PEER-REVIEW | FACIAL AESTHETICS |
Figure 12 Subjective perception of late postoperative LED
treatment acceptability
(24 hours after treatment) as reported by study subjects after the first
session (T1-IOP) and after the last treatment (T1 + 30-IOP):
NISA = Treatment Not Interfering with Social Activities;
NIMU = Treatment Not Interfering with use of
Make-Up; AOP = Absence of Pain; AOD = Absence of Desquamation;
AOR = Absence of Redness
PATIENT ACCEPTABILITY 24 HOUR POST-TREATMENT 100% 80% 60% 70% 60% 90% 100% 40% 20% 10% 0%
T1-END+24h NISA
Totally agree
T1+30+24h NISA
Partially agree considered the treatment extremely effective, 20%
very effective, 20% effective, and 30% moderately effective (Figure 13). The most important improvement reported was on
overall skin tone perceived by study subjects. All treated subjects considered LED photobiomodulation effective at T2 (T1 + 45 days). Fifty percent considered the treatment extremely effective, 40% very effective, and 10% moderately effective. Slight variations in the clinical evaluation score were observed at T3 (T1 + 75 days), always keeping a 100% satisfaction rate. Of these, 30% of subjects considered the treatment extremely effective, 20% very effective, 20% effective and 30% moderately effective. In spite of the opposite trend observed for superficial skin spots as measured by Visia computerised skin complexion analysis, most study subjects considered this specific parameter improved. Eighty percent of subjects confirmed an improvement at T2 (30% extremely effective, 20% very effective, 10% effective, and 20% moderately effective). Ninety percent of subjects confirmed an improvement also at T3 (30% extremely effective, 10% very effective, 30% effective, 20% moderately effective) (Figure 14).
Discussion Narrowband incoherent IR-A LED photobiomodulation within the action spectra of 580 nm to 860 nm should
SKIN TEXTURE
100% 80% 60% 40% 20% 0%
40% 30%
20% 10%
T2 (T1+45) Extremely effective 36 ❚ 30%
20% 20%
30% T3 (T1+75) Very effective Effective
100% 80% 60% 40% 20% 0%
T1-END+24h NIMU
Indifferent
T1+30+24h NIMU
Disagree The most
important improvement reported was on overall skin tone perceived by study subjects.
T1-END+24h AOP
T1+30+24h AOP
Totally disagree
rejuvenate exposed skin by positively modulating overall cellular levels, increasing dermal collagen synthesis, and down-regulating matrix metalloproteinases. The final clinical result of LED photobiomodulation should therefore correlate with progressive dermal structural changes triggered by sequential exposures to specific wavelengths. Two major potential drawbacks of this interesting approach to skin rejuvenation are identified by the short temporal coherence (coherence length) and the low spatial or lateral coherence characterising narrowband LED, making treatment distance between light source and irradiated surface crucial for the effectiveness of photobiological events. The more monochromatic the light, the longer the length where the light field is coherent in volume, and the smaller the divergence of the light beam at the point of irradiation 23
. These particular physical
Figure 13 Subjective perception of LED treatment efficacy on overall skin texture improvement and wrinkle reduction at T2 = T1 + 45 days, and T3 = T1 + 75 days as reported by study subjects
WRINKLE REDUCTION 20% 40% 20%
20% 10%
10% T2 (T1+45) Moderately effective 30% 10% T3 (T1+75) Totally ineffective 20% 20%
aspects of LED radiation allow for uniform irradiance on highly irregular skin surfaces, like the human face. Most LED delivery systems consist of linear stripes of variable length, regularly distributed along flat or curved panels. This feature showed to be only partially effective in ‘recontouring’ the complex anatomy of the human face. In the present study a novel narrowband sequentially
combined 840 nm CW + 880 nm PW LED facial mask light delivery system has proven to be safe and effective in reducing facial wrinkle count, improving overall skin texture, tone, and elasticity. A minor increase in surface spotty dyspigmentation count was detected by computerised facial feature analysis by Visia Complexion Analysis, 15 and 45 days after the treatment. This particular finding could be explained as a sub-clinical post-inflammatory hyperpigmentation (PIH) due to a micro-thermal paracrine-cytokine signaling up-regulation of keratinocyte and fibroblast alpha-Melanocyte Stimulating Hormone (MSH) release P53-dependent 24–25
.
The majority of study subjects considered the treatment quite effective (90–100%) and acceptable, both intra-operatively, and post-operatively. The combination of CW emission immediately followed by PW emission may possibly explain the high degree of clinical success in improving premature facial skin ageing.
March 2013 |
prime-journal.com
T1-END+24h AOD
T1+30+24h AOD
T1-END+24h AOR
T1+30+24h AOR
10%
10% 10%
10% 10%
10% 10%
10% 30%
10% 20%
10% 90% 80% 90% 90% 80% 90%
% of subjects
% of subjects
% of subjects
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