completed a six-month, 20-subject study looking at one side of the face treated with IPL and the other side treated with both IPL and 20 minutes of continuous-wave, 633 nm, red LED energy. The results were clearly better on the combined treatment side.

For more information see also our RSRP interview with Dr. Goldberg: Combining Light-Based Treatments and Topicals for Rosacea: Dr. David J. Goldberg, MD.

The effect of IPL and LED appears to be additive. That is, the combination works better than each one separately. Papules & pustules are generally best treated with oral and/or topical agents. Inflammation or swelling is best treated with a combination of IPL and yellow/red LED. This group also is treated with near-infrared LED.

See also: Red LED Lamps & Other Forms of Low-Level Light Therapy and other LED Therapy articles.

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Blue light in combination with red light has been shown to be effective in the treatment of acne. It has been proposed that the 2 colours act together synergistically to combine their antibacterial and anti-inflammatory actions.

This paper looks at the handheld unit called the Omnilux clear-U (from Photo Therapeutics). This unit has a flat plane measuring, 60mm x 50mm, consisting of LEDs emitting light at wavelengths of blue light; 415nm (at 40mW/cm2) and red light; 633nm (at 70mw/cm2). The unit allows you to switch between the red and blue modes of operation.

According to the clear-U web site, the LEDs `destroy the bacteria responsible for the inflammation, stimulate healthy tissue growth, decrease inflammation and pore size, and limit oil production in the future’.

Photo Therapeutics Ltd. have recently trademarked the term `OMNILUX clear-U’ and also the logo .

Those doing the trial rated the unit very easy to use and just 2 of them reported mild transient redness after their self-treatments. The treatments consisted of 20 minutes of blue light and 30 minutes of red light, alternating every 2-3 days. The unit was held in contact with the face.

There are now several studies that show that LEDs using blue light alone or in combination with red light can successfully treat rosacea. Previous studies demonstrated the effectiveness of a clinic-based treatment scenario – this paper duplicates the results using a self-administered regime.

Following is a quote from the paper discussing how the LEDs are thought to provide a benefit.

Although the exact mode of action is still to be elucidated it is believed that the effectiveness of phototherapy is brought about by the destruction of P acnes through the mechanism of photodynamic therapy combined with the stimulation of cellular activity by intracellular and intercellular pathways. Red light (633 nm) although less effective at activating coproporphyrin III than blue light, penetrates more deeply into the tissue and importantly has noted anti-inflammatory properties. It has been demonstrated in vitro, that red light has influenced anti-inflammatory cytokines from macrophages and increased the synthesis of fibroblast growth factor from photoactivated cells and low-level laser irradiation within the visible red waveband can produce various beneficial effects such as stimulation of cell proliferation, release of growth factors, collagen deposition, and neovascularization.

These results, although relating more directly to acne, are still promising for rosacea sufferers. The anti-inflammatory actions of low level light therapy are ideal for rosacea lesions as well as acne lesions. This plays well with the theory that rosacea is an inflammatory condition, and breaking the inflammatory pathway is key in achieving relief from symptoms.

Here is the abstract of the recently published paper;

Handheld LED array device in the treatment of acne vulgaris, J Drugs Dermatol. 2008 Apr;7(4):347-50., Sadick NS., Weill Medical College of Cornell University, Department of Dermatology, New York, NY, USA.

The successful treatment of acne still remains problematic. Conventional therapies often prove inconsistent with unacceptable side effects and recurrence rates, leading to patient noncompliance. A thermal phototherapy treatment using a combination of blue light and red light has recently attracted much attention and seems to offer an effective alternative. The objective of this study was to evaluate the efficacy of blue light (415 nm) in combination with red light (633 nm) in the reduction of inflammatory lesions on the face of subjects (n=21) with mild to moderate acne vulgaris after a course of 8 20-minute (blue) or 30-minute (red) alternated light treatments, self-administered by a handheld unit over a period of 4 weeks.

