LLT and LED-induced 1st degree burns and flushing

[drnase]

Until I get this up on my site, I wanted to post once on this topic.

If you have Type I rosacea with a red face, inflammation, facial flushing, or sensitivity to the outside elements you should absolutely not use the LED or LLT systems.

I will keep this brief. There may be 6 people on all these boards that have reported positive experiences and they were mainly on acne as is to be expected.

The LLT and LED mechanism of action is claimed to be "anti-inflammatory". This is the most overused and misunderstood word in the rosacea sufferers vocabulary. In many cases, things that promote dramatic increases in blood flow remove the inflammation -- e.g look up arthritis treatment and diabetic wound healing. This is great because these disorders are NOT based on a flushing disorder.

You do not treat a flushing disorder with a flushing machine. You may push along some of the old neutrophils, but there is a greater chance that your face will become much more sensitiive.

I was a little baffled at the degree that one or two people will defend this to their life's end. Now I understand better -- some get commissions for each unit sold. They submit a name or the person buying it is asked to mention their name. That is what is behind many (but not all) of these "sellers" attacks. I thought it was germane that everyone knew this.

If there are 5 or 6 good reports (and these people are using 4 to 5 other medications which makes it impossible to locate the beneficial variable), I have received well over 110 to 125 reports of blister skin, 1st degree burns, and increased flushing. We should kindly ask Dermalux how many rosacea sufferers returned their machines within the first 30 days -- that would speak for itself.

I think this idea of treating ones self 20 mintues a day has a very appealing lure to it. I truly wish it would work, no matter what others think. But it does not.

I spoke to one of our laser gurus in the UK over the phone two days ago and he brought up the fact that he was treating patients using LED or LLT that had hurt themselves. Others he is turning away because he does not know what to do with these cases. This physicians reputation is beyond reproach, but I do not think he will ever butt his head in here because he does not want to be involved in any controversy. Two other laser physicians from the UK have treated over a dozen burn cases and one UK dermatologist who I am in constant contact with has treated three cases. I know 7 people from Australia on this board who have returned their machines within 30 days for full refund due to uncontrolled flushing and 24 hour red faces. I have over 60 reports from US rosacea sufferers trying it and 4 well known laser physicians who we have all heard from who are treating these patients now for LED and LLT-induced permanent side effects. I hope that these physicians will come forward, but with the recent animosity, I doubt they will.

In all humility, I know more about both of these systems than almost everyone else. I know the physics behind these machines, the effects on living tissue and cells and MOST importantly the clinical actions on patients. If you do not have the clinical experience and see what is happening first hand and actually measure the blood flow increases with laser doppler, you cannot go back and forth via words on this board with any degree of accuracy.

I am stepping in right now because with one moderator pushing this hard and another who (well no comment), this board is going to turn into an LED and LLT treatment board.

Be warned, most rosacea sufferers will be harmed by this treatment. To make a home made system and then pass out information on how to make something never tested on rosacea skin is absolutely irresponsible. In fact, the UK laser physicians who we all know quoted that he just treated, "a rosacea sufferer who put together an LED machine from Radio Shack parts". This person has a first degree burn and the flushing, redness and burning may never be treated fully.

If you want real medical explanations, please call any Diabetic Wound Healing Center, Rhuematoid Arthritis Treatment Center, Carpel Tunnel Treatment Center and talk to the physicians on staff. They will tell you point blank that they use these systems to increase blood flow to the area. Blood flow increases are dramatic -- reaching up to 600% increase in blood flow. Is this what rosacea sufferers want? Please use common sense on this one.

Currently the FDA has passed the use of LED and LLT therapy for disorders that "can be treated by increased blood flow".

1. Laboratory studies have shown that skin cells grow 150-200 percent faster when exposed to certain LED light wavelengths. Independent research for over 40 years has shown LED red and infrared light delivers powerful therapeutic benefits to living tissue. Both visible red and infrared light has been shown to affect at least 24 different positive changes at a deep level. Visible red light, at wavelengths from 630-660 nanometers, penetrates tissue to a depth of 8-10 mm. LED light is very beneficial in treating problems close to the skins surface such as wounds, cuts, and scars. Skin layers, because of their high blood and water content, absorb red light very readily and deliver enough energy to stimulate a response from the body to heal itself. This photobiomodulation is achieved solely through significant increases in skin blood flow through all levels of the skin.


2. You may have recently read about L.E.D. Light Therapy in a recent issue of Elle Magazine, boasting the anti-aging and anti-inflammatory benefits. Their studies revealed that exposing the skin to red L.E.D. lights for a little under 20 minutes can plump skin, smooth wrinkles and fine lines. Another study revealed that exposure to L.E.D. lights for approx. 3 minutes per area can promote collagen stimulation by 200% within a 24 hour period! LED works by increasing blood flow by up to 4 times the resting amount (400%) and this is the main mechanism by which these systems work. Buyer Beware – these machines are NOT made for rosacea because it is not a stable inflammatory skin process. It is an inflammatory process that feeds on itself – more blood flow to the area helps damage more blood vessels, hypersenitize them and create a vicious positive feed back loop that may be very hard to break. The home unit which was mentioned in magazine article retails for $2,495 and the photo of the unit shown in the article appeared to have the smaller (weaker) 3 - 5 mm lights.


Now, there is one very intersting effect of both systems directly on cells. They can stabilize and make cells healthy via photobiomodulation. Someone make a machine that just does this and does not increase blood flow and you have something.

This subject was much too important for me to ignore it and continue working on my site. This is an absolute buyer beware and just know that many of the physicians that I have been in contact do not know how to treat a burn on top of rosacea flushing and redness.

Feel free to take this subject where you will. There is no harm to present medical information on these two systems. I have no other response to either of these systems. Updates will be placed on my site as debates are not constructive here with a few.

