Grandinétti Vanessa dos Santos, Miranda Eduardo Foschini, Johnson Douglas Scott, de Paiva Paulo Roberto Vicente, Tomazoni Shaiane Silva, Vanin Adriane Aver, Albuquerque-Pontes Gianna Móes, Frigo Lucio, Marcos Rodrigo Labat, de Carvalho Paulo de Tarso Camillo, Leal-Junior Ernesto Cesar Pinto
Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University, Rua Vergueiro, 235, São Paulo, SP, 01504-001, Brazil.
Lasers Med Sci. 2015 Jul;30(5):1575-81. doi: 10.1007/s10103-015-1755-0. Epub 2015 May 19.
From the very first reports describing the method of action of phototherapy, the effects have been considered to be the result of photochemical and photophysical interactions between the absorbed photons and tissue and not related to secondary changes in tissue or skin temperature. However, thermal effects have been recently reported in dark pigmented skin when irradiated with single wavelengths of 810 and 904 nm of low-level laser therapy (LLLT) devices even with doses that do not exceed those recommended by the World Association of Laser Therapy (WALT). The aim of this study was to evaluate the thermal impact during the concurrent use of pulsed red and infrared LEDs and super-pulsed lasers when applied to light, medium, and dark pigmented human skin with doses typically seen in clinical practice. The study evaluated the skin temperature of 42 healthy volunteers (males and females 18 years or older, who presented different pigmentations, stratified according to Von Luschan's chromatic scale) via the use of a thermographic camera. Active irradiation was performed with using the multi-diode phototherapy cluster containing four 905-nm super-pulsed laser diodes (frequency set to 250 Hz), four 875-nm infrared-emitting diodes, and four 640-nm LEDs (manufactured by Multi Radiance Medical™, Solon, OH, USA). Each of the four doses were tested on each subject: placebo, 0 J (60 s); 10 J (76 s); 30 J (228 s); and 50 J (380 s). Data were collected during the last 5 s of each dose of irradiation and continued for 1 min after the end of each irradiation. No significant skin temperature increases were observed among the different skin color groups (p > 0.05), age groups (p > 0.05), or gender groups (p > 0.05). Our results indicate that the concurrent use of super-pulsed lasers and pulsed red and infrared LEDs can be utilized in patients with all types of skin pigmentation without concern over safety or excessive tissue heating. Additionally, the doses and device utilized in present study have demonstrated positive outcomes in prior clinical trials. Therefore, it can be concluded that the effects seen by the concurrent use of multiple wavelengths and light sources were the result of desirable photobiomodulation effect and not related to thermal influence.
从最初描述光疗作用机制的报告开始，人们就认为其效果是吸收的光子与组织之间光化学和光物理相互作用的结果，与组织或皮肤温度的继发性变化无关。然而，最近有报道称，在使用810和904纳米单波长的低强度激光治疗（LLLT）设备照射深色皮肤时，即使剂量未超过世界激光治疗协会（WALT）推荐的剂量，也会产生热效应。本研究的目的是评估在临床实践中通常使用的剂量下，同时使用脉冲红色和红外发光二极管（LED）以及超脉冲激光时，对浅色、中等色和深色人种皮肤产生的热影响。该研究通过使用热成像相机评估了42名健康志愿者（年龄在18岁及以上的男性和女性，根据冯·卢尚色度表呈现不同色素沉着）的皮肤温度。使用包含四个905纳米超脉冲激光二极管（频率设置为250赫兹）、四个875纳米红外发光二极管和四个640纳米LED的多二极管光疗集群进行主动照射（由美国俄亥俄州索伦市的Multi Radiance Medical™制造）。对每个受试者测试了四种剂量：安慰剂，0焦耳（60秒）；10焦耳（76秒）；30焦耳（228秒）；和50焦耳（380秒）。在每次照射剂量的最后5秒收集数据，并在每次照射结束后持续1分钟。在不同肤色组（p＞0.05）、年龄组（p＞0.05）或性别组（p＞0.05）中均未观察到明显的皮肤温度升高。我们的结果表明，超脉冲激光与脉冲红色和红外LED的同时使用可用于所有类型皮肤色素沉着的患者，而无需担心安全性或组织过度发热。此外，本研究中使用的剂量和设备在先前的临床试验中已显示出积极的结果。因此，可以得出结论，多种波长和光源同时使用所产生的效果是理想的光生物调节作用的结果，与热影响无关。