Lesion counts progressively reduced throughout the 4-week light therapy period and continued to reduce up to 8 weeks post therapy, with a final average reduction of 69% seen 8 weeks after the treatment course (P>.001). This pattern is similar to previously reported studies.

Note that Photo Therapeutics also sell a similar handheld unit called the OMNILUX new-U which offers red and near infrared treatments in the same unit. Although this is targeted at treating the effects of aging, it may also be useful in treating rosacea.

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This recent update is from a document called Cellular Mechanisms of Low-Power Laser Therapy.

Thanks for the update TP. This thread is worth a read for those interested in Low Level Light Therapy (LLLT) such as LEDs, infrared, red and blue light.

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This paper is good news for both those undergoing IPL treatments and those interested in Light Emitting Diode (LED) therapy as a anti-redness treatment. Patients treated immediately after IPL with a LED device showed that their post-treatment redness subsided faster compared to not also being treated with LED.

Use of light-emitting diode photomodulation to reduce erythema and discomfort after intense pulsed light treatment of photodamage, J Cosmet Dermatol. 2008 Mar;7(1):30-4., Khoury JG, Goldman MP., La Jolla SpaMD, La Jolla, CA, USA.

Objectives: This study evaluates the use of light-emitting diode (LED) photomodulation therapy to accelerate resolution of post-intense pulsed light (IPL) erythema.

Methods: In this split-face study, 15 subjects were randomized to receive LED treatment to one side of the face as determined by computer-generated randomization numbers. All 15 subjects received a single IPL treatment for facial photodamage. Immediately after IPL treatment, one side of the face was treated for 35 s with the LED device. The other side was not treated. Subjects returned 24 h later for a second LED treatment on the same side of the face. Post treatment erythema was rated on both sides of the face by the blinded investigator and by subjects immediately after IPL treatment, 24 h later, and 1 week later on a scale of 0% (no erythema) to 100% (severe erythema). Patients commented on post treatment discomfort immediately after IPL treatment.

Results: Mean erythema scores on the first visit were significantly higher (P = 0.0054) on the side not treated with LED (52.7 +/- 24.6) than on the LED-treated side (43.3 +/- 21.9). Visit 2 data showed a similar trend (P = 0.0281). The subjects reported similar findings with mean erythema scores on the first visit on the LED-treated side (46.7 +/- 25.3) compared with the untreated side (60.0 +/- 23.3); the difference was significant (P = 0.0382). On the second visit, the mean erythema scores trended lower on the LED-treated side (24.3 +/- 22.1) than on the untreated side (27.9 +/- 25.8), but the difference did not reach statistical significance (P = 0.1365). Erythema scores on both facial sides were 0 for all subjects 1 week after IPL treatment. Four patients commented that post treatment discomfort was considerably less on the LED-treated side immediately after treatment.

Conclusion: LED photomodulation treatment may accelerate the resolution of erythema and reduce post treatment discomfort in IPL-treated patients with photodamage.

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RSRP: Combining Light-Based Treatments and Topicals for Rosacea: Dr. David J. Goldberg, MD

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While the Dermatology Times is a news magazine, and should not be thought of as peer reviewed, it can sometimes give quick insights into interesting information. Here, it is interesting to see that red and yellow LED devices may well have a part to play in overall rosacea treatments. Read the full article to see how LED therapy is emerging as useful for rosacea.

National report — Light-based treatment, in combination with topical treatment, is effective in relieving the symptoms of rosacea such as acne, flushing and redness, one dermatologist says.

“Systemic or topical treatments are clearly efficacious in the treatment of acne that occurs within the setting of rosacea, but do little for the redness or flushing,” says David Goldberg, M.D., director of Skin Laser & Surgery Specialists of New York and New Jersey and a clinical professor of dermatology and director of laser research at Mount Sinai School of Medicine in New York.