[peter.crouch]

Geoffrey Nase must have been reading my mind when he posted this as I was just about to press submit with the following:-

Dear All,
In no way do I want this post to diminish from the personal initiative of others seeking to find a cost effective treatment for their rosacea however I have seen two patients this week (one on Monday and another today) who has seriously risked their skin health (and possibly their vision) by exposing themselves to home constructed super bright Infra red LED arrays. The LEDs were purchased from separare mail order electrical wholesalers - (one was Maplin) in the UK. They require little expertise to solder onto printed circuit boards and wire up to a 12v mains adapter.

One patient had purchased 20 of these 26mm LED Clusters each consisting of 14 LEDs and arranged them in 2 face panels - all quite ingenious really. They output very bright light in the 570-660nm wavelengths. He had sat in front of these for 30-60 minutes last Saturday (he cant remember exactly how long) and then again on Sunday as he had noticed only slight warmth. He came to see me on Monday with swelling of his eyelids and extreme facial redness. I think that if anything this will have made his rosacea worse not better and I had to advise him not to use this home made device again and to get his eyesight checked - he couldnt keep his eyes open long enough for me to formally assess his eyesight as his eyelids were too swollen so I asked him to see an optician a.s.a.p. I heard today that the optician told him that he hasn't suffered permanent damage (thankfully) but not to do it again.

The other patient that I saw on Wednesday had constructed a similar array using different LEDs and had tried to use it on four occasions over the past 2 weeks each time for less time but each time had stopped after 20-30 minutes due to "sunburn". I had to advise him not to try this again.

When I think of the regulations, testing, calibration, trials and approvals that any medical device needs to go through before it can be used safely, I shudder to think of the damage that could have been caused by these improvised devices. The technology has now advanced to the point that Superbright LEDs output in these arrays can represent significant danger unless properly prescribed and delivered in a controlled and regulated manner.

Geoffrey - I agree, sometimes, you cant stand by and remain silent in the face of unwitting, well intentioned but dangerous self exploration.

Please, no one else attempt to construct your own LED array and risk your health in this unpredictable, unregulated way. Medical Devices should be properly constructed not thrown together from items never intended to be used for medical treatments.

Kind regards,

Peter

[IowaDavid]

Until I get this up on my site, I wanted to post once on this topic.

If you have Type I rosacea with a red face, inflammation, facial flushing, or sensitivity to the outside elements you should absolutely not use the LED or LLT systems.

I will keep this brief. There may be 6 people on all these boards that have reported positive experiences and they were mainly on acne as is to be expected.

The LLT and LED mechanism of action is claimed to be "anti-inflammatory". This is the most overused and misunderstood word in the rosacea sufferers vocabulary. In many cases, things that promote dramatic increases in blood flow remove the inflammation -- e.g look up arthritis treatment and diabetic wound healing. This is great because these disorders are NOT based on a flushing disorder.

You do not treat a flushing disorder with a flushing machine. You may push along some of the old neutrophils, but there is a greater chance that your face will become much more sensitiive.

I was a little baffled at the degree that one or two people will defend this to their life's end. Now I understand better -- some get commissions for each unit sold. They submit a name or the person buying it is asked to mention their name. That is what is behind many (but not all) of these "sellers" attacks. I thought it was germane that everyone knew this.

If there are 5 or 6 good reports (and these people are using 4 to 5 other medications which makes it impossible to locate the beneficial variable), I have received well over 110 to 125 reports of blister skin, 1st degree burns, and increased flushing. We should kindly ask Dermalux how many rosacea sufferers returned their machines within the first 30 days -- that would speak for itself.

I think this idea of treating ones self 20 mintues a day has a very appealing lure to it. I truly wish it would work, no matter what others think. But it does not.

I spoke to one of our laser gurus in the UK over the phone two days ago and he brought up the fact that he was treating patients using LED or LLT that had hurt themselves. Others he is turning away because he does not know what to do with these cases. This physicians reputation is beyond reproach, but I do not think he will ever butt his head in here because he does not want to be involved in any controversy. Two other laser physicians from the UK have treated over a dozen burn cases and one UK dermatologist who I am in constant contact with has treated three cases. I know 7 people from Australia on this board who have returned their machines within 30 days for full refund due to uncontrolled flushing and 24 hour red faces. I have over 60 reports from US rosacea sufferers trying it and 4 well known laser physicians who we have all heard from who are treating these patients now for LED and LLT-induced permanent side effects. I hope that these physicians will come forward, but with the recent animosity, I doubt they will.

In all humility, I know more about both of these systems than almost everyone else. I know the physics behind these machines, the effects on living tissue and cells and MOST importantly the clinical actions on patients. If you do not have the clinical experience and see what is happening first hand and actually measure the blood flow increases with laser doppler, you cannot go back and forth via words on this board with any degree of accuracy.

I am stepping in right now because with one moderator pushing this hard and another who (well no comment), this board is going to turn into an LED and LLT treatment board.

Be warned, most rosacea sufferers will be harmed by this treatment. To make a home made system and then pass out information on how to make something never tested on rosacea skin is absolutely irresponsible. In fact, the UK laser physicians who we all know quoted that he just treated, "a rosacea sufferer who put together an LED machine from Radio Shack parts". This person has a first degree burn and the flushing, redness and burning may never be treated fully.

If you want real medical explanations, please call any Diabetic Wound Healing Center, Rhuematoid Arthritis Treatment Center, Carpel Tunnel Treatment Center and talk to the physicians on staff. They will tell you point blank that they use these systems to increase blood flow to the area. Blood flow increases are dramatic -- reaching up to 600% increase in blood flow. Is this what rosacea sufferers want? Please use common sense on this one.

Currently the FDA has passed the use of LED and LLT therapy for disorders that "can be treated by increased blood flow".

