Kim Won-Serk, Calderhead R Glen
Department of Dermatology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Laser Ther. 2011;20(3):205-15. doi: 10.5978/islsm.20.205.
Low level light therapy (LLLT) has attracted attention in many clinical fields with a new generation of light-emitting diodes (LEDs) which can irradiate large targets. To pain control, the first main application of LLLT, have been added LED-LLLT in the accelerated healing of wounds, both traumatic and iatrogenic, inflammatory acne and the patient-driven application of skin rejuvenation. Rationale and Applications: The rationale behind LED-LLLT is underpinned by the reported efficacy of LED-LLLT at a cellular and subcellular level, particularly for the 633 nm and 830 nm wavelengths, and evidence for this is presented. Improved blood flow and neovascularization are associated with 830 nm. A large variety of cytokines, chemokines and macromolecules can be induced by LED phototherapy. Among the clinical applications, non-healing wounds can be healed through restoring the collagenesis/collagenase imbalance in such examples, and 'normal' wounds heal faster and better. Pain, including postoperative pain, postoperative edema and many types of inflammation can be significantly reduced. Experimental and clinical evidence: Some personal examples of evidence are offered by the first author, including controlled animal models demonstrating the systemic effect of 830 nm LED-LLLT on wound healing and on induced inflammation. Human patients are presented to illustrate the efficacy of LED phototherapy on treatment-resistant inflammatory disorders.
Provided an LED phototherapy system has the correct wavelength for the target cells, delivers an appropriate power density and an adequate energy density, then it will be at least partly, if not significantly, effective. The use of LED-LLLT as an adjunct to conventional surgical or nonsurgical indications is an even more exciting prospect. LED-LLLT is here to stay.
低强度光疗法（LLLT）已凭借新一代能够照射大面积目标的发光二极管（LED）在许多临床领域引起关注。对于LLLT的首个主要应用——疼痛控制，LED-LLLT已被应用于加速创伤性和医源性伤口的愈合、炎性痤疮的治疗以及由患者驱动的皮肤年轻化应用。原理与应用：LED-LLLT背后的原理基于其在细胞和亚细胞水平上已报道的疗效，特别是对于633纳米和830纳米波长，本文提供了相关证据。830纳米波长与改善血流和新生血管形成有关。LED光疗可诱导多种细胞因子、趋化因子和大分子。在临床应用中，例如通过恢复胶原合成/胶原酶失衡，可使不愈合伤口愈合，“正常”伤口愈合得更快更好。疼痛，包括术后疼痛、术后水肿和多种炎症均可显著减轻。实验与临床证据：第一作者提供了一些证据实例，包括对照动物模型，证明830纳米LED-LLLT对伤口愈合和诱导炎症的全身作用。列举了人类患者案例以说明LED光疗对难治性炎症性疾病的疗效。
如果LED光疗系统具有针对靶细胞的正确波长、提供适当的功率密度和足够的能量密度，那么它至少会有部分效果，即便不是显著效果。将LED-LLLT用作传统手术或非手术适应症的辅助手段是一个更令人兴奋的前景。LED-LLLT将会持续存在。
