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8/10/2019 DrFritz PDT Omnilux
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Photodynamic Rejuvenationcomparison of LLLT with10% and 20 % ALA PDT
Carmen Solavastru and Klaus Fritz
University Carol Davila Bukarest (Ro) andDermatology and Laser Center Landau (D)
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PDT Treatment effects :
Reduces signs of exogenous
skin ageing such as AK,pigmentation, alwaysimproves skin texture, too
Induces collagenneogenesis resulting insmoothening and tighteningof the skin
Light sources themselfmay decreasepigmentation,solarlentigines andteleangiectasia
Background:
Ageing skin ageing is caused significantly by photoageing,actinic keratoses occur.
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Omnilux light Technology1. Light Emitting Diode
matrix
2. LEDs are chips that
directly convertelectricity to light
Background device/ light source
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Omnilux blue
415nm wavelength
with 5 ALA for Actinic Keratosis
Omnilux revive 633nm wavelength
for primary skin rejuvenation alone or in
combination with 5 ALA for photodamage
Omnilux plus
830nm wavelength for wound healing
Background device/ light source
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Types of light reaction
1. Activation of cell receptors
in the mitichondria or on the cell membrane lead to
increased cell metabolism = photobiostimulation:
Skin rejuvenation, wound healing, , tissue regeneration
2. In combination with ALA as a topically applied
photosensitiserFor the treatment of non melanoma skin cancers, acne
and photodamaged skin
Background device/ light source
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Role of LLLT (Low level light therapy)
data of Randomised Clinical
Trials and laboratory based
research show improved
Collagen synthesis Anti bacterial
Background device/ light source LLLT alone
oWound healing and tissue repairoangiogenisisoRelief of inflammation
oneuroregenerationoCytoprotection
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633nm (Visible red light) alone
Left
(Covered)
Right
(Treated)
Before treatment 12 weeks after treatment
National Medical CenterRepublic of Korea
Background device/ light source LLLT alone
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Control group
830nm alone
830nm+633nm
Percentage reduction
Change in the severity of wrinkles (Visiometer Results: profilometry value)
< R3 value = The Average Roughness >
Time
(- 36%)50%
55%
60%
65%
70%
75%
80%
85%
90%
95%
100%
105%
Before
Treatment
2 weeks
post treatment
4 weeks
post treatment
8 weeks
post treatment
12 weeks
post treatment
633nm
alone
Background device/ light source LLLT alone
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Treatment Results 67% (4/6)significant treatment response
Reduction in fine lines and wrinkles Skin softness improved
Background device/ light source LLLT alone
Lowe N. Lowe P (2005) J. Cosmetic and Laser Therapy volume
7 issue : Pilot Study to determine the efficacy of ALA-PDTphotorejuvenation for the treatment of facial ageing
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The effect of combination Omnilux
phototherapy on fine lines and wrinkles
Russell B Journal of Cosmetic and Laser Therapy 2005; 7: 196
200
Background device/ light source LLLT alone
Reduction in valley depth (st) or wrinkles atweek 12.
83% and 81% reporting a softening of fine linesand wrinkles at weeks 9 and 12 respectively.
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Studies and case reports on rejuvenationTouma DJ, Gilchrest BA.
Topical photodynamic therapy: a new tool in
cosmetic dermatology.Semin Cutan Med Surg.
2003 Jun;22(2):124-30.
Gold MH, Goldman MP.5-aminolevulinic acidphotodynamic therapy: where we have been and
where we are going. Dermatol Surg. 2004
Aug;30(8):1077-83; discussion 1083-4.
Zakhary K, Ellis DA.
Applications of aminolevulinic Acid-based
photodynamic therapy in cosmetic facial plasticpractices.Facial Plast Surg. 2005 May;21(2):110-6
Touma D, Yaar M, Whitehead S et al.A trialof short incubation, broad-areaphotodynamic therapy for facial
actinic keratoses and diffusephotodamage.Arch Dermatol 2004; 140:33-40.