1. Laboratory studies have shown that skin cells grow 150-200 percent faster when exposed to certain LED light wavelengths. Independent research for over 40 years has shown LED red and infrared light delivers powerful therapeutic benefits to living tissue. Both visible red and infrared light has been shown to affect at least 24 different positive changes at a deep level. Visible red light, at wavelengths from 630-660 nanometers, penetrates tissue to a depth of 8-10 mm. LED light is very beneficial in treating problems close to the skins surface such as wounds, cuts, and scars. Skin layers, because of their high blood and water content, absorb red light very readily and deliver enough energy to stimulate a response from the body to heal itself. This photobiomodulation is achieved solely through significant increases in skin blood flow through all levels of the skin.


2. You may have recently read about L.E.D. Light Therapy in a recent issue of Elle Magazine, boasting the anti-aging and anti-inflammatory benefits. Their studies revealed that exposing the skin to red L.E.D. lights for a little under 20 minutes can plump skin, smooth wrinkles and fine lines. Another study revealed that exposure to L.E.D. lights for approx. 3 minutes per area can promote collagen stimulation by 200% within a 24 hour period! LED works by increasing blood flow by up to 4 times the resting amount (400%) and this is the main mechanism by which these systems work. Buyer Beware – these machines are NOT made for rosacea because it is not a stable inflammatory skin process. It is an inflammatory process that feeds on itself – more blood flow to the area helps damage more blood vessels, hypersenitize them and create a vicious positive feed back loop that may be very hard to break. The home unit which was mentioned in magazine article retails for $2,495 and the photo of the unit shown in the article appeared to have the smaller (weaker) 3 - 5 mm lights.


Now, there is one very intersting effect of both systems directly on cells. They can stabilize and make cells healthy via photobiomodulation. Someone make a machine that just does this and does not increase blood flow and you have something.

This subject was much too important for me to ignore it and continue working on my site. This is an absolute buyer beware and just know that many of the physicians that I have been in contact do not know how to treat a burn on top of rosacea flushing and redness.

Feel free to take this subject where you will. There is no harm to present medical information on these two systems. I have no other response to either of these systems. Updates will be placed on my site as debates are not constructive here with a few.


Geoffrey Nase must have been reading my mind when he posted this as I was just about to press submit with the following:-

Dear All,
In no way do I want this post to diminish from the personal initiative of others seeking to find a cost effective treatment for their rosacea however I have seen two patients this week (one on Monday and another today) who has seriously risked their skin health (and possibly their vision) by exposing themselves to home constructed super bright Infra red LED arrays. The LEDs were purchased from separare mail order electrical wholesalers - (one was Maplin) in the UK. They require little expertise to solder onto printed circuit boards and wire up to a 12v mains adapter.

One patient had purchased 20 of these 26mm LED Clusters each consisting of 14 LEDs and arranged them in 2 face panels - all quite ingenious really. They output very bright light in the 570-660nm wavelengths. He had sat in front of these for 30-60 minutes last Saturday (he cant remember exactly how long) and then again on Sunday as he had noticed only slight warmth. He came to see me on Monday with swelling of his eyelids and extreme facial redness. I think that if anything this will have made his rosacea worse not better and I had to advise him not to use this home made device again and to get his eyesight checked - he couldnt keep his eyes open long enough for me to formally assess his eyesight as his eyelids were too swollen so I asked him to see an optician a.s.a.p. I heard today that the optician told him that he hasn't suffered permanent damage (thankfully) but not to do it again.

The other patient that I saw on Wednesday had constructed a similar array using different LEDs and had tried to use it on four occasions over the past 2 weeks each time for less time but each time had stopped after 20-30 minutes due to "sunburn". I had to advise him not to try this again.

When I think of the regulations, testing, calibration, trials and approvals that any medical device needs to go through before it can be used safely, I shudder to think of the damage that could have been caused by these improvised devices. The technology has now advanced to the point that Superbright LEDs output in these arrays can represent significant danger unless properly prescribed and delivered in a controlled and regulated manner.

Geoffrey - I agree, sometimes, you cant stand by and remain silent in the face of unwitting, well intentioned but dangerous self exploration.

Please, no one else attempt to construct your own LED array and risk your health in this unpredictable, unregulated way. Medical Devices should be properly constructed not thrown together from items never intended to be used for medical treatments.

Kind regards,

Peter


Can either of you please post the specific energy levels that were used by these patients that harmed themselves? Give us something to work with here rather than categorically saying LEDs are "bad". That's like saying lasers are bad, but failing to note that you were treated with a YAG at 500j/cm2.

Plus, if you're spending 2,500 USD on an LED unit you are a) A fool with money to burn, or b) Buying LEDs that are rated far higher than the LEDs I'm using. It's impossible to get burned by the LEDs on my array as beyond an inch or two from the array there is no heat!

That's the whole point of the LEDs! They are non-thermal! This is why the wavelength is important and not the output. If I wanted a super power output I'd go buy football stadium lights and put a monochromatic filter over them. THAT would be 660nm red light that was thermal in nature. That would certainly cause flushing.

All of the abstracts I read about red light therapy were quoting numbers that were measured on the scale of joules/cm2--that's getting into thermal treatment.

As I said before, this is _non-thermal_ treatment. That's why the wavelength is important as the wavelength appears to be the reason it is effective at non-thermal levels. Sitting in front of a normal 60-watt light bulb would produce much more thermal energy and might very well cause a rosacea sufferer to flush as this is light energy that is high enough to heat the surrounding air/or skin if you're nearby.

And, please, do not conflate "light" and "LED light". LEDs work differently than other light sources. That's the reason local governments are putting them into traffic lights and they are being used for other civic necessities--they last a very long time and don't waste energy by producing heat.