“Conversely, laser and laser light technology are highly effective in the treatment of rosacea-induced redness and flushing, but don’t work well for the acne component of the condition. Nothing says you can’t combine standard treatment — that is, topical — with light-based treatment,” he says.

…

Technology differences

“Each technology does something a little different,” Dr. Goldberg says. “The yellow LED and IPL both lessen redness, so they work in synergy. We will often combine the yellow LED with red LED, the latter of which works well on the inflammation of the condition.”

The LED devices do not cause pain and are not thermal, in contrast to laser technologies, according to Dr. Goldberg.

“There is no risk such as scarring when using LED devices,” Dr. Goldberg says. “They can also work on any skin type, including ethnic skin. You have to be more careful in using laser and laser-like technologies because of their thermal effect.”

• full article: Combining light-based treatments, topicals for rosacea.

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Citing studies like Low-level laser therapy induces dose-dependent reduction of TNFalpha levels in acute inflammation, and Effect of low intensity laser light in the red range on macrophage superoxide dismutase activity the RSRP article makes the link between the reduction of tumor necrosis factor (TNF-a) and increases in levels of superoxide dismutase (SOD) with the benefit seen by users of this emerging form of treatment.

Red LED and Low Level Light Therapy is emerging as a beneficial form of treatment for rosacea sufferers. As more research is published and more patients report good results, this therapy looks like becoming a promising treatment for us all.

Thanks to Dan for joining together some more dots to help us  understand Red LEDs, LLLT and treating rosacea.

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Mayumi Tosa, MD, Mayumi Clinic, Tokyo, CA, United States

Light-emitting diode (LED) has been used widely for acne treatment and skin rejuvenation in recent years. The LED therapy involves the mechanism of photomodulation without downtime, leading to safe and painless therapy. In our latest study of acne treatment, we used a new LED system in which, unlike conventional LED, pure light alone is emitted and multiwavelength irradiation can be obtained. We report the results of efficacy and safety evaluation of the new system.

Subjects: Twenty subjects (4 men and 16 women) aged 20 to 35 years with acne at grades 4 to 10 according to the Leeds Grading System.

Method: Device: LED Therapy manufactured by Futek Inc.

Features: A conventional LED is mounted with a diffusion lens on its irradiation side to increase the LED luminance and complement the wide angle of the light, which, as a result, reduces the light intensity by about 20%. To cover these shortcomings, more than one high intensity chips were implanted, instead of a diffusion lens, in the device we used, allowing us to control all wavelengths. (1) Light wavelengths: Five different wavelengths of 460 nm, 575 nm, 644 nm, 870 nm, and 940 nm. (2) Total number of LED elements: 3480. (3) Total number of LED light power: 3656 mW. (Light output does not include thermal energy.) In acne patients, after facial cleansing for 15 minutes, blue and red lights were irradiated concurrently twice a week at a distance of less than 10 cm from the face. The satisfaction level of the patients was evaluated after 10 procedures with the use of a 5-grade scale for satisfaction level and was reevaluated with the use of the Leeds Grading System.

Results: (1) The patients felt improvement after receiving an average of 5 procedures. Those with inflammatory acne and acne scar showed better improvement. Those with oily skin also showed improvement in their skin. The therapy also made it easier to remove white comedos. (2) The reevaluation using the Leeds Grading System after 10 procedures showed improvement of 3 grades or more in all the patients. It is necessary for subjects to achieve grade 6 or more, however, to continue the therapy. Of them, 80% showed improvement after receiving 20 procedures to grades 1 to 3.

Conclusion: The therapy using the new LED system quickly improved serious inflammatory acne and acne scars, indicating a high efficacy of the therapy.

Author disclosure: Nothing disclosed at press time. Commercial support: None.

Poster Discussion Session P3316, American Academy of Dermatology, 64th Annual Meeting, March 3-7 2006, San Francisco.

Supplement to Journal of The American Academy of Dermatology, March 2006, Volume 54, Number 3.

• JAAD Poster Abstracts Online (29Mb)

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