Ruiz-Rodriquez R, Sanz-Sanchez T,CordoboS. Photodynamicphotorejuvenation. Dermatol Surg2002; 28:742-744.
Gold MH.Intense pulsed light therapyfor photorejuvenation enhanced with20%aminolevulinic acid photodynamictherapy.J Laser Med Surg 2003; 15(S):47.
ALA +Light
Background light source + ALA
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&term=%22Touma+DJ%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&term=%22Gilchrest+BA%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&term=%22Gold+MH%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&term=%22Goldman+MP%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&term=%22Zakhary+K%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&term=%22Ellis+DA%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&term=%22Ellis+DA%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&term=%22Zakhary+K%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&term=%22Goldman+MP%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&term=%22Gold+MH%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&term=%22Gilchrest+BA%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&term=%22Touma+DJ%22%5BAuthor%5D8/10/2019 DrFritz PDT Omnilux
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Fink Puches R, Soyer.H.-P.,Hofer A et a. Long-term follow-up andhistological changes of superficial
non melanoma skin cancers treat-ed with topical delta-aminolevulinic acid
photodynamic therapy, ArchDermatal. 1998;134:821-826.
Touma DJ,Szeimis RM:Topical PDT in Krutmann Skin Ageing2006 (157-166)
studies have also demonstrated
increased fibrosis and
New collagen formation in the dermis several months
after 5 ALA~PDT for the treatment of basal cell and squamouscell carcinomas.
Photo s co urtes y of Mark S. Nestor, M.D., Ph.D.
Background light source + ALA
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Min Young Park, MD, Seonghyang Sohn, PhD, Eun-So Lee, MDand You Chan Kim, MD
Journal of the American Academy of DermatologyVolume 62, Issue 1, Pages 85-95(January 2010)
Photorejuvenation induced by 5-aminolevulinic acidphotodynamic therapy in patients with actinic keratosis:
A histologic analysis
14 patients with actinic keratoses treated twice with ALA-PDT by using a 1200 W
metal halogen lamp at 1-month intervals.
Skin biopsy before and 1 month after the PDT
routine and immunohistochemical stainingparameters associated with photoaging by using image analysis.
Background light source + ALA
http://www.eblue.org/article/S0190-9622(09)00694-X/abstracthttp://www.eblue.org/article/S0190-9622(09)00694-X/abstracthttp://www.eblue.org/article/S0190-9622(09)00694-X/abstracthttp://www.eblue.org/article/S0190-9622(09)00694-X/abstract8/10/2019 DrFritz PDT Omnilux
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Source: Journal of the American Academy of Dermatology 2010; 62:85-95)
Mean expression of TGF-, TR II, procollagen I,procollagen III, and total collagen volume
increased with each session of ALA-PDT.
TGF-does not only up-
regulate procollagensynthesis,but it also down-regulates theexpression of MMPs
Background light source + ALA
http://www.eblue.org/article/S0190-9622(09)00694-X/abstracthttp://www.eblue.org/article/S0190-9622(09)00694-X/abstracthttp://www.eblue.org/article/S0190-9622(09)00694-X/abstracthttp://www.eblue.org/article/S0190-9622(09)00694-X/abstract8/10/2019 DrFritz PDT Omnilux
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Source: Journal of the American Academy ofDermatology 2010; 62:85-95)
Procollagen type I and
type III
The expression of collagenprecursors was alsoincreased, especially in the
papillary dermis and upperreticular dermis.
The average increase was
significantly different
Background light source + ALA
Fi 5
http://www.eblue.org/article/S0190-9622(09)00694-X/abstracthttp://www.eblue.org/article/S0190-9622(09)00694-X/abstracthttp://www.eblue.org/article/S0190-9622(09)00694-X/abstracthttp://www.eblue.org/article/S0190-9622(09)00694-X/abstracthttp://www.eblue.org/article/S0190-9622(09)00694-X/abstracthttp://www.eblue.org/article/S0190-9622(09)00694-X/abstracthttp://www.eblue.org/article/S0190-9622(09)00694-X/abstracthttp://www.eblue.org/article/S0190-9622(09)00694-X/abstract8/10/2019 DrFritz PDT Omnilux
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Fig 5
Source: Journal of the American Academy of Dermatology 2010; 62:85-95)
Mean expression of TGF-, TR II, procollagen I,procollagen III, and total collagen volume
increased with each session of ALA-PDT.