As I have seen Dr. Nase call the Dermalux unit an "LED" unit in the past (it does not use LEDs), I would implore both Dr. Crouch and Dr. Nase to a) quote the energy output of the units that harmed these patients, and b)what the light source is.

Thanks,

David

[drnase]

There is no way in this world that a constructive debate can come out of this but in the pursuit of courtesy, I will try to answer Davids most cogent questions.

1. Every single LED and LLT will cause dramatic increases in blood flow. Every one, every wavelength, and every self made system.

2. Non-thermal is not what you think it means. It just means that heat is not generated in the skin via the machine -- it does not mean that subsequent heat will be generated from the flushing, because it will. Non thermal does not relate to the blood flow increases.


Thats really about it. Each system or variation has the same basic mechanism of action so you dont need to address them separately.

That is all I wated to do in this post -- present the medical side of this for safety sake. This could easily be a four pager with debates. That is not my intent. The informatin is up there from LED and LLT supporters and from medical and biomedical professionals. Now people have information that they can base a decision on.

[IowaDavid]

Dr. Nase, with all due respect, you did not answer my question. And, furthermore, your point 1. is prima facie not true. That's silly.

Please, can you give me the energy level where these patients were harmed by red light? I really am interested in understanding this.

There is no way in this world that a constructive debate can come out of this but in the pursuit of courtesy, I will try to answer Davids most cogent questions.

1. Every single LED and LLT will cause dramatic increases in blood flow. Every one, every wavelength, and every self made system.

2. Non-thermal is not what you think it means. It just means that heat is not generated in the skin via the machine -- it does not mean that subsequent heat will be generated from the flushing, because it will. Non thermal does not relate to the blood flow increases.


Thats really about it. Each system or variation has the same basic mechanism of action so you dont need to address them separately.

That is all I wated to do in this post -- present the medical side of this for safety sake. This could easily be a four pager with debates. That is not my intent. The informatin is up there from LED and LLT supporters and from medical and biomedical professionals. Now people have information that they can base a decision on.

[adyus]

You are both intelligent persons. I respect both of you because you are intelligent persons. Please do not get involved in a personal confrontation and please accept that there are different points of view for every issue.

Adrian

[peter.crouch]

Dear All,
The problem is I have absolutely no idea what the energy output of these devices is - this is exactly the problem associated with constructing and using them.

For example, I don't know precisely what the distance the patients were from the device and neither patient knew if they kept at a constant distance throughout the treatment as they had their eyes closed.
The arrays had 2 types of LEDs in the clusters - some at 570nm and others at 660nm. As neither patient brought the devices with them when they came to see me I can't measure the energy output (actually I don't have a device that can measure this - our lasers and IPL machines each have a calibration meter so I know the output and the treatment time and exact treatment distance).

Although I don't know what energy output these improvised devices are producing, what I can see however is the tissue damage arising from using them ~ both patients were lucky to escape permanent damage. I have no problem with properly constructed/ tested / calibrated devices with FDA approval.

Kind regards,

Peter

[drnase]

Dear All,
The problem is I have absolutely no idea what the energy output of these devices is - this is exactly the problem associated with constructing and using them.

For example, I don't know precisely what the distance the patients were from the device and neither patient knew if they kept at a constant distance throughout the treatment as they had their eyes closed.
The arrays had 2 types of LEDs in the clusters - some at 570nm and others at 660nm. As neither patient brought the devices with them when they came to see me I can't measure the energy output (actually I don't have a device that can measure this - our lasers and IPL machines each have a calibration meter so I know the output and the treatment time and exact treatment distance).

Although I don't know what energy output these improvised devices are producing, what I can see however is the tissue damage arising from using them ~ both patients were lucky to escape permanent damage. I have no problem with properly constructed/ tested / calibrated devices with FDA approval.

Kind regards,

Peter


Thank you Dr. Crouch for that medical information and analysis.

As one person brought up in an email, I am personally interested in the effect of photobiomodulation. The ability of certain lights and energy to ""heal" skin cells and blood vessel cells. The "light" hits millions of cells throughout the skin and increases mitochondrial action (oxygen and energy),, helps fix plasma membranes and increases the influx of calcium to help normalize the cell membrane potential. These are all great things for cells on rosacea skin.

HOWEVER, each of these processes signals a significant increase in blood flow to each cell to support all of these upregulated functions and remove metabolic byproducts. That means a sustained increase in facial blood flow to millions of cells. That is a problem. All of these systems do that no matter what variant of machine.

Find a machine that will heal all the damaged inflammatory cells without increasing blood flow or increasing the chance of a burn or more flushing and you have really got something.

[IowaDavid]

Hi Dr. Crouch, yes, I was concerned about harming myself with red light therapy as well. I started gingerly with the all-red acnelamp 3-headed model. As per that company's data, the blue/red mixed acnelamp has an output of 2.65 ujoules/cm2 for the red light.

The all-red acnelamp head has 3 times the number of red LEDs so the output for my unit, for each head, is 7.95 ujoules/cm2 at a distance of 6 inches (the distance recommended by the company). I started using this model 15 minutes per day. As the days passed, I began to notice that my face was calmed after using the all-red lamp, so I began extending the time of treament. Then I started using it twice a day (after speaking to the company about this via email), for 15 minutes each time. When I saw this was helping rather than hurting, I gradually raised my exposure time each day until I was using the lamp for between 30 minutes-60 minutes each day (depending on the time I had).

I thought that it was silly to spend an hour in front of a lower-powered lamp when I could make my own, more powerful array, and spend less time sitting there with my protective goggles on. I measured, with a flash meter, used for photograpy, that, at a distance of 6 inches, one head of the acnelamp had an intensity of 40 footcandles.

I did some research, found a supplier of red LEDs that produced light at 660nm, taught myself how to wire them, and created 3 3-headed arrays with 28 red LEDs arranged in roughly the pattern of the acnelamp's (the acnelamp lamp heads have 24 red LEDs). So this new array was, in theory, 3 times as powerful as the acnelamp (though I do think the LEDs I bought are brighter than the acnelamp's LEDs). I arranged these arrays so I had one pointing head-on and one on either side (to get the sides of my face and my ears). I measured the footcandles with the light meter of this array that I built, and found a distance where the light intensity was about 40 footcandles (at first, I just tried to put my face 6 inches from these arrays, but their viewing angle was 15 degrees, so the light would not diffuse and provide overlapping/total coverage at this distance). I played around with the distance I sat from the array while treating myself and checking how I responded at various distances (and thus, varying intensities of light~ujoules/cm2).

After a few months of using this array, I found that I was doing the same thing as with the original acnelamp: I was extending my treatment times up to 40-60 minutes each day. Again, I thought it was silly to spend this much time in front of the array when I could build a more powerful one.

By this time, I was beginning to suspect that anything I could build with the LEDs I was using would not harm me. I ordered a new batch of 1500 red LEDs at 660nm but this time with a viewing angle of 30 degrees (so that the array and my distance from them could be shrunk, as the light would diffuse at half the distance as the 15 degree viewing angle red LEDs).

So, I am now using this array:
http://i19.photobucket.com/albums/b179/Condolezzak/DSCN0049.jpg

And, again, I'm finding that I can spend long amounts of time in front of it. So, assuming there is a threshold for intensity/output where red light treatment begins to be harmful (I would honestly like to know where this is so I could stop wasting my time experimenting), it is most likely far higher than anything I could make with these LEDs.

I'm trying to figure out how to rig a second tier of arrays like the ones pictured above, and compose each tier of 8, rather than 6, rectangular "towers", so instead of 6 towers, I would have 16. But, I'm still working on this. I haven't measured the output of the array I'm currently using (there wasn't any need, really) with the flashmeter, but I can check it.

I've spoken with another member on this board, who knows far more about engineering, electronics, and physics than I do, and he seems to think that what I'm currently using is toward the lower end of the "beneficial" range of red light therapy.

So, that, in summary (a bit of a long one :D ) is how I got to where I am right now. I started using the acnelamp regularly in late March or early April of last year (I can't remember exactly when I started using it everyday), so, I have around 9 months of cumulative experience, using one of the above-mentioned arrays at least once a day, but usually twice, for an average total exposure time of, I would guess, 30-35 minutes a day (but, that's using the three different arrays so cumulative photon exposure is kind of hard to estimate). I don't know what kind of red light device the patients that experienced negative effects were using; and, as you mentioned, the power of these devices is also unknown.

I just don't want people to be scared off from this treatment because someone posts here and has a "Dr." in front of their name, because it has proven to be a godsend for me, especially when used as an adjunct treatment modality to in-office laser treatments like the Gemini or Lumenis or what-have-you.

I appreciate your post, and I, like you, would very much like to find out what sort of device the people that were harmed were using so we could find some sort of benchmark or "limit" for red light therapy.

Best regards,

David

[peter.crouch]

Dear David,
Please don't be put off by my posts - certainly my agenda for posting is not to diminish what you have achieved (hence my reference to admiration for those who have the personal initiative to research and the ingenuity to construct home made devices).

As Geoffrey says, the interaction between physics and biology with LED photomodulation is an exciting development. The prospect of being able to trigger repair and rejuvenation processes at the cellular level with a sequence of light is truly fascinating. The issue here is not one of high power output, but one involving correct sequencing of the colour of the LEDs in the arrays. Anything that is going to increase blood flow is likely to be a bad idea for rosacea sufferers because they are a special group (but the technology will legitimately exist for treating other conditions).

It sounds like you have you have been careful not to construct something too powerful to risk doing any real harm. The patients I saw this last week had not been so cautious and both sufered injury and I suspect that it is inevitable that it will be people with "Dr" in front of their names that people turn to when things go wrong. Geoffrey, as a vascular physiologist with an international rosacea pedigree is patently concerned that increasing blood flow will do more damage than good.

Geoffrey and I are only urging caution and reiterating that doing anything that increases blood flow seems to be counterintuitive with rosacea. If the only means of testing home constructed devices is to sit in front of them and see what happens is it any wonder that harm results for some ?

Kind regards,

Peter

[IowaDavid]

Thank you for your post--I understand that medical professionals have pursued that profession with an interest in helping people.

My concern was that Dr. Nase made a categorical--and I might venture to say, vindictive--post regarding LED therapy.


I'm not a doctor, nor am I a scientist. I studied English literature and taught myself how to build my own array. But, as a writer, I've been told, over and over again, that when someone makes statments using the words, "all", "always", "any", "never", etc... that one should regard said statements with extreme skepticism.

I am only here to express qualified statements regarding my anecdotal experiences with LLLT. When someone posts a categorical, contrarian, and patently false sentiment, please do not hold it against me for responding.

I only want to help fellow rosaceans that may be uninsured, spending hundreds--if not thousands--of dollars a year for medical care.

It's incredibly frustrating when you're 21 years old and you get your vitality and ability to be a functioning adult ripped away from you. And then you keep trying to help yourself with available treatments and a parade of dermatologists, doctors, and laser physicians.

And, say, 3 years into this process, when you're admitted to the Emergency Room with a core temperature of 84.6 degrees F, as you've been trying to stay cool in the air-conditioning and avoid a heat-response flush during several weeks of a US midwestern summer, and then you spend 7 days in the internal medicine ward of a US private hospital,w with your doctors saying you really shouldn't be alive--all the while, again, still uninsured--and end up costing yourself 10,000 USD, and after this, you still get no help from laser doctors and fall back AGAIN into that same state trying to deal with this disease....