TGF-does not only up-
regulate procollagensynthesis,but it also down-regulates theexpression of MMPs
Background light source + ALA
k d l h
http://www.eblue.org/article/S0190-9622(09)00694-X/abstracthttp://www.eblue.org/article/S0190-9622(09)00694-X/abstracthttp://www.eblue.org/article/S0190-9622(09)00694-X/abstracthttp://www.eblue.org/article/S0190-9622(09)00694-X/abstract8/10/2019 DrFritz PDT Omnilux
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After ALA-PDT, the mean epidermal thickness and dermal inflammatory
infiltrate were reduced.
The total collagen volume in the dermis significantly increased with expressionof type I and III procollagen.
The level of transforming growth factor and transforming growth factor typeII receptors in the epidermis also increased.
The elastotic material with co-localizing fibrillin-1 and tropoelastin expression inthe dermis decreased after treatment.
The expression of matrix metalloproteinases-1, -3, and -12 also decreased.
Background light source + ALA
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Two sessions of MAL-PDT increases
immunohistochemical expression of MMP-9 in the
dermis at 3 months after treatment, and also of
Collagen type I.
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Method: 10 patients each group
Group A
was treated with bluelight of 415 nm+633 each side
( Omnilux ) 8-12times 1x/week for 10min eachwavelenghth andside of the face
Group B
received classic ALAtreatment with
20 % ALA (prescription),
applied for 3 h andtreated with 415 nm 10min +10min of 633 nm
Group C
received 10 % ALA for 30 min and
415 nm 10 min + 633 nm 10 min
Own results
12 i O il
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A 12 times Omnilux
= 415 nm + 633 nm
improvedsignificantly
radiancy ,
skin toneand
pore size
Courtesy Dr Klaus Fritz
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B classic 20 % ALA , 3 h and treated with
415 + 633 nm 10 min each/side
reduced actinic keratoses more than 90 %,
reduced dyschromia significantly and
resulted in a smoother skin texture ,
all signs of skin ageing reduced significantly
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B classic 20 % ALA , 3 h and treated with
415 + 633 nm 10 min each/side
reduced actinic keratoses more than 90 %,
reduced dyschromia significantly and
resulted in a smoother skin texture ,
all signs of skin ageing reduced significantly
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C 10 % ALA for 30 min , 415 nm +633 nm 10 min each/side
improved same parameters up to 70 % astreatment No. B
but allowed less redness, crusting ,pain and
irritation .
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C 10 % ALA for 30 min , 415 nm +633 nm 10 min each/side
improved same parameters up to 70 % astreatment No. B
but allowed less redness, crusting ,pain and
irritation .
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conclusion and summary
modified application of PDT of 10% and 30 minusing the 415 + 633 nm Omnilux with its anti-inflammatory effects are very effective inrejuvenation of ageing skin .This protocol
allows both, a cosmetic improvement and thepreventive effects in actinic keratoses.
LLLT with 415 nm and 633 nm only can
improve radiancy and smoothness of the skineven without ALA
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conclusion and summary
Compared to other procedures such as lasers orchemical peels PDT needs 1 2 sessions only
every 1- 3 years, need few visits ,and combinehighly effective cosmetic improvements with a lowrisk of side effects at comparibly low costs.
Ph t d i R j ti
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Carmen Solavastru and Klaus Fritz
University Carol Davila Bukarest (Ro) andDermatology and Laser Center Landau (D)
Thank You
Photodynamic Rejuvenationcomparison of LLLT with10% and 20 % ALA PDT