I could go on with this story. PM me if you're interested.

What I will not do is allow falsehoods to go as unchallenged facts because a poster here has a "Dr." in front of their name. I'm not accusing you of anything; you've been quite helpful in defining your experience with patients and I share your honest interest in finding where red light therapy stops being helpful and begins to harm rosaceans.

When I have found something that anyone can do, for a few hundred dollars, and it will last them several years--I'm not going to shut up about that. And I won't be shut up by anyone. That's all.

Again, thank you for your posts. I very much appreciate your clarifications.

Best Regards,

David

[redhotoz]

I find it interesting that Geoffrey considers the use of LLLT lamps to be harmful to Type 1 Rosacea in any way, shape or form, regardless of whether it is a home made or commercially bought machine, whereas Dr Crouch has “no problem with properly constructed/ tested / calibrated devices with FDA approval.”

Since I am currently considering making or buying a red lamp, it would seem that an FDA approved lamp would be my safest choice. I have read that quite a few people now use commercially-made (and certified safe) red light and LED lamps, yet across the entire rosacea on-line community, I have only ever heard of Iowa David using a home made LED array. Since David has shown improvement in his Rosacea with his set up, it would be David that I would direct the questions to, if I decided to make one at home.

I started to think what I would do if my face had a negative reaction to the lamp. Surely most people who suffer skin burns would go straight to their GP, or to the emergency department at their local hospital. The next most likely choice would be their dermatologist. I couldn’t even imagine thinking of going to see a laser specialist with burns to my face, besides the waiting period to get an appointment with a highly reputable laser specialist.

If two people using “home constructed super bright Infra red LED arrays” chanced to turn up at the same laser clinic in the same week to report such damage, then surely there must be many, many hundreds every month throughout the UK, reporting burns to other doctors.

If that was the case, surely it would be widely reported in the newspapers, on TV and on the Internet, there would be safety warnings in the electrical stores, etc. Most importantly, there would be medical reports about the damage sustained. None of this seems to have occurred. Or was it just pure coincidence that two people with home made units burnt their faces a few days apart, in the same area?

If it is happening so widely in the UK, there must be vast numbers of cases in the safety-obsessed USA. Why hasn't the FDA issued a safety alert? I am mystified!

Dr Crouch, when the patients you saw "were lucky to escape permanent damage", did you report the incidents to the regulatory authorities in the interests of public safety? If so, could you please let me know which body it was reported to? Other Rosaceans could refer their own doctors to it, to check on how many other reports had been received, and find out what safety advice they planned to issue. Surely Rosaceans are entitled to that protection?

Geoffrey, if “In many cases, things that promote dramatic increases in blood flow remove the inflammation” and being that you have stated that Type I Rosacea has a component of inflammation, wouldn’t it appear that red light therapy would benefit Rosacea? I am confused about this now. If, as you state, Type I Rosacea does infact have a component of inflammation (and I believe it does) and red light therapy is touted to have an anti-inflammatory effect, I am not sure why you believe it won’t help with reducing the inflammation? I am not sure why you appear to be so forthright in objecting to this therapy when others have had a good result.

Aren’t we all here to find what works for us individually as Rosaceans, particularly since we all react so differently.

Oh for a cure!!!

Red

[Bradley]

David it would be great if you could post some before/after pics of your skin to see how the red-light treatment has benefited you.

Dr. Crouch, I'm slightly confused as to why anyone, who has experienced a facial burn as a result of their own constructed light unit, would visit you (a laser specialist) to report their problem? Surely they would visit their own general practitioner and then be referred to a dermatologist or surgeon? Forgive me if you have previously mentioned you are in fact a GP yourself.

[peter.crouch]

Here we go,

Redhotoz,
I said in my last post that I would not recommend red light therapy for rosacea ( please read the post carefully). My comments about FDA approval were meant to be taken in context of medical devices.

Actually, I am acutely aware of my responsibilities to report medical devices that could cause harm. I looked into whether I could report the LEDs to the Medical Devices Agency and guess what they said? As these home constructed devices are not CE marked Medical Devices, (they are one-off self-constructed energy sources using components not sold for that purpose as any commercially available system) ~ I therefore can't report them. I also ased Maplin if they could put something into their catalogue about the LED arrays and they said they would look into it but as they said, the LEDs are sold as electrical components, not as medical devices.

As for why I would have 2 patients in a week - (I've met this scepticism before), I've no idea - perhaps because I seem to be seeing a lot of rosacea patients who read the acne rosacea boards lately - I hardly ever know the rosacea community user name of the patients who consult ( usually their names on here are different for obvious reasons). If I get a request for advice about a patient damaged by exposure to energy from a treatment, our call bureau are trained to route the call through to me a.s.a.p. and I will see them a.s.a.p. or advice them to seek appropriate care locally. I was mightily relieved when I spoke to them immediately they had called the call handling bureau that they were not patients I had personally treated. Both patients said that they had gotten the idea "from the internet".

I trust that others share my views regarding the tone and content of your post. Is it any wonder that laser physicians dont want to post in this environment. I'm quite happy to gift my time to post about topics I know something about. Why is it that these community bulletin boards can't stay focussed on just working constructively together to further expand treatment options for those afflicted with rosacea?

Kind regards,

Peter

[peter.crouch]

David it would be great if you could post some before/after pics of your skin to see how the red-light treatment has benefited you.

Dr. Crouch, I'm slightly confused as to why anyone, who has experienced a facial burn as a result of their own constructed light unit, would visit you (a laser specialist) to report their problem? Surely they would visit their own general practitioner and then be referred to a dermatologist or surgeon? Forgive me if you have previously mentioned you are in fact a GP yourself.

Dear Bradley,
No worries, I am also a General (Family) Practitioner and a Forensic Medical Examiner. As I consult locally as a laser physician, if people attend our local A&E Dept or GP out of hours service or see our local dermatologists with a laser/IPL problem then it is likely that they will be referred to me for an opinion as a local laser specialist. I receive many referrals a month from our local dermatologists and GP Dermatology specialists.

Kind regards,

Peter

[drnase]

David,

In Bio-Medical science where we do benchwork and clinical work on patients, we often state the benefits and side effects. We add numbers and statistics to the information to give it validity. As you can see one physician did back up exactly what I said and he did that for the good of other rosacea sufferers despite the current atmosphere.

If anyone where to read both posts, you would just find facts, numbers and warnings. Absolutely no vindictiveness. This is the same way that we would write a manuscript or letter to the editor. There is never ill will between scientists or physicians who scrutinize each others work -- this process is one that makes each of us better.

As to categorically stating that these machines are not for rosacea right now. I stand behind that 100%. The simple fact cannot be contorted or misplaced -- photobiomodulation significantly increases blood flow to millions of cellls that it is trying to heal. You cannot get away from this fact. This increase in blood flow can last for hours. If your veins and lymphatic vessels are not working properly, the blood cannot be removed and hence progression of rosacea.

These are all sound facts with no agenda. I am the first guy to go out on a limb for any possible new treatments. You have personally seen this for 8 years. That is also not in dispute.

I stated that people were getting hurt and they should be very careful. If I sat back and did not be a rosacea advocate and NOT report the many adverse reports from rosacea sufferers -- then you should say shame on me. For me to sit on my hands and let more people get burned because I want this forum to run flawlessly with no disputes would be dishonorable to say the least. A physican has reported two such cases and many others have also, but I will wait for them to post if they want to get involved, as most wont.

Thank you Dr. Crouch. Peter, you have seen the atmosphere lately in which no physician would dare post -- but you did on two cases and a serioius warning. To post information like this when it will certainly be under high scrutiny shows your character.

I hope that the pro- people re-read the information and take it for what it is. Just factual information.

[prryjones]

Regards,
If you guys (who tout the efficacy of these light tx devices) want to convince others of their validity, then I'd suggest before and after pics.
I would also advise you to convince other, local (to you, that is) rosacea sufferers to do this. Also before and after pics. A sizable patient population showing good results would really and credibility to your claims.
Also wouldn't be a bad idea to dig up some studies on this type of thearapy and its effects on rosacea (any done?).
If you sincerely want to spread the word, then get in touch with a local Derm and plead your case. If he won't listen (prob. not), then maybe he can put you in touch with someone who will.

There was a gentleman once (maybe he is still around) who touted the "cure" for rosacea as being the industrial solvent DMSO combined with the anti-fungal drug fluconazole. Of course, he was a layman and no studies, valid or otherwise had been done. (Sort of like this case, no?)
Anyway, he expected to just proclaim this "cure", and that everyone would just "trust" him...although he had not pics, evidence, or even professional credentials to give him some credibility. Just like this.

You can't expect, considering this situation, any more positive response than that.

[DukeCity]

DUARFASIESAN - Your name spelled backwards is not very nice, you just joined this afternoon and you have no agenda here??

[Steve95301]

I think you have to be a complete idiot to get a 1st degree burn from LEDs. Its like getting a paper cut from a balloon.

Exactly, I think that's the whole point. The people advocating these devices seem to know quite a bit about electronics. The average rosacean, I think, does not.

Therefore if the normal, electronically-ignorant rosacean were to attempt to build such a machine, I can imagine the results being disastrous.

Oh, wait: that's exactly what a Medical Doctor has testified to having witnessed in his own practice.

How can advocating caution be considered a bad thing?? Especially when the possible harm is supported by sound theory and actual case reports?

I realize some of the pro-red-light folks consider Dr. Nase to be a histrionic/hypochondriac, and the "ego" factor is quite evident in most of the back-and-forth posts, each defending his own.

But quite apart from anyone's ego, I think that the more information that is available the better, and I am glad that two medical professionals have followed their own moral compass in sharing that information, despite the potential flaming.

[keisha06]

I like to see both sides to ALL treatments - good reports and bad. I'm glad for those that have had good results with the red light treatments, and equally glad to see the reviews to the opposite. This lets me make decisions, one way or another, with a balance of information - which way I choose to go is up to me.

I have had very good results with treatments with Dr Darm and will likely do more this spring - but I am none-the-less, appreciative of posts to the contrary - this helps achieve some realistic balance. The same go for those that have good and bad results with Dr Soldo, and those that have good and bad results with new products like the Neocutis cream.

What I would like to see is less "personal attacks" in these posts. If you disagree with something - then post the facts and leave the personality part of it out - I know it hard, but it is worth trying to achieve. Is it so much to ask that someone simply say "I disagree with this and this is why" and state the facts? Share your personal experiences and any facts and leave it at that - let us all support one another by giving information so we can all make the decisions best for us.

I have to say that lately I don't envy the moderators - tough job guys but it is appreciated (even if doesn't seem so at times).

I have greatly appreciated the information all members who have shared of their experiences, and I will also say once again - I appreciate all the information Dr Nase has shared about current and upcoming treatments - it gives me hope (and information I wouldn't get elsewhere) and from that point, I can investigate and make decisions as to what to try if and when it is available (I do realistically realize that perhaps all future treatments may not come to pass). One great personal example for me is Lyrica - I do get nerual burning, although it is less now than it used to be due to the treatments I have had from Dr Darm, but it is still there, but this is something I would not know about (and my GP sure wouldn't know :shock: ) - this gave me an option to follow up - if I choose to do so. I did some searching on it - and decided yes it was something for me. And while I have only been on it a little over a week - so far I do see some small improvements. I've also utilized some of the great information on supplements that all in this group (and others) have posted. I've chosen what I felt was most important/best for me - but many I would never have known about if I hadn't read them on one of these support groups.

I have no problem with anyone disagreeing with anything anyone posts (including those posts by Dr Nase) - but not when it is directed against the individual rather than the treatment/facts. Posting oposition to something simply because of "who" posted it rather than the content of the post itself only creates these uproars that cause various members to leave. Controversy is OK, that's life as no two people (let alone a group) will always agree - but it should be on the treatment/product - not the individual. We know there are factions but the rhetoric is getting old on both sides - let it go.

Maybe one thing to keep in mind before posting content directed more against an individual that what they have said is that we need to depend on each other - and one of those that gets "driven away" by one of these uproars may be the one who has the information to share that YOU need.

Sorry to rant a bit here :-({|= , but I've been saddened to see what has been going on lately and I've been reminded very often of something I heard former US President Jimmy Carter say in an interview (and I am Canadian, not American) - "debates were much more polite and productive when we began with my honorable opponent" . . . I can very much see his point (it was said whether the opponents felt it or not).

For those that like such things . . . here is a quote I've always like . . ."if wisedoms way you wisely seek, five things observe with care, of whom you speak, to whom you speak, and why and when and where"

Here's to a good year for all Rosacea suffers!

[redhotoz]

Sure, most of us wouldn’t have the time, energy or inkling to build our own red light machine. I truly think Iowa David has shown great ingenuity and is a very brave man to be a pioneer for us Rosaceans. Of course, if we don’t want to make our own machine, there are commercially made ones available.

What appeals to me about this idea is that it would be a one-off investment. I have been reading so much about this medication or that topical and like most Rosaceans, it becomes overwhelming at times. This is what has lead me to start reading about red light therapy. That and the link with Rosacea and inflammation.

BTW, I have checked out how to purchase a commercially made machine from the company mentioned. There is no little box that asks for the name of the person referring you to them. How in the heck is someone going to know if I buy one or not? I’m not going to put a post up advertising my name and when I purchased it, so that someone can ring the company and get commission for my purchase. Come on, it’s absolutely ludicrous to even suggest this!

We all know that what works for one Rosacean may or may not work for another. How many have had a fantastic result from the standard approach of Rozex Gel (MetroGel in America)? Yet, it appears to be the first thing a GP will prescribe, along with antibiotics. So, surely if red light therapy is working for some people with Rosacea, it is worth at least considering instead of slam dunking it?!

Surely it is up to the individual to decide what to try or what not to try. Getting a good feel for the pros and cons of anything touted to be helpful with Rosacea is the best way we can make an informed decision.

As the saying goes: Don’t believe everything you read on the Internet. THIS is why people feel so strongly about the ‘politics’ surrounding the on-line world of Rosacea. It’s just that some people don’t see what’s happening!

Red

[IowaDavid]

David it would be great if you could post some before/after pics of your skin to see how the red-light treatment has benefited you.

Dr. Crouch, I'm slightly confused as to why anyone, who has experienced a facial burn as a result of their own constructed light unit, would visit you (a laser specialist) to report their problem? Surely they would visit their own general practitioner and then be referred to a dermatologist or surgeon? Forgive me if you have previously mentioned you are in fact a GP yourself.


Here, I just took this picture now. I didn't use a flash because that tends to white-out color differences.
http://i19.photobucket.com/albums/b179/Condolezzak/currentskin.jpg

Here is me after an especially aggressive Gemini treatment. Use of the red light therapy helped me bounce back from this state after about a week.
http://i19.photobucket.com/albums/b179/Condolezzak/Post-laserfront.jpg

http://i19.photobucket.com/albums/b179/Condolezzak/Post-laserside1.jpg

Here I am before going into the hospital (this is summer of 2003; I started using the red light in spring of 2005).
http://i19.photobucket.com/albums/b179/Condolezzak/Beforehospital.jpg

Here I am in the hospital (sept. 2003):
http://i19.photobucket.com/albums/b179/Condolezzak/DavidHospital1.jpg


I don't have any digi pics of me hanging around from 2004 or 2005 that I know of. Like most rosaceans, I don't particularly like the way my skin looks so I avoid being a camwhore.

To clarify: The red light therapy has been helpful mostly in reducing my resting diffuse rednes, the intensity of my flushes, and has raised the bar on what triggers cause me to flush. It doesn't get at any of those permanently dilated or very stubborn diffuse red areas. You need an in-office laser treatment for that, as far as I know. Also, I have raynaud's along with the rosacea, so my nose is bit red in that current pic, partially from rosacea, partially from the raynaud's.

Anyway, I have a laser treatment tomorrow, so I figured I should post these now.

David

[IowaDavid]

David,
As to categorically stating that these machines are not for rosacea right now. I stand behind that 100%. The simple fact cannot be contorted or misplaced -- photobiomodulation significantly increases blood flow to millions of cellls that it is trying to heal. You cannot get away from this fact. This increase in blood flow can last for hours. If your veins and lymphatic vessels are not working properly, the blood cannot be removed and hence progression of rosacea.

These are all sound facts with no agenda. Just factual information.

Again, Dr. Nase, I ask you: What devices were used, what wavelength was used, and how much energy was delivered to these patients' skin that were harmed?

You're not stating facts here, you're making statements and assuming we'll take your word for it. Facts would be if you showed me some sound references and specifically stated the details I asked for (device used, wavelength, energy level).

I'm getting a little tired of this repetition--it seems like an effort to obfuscate the debate rather than clarify it.

Thanks,

David

[Tricia]

Dr. Crouch, first I'd like to thank you for posting here and giving us your feedback on this. Kind of like walking into a den of sharks, which makes me appreciate the time you spend with us all the more.

David, I can understand why you're so pro-redlight therapy as it's obviously working for you. Dr. Nase though has brought up some very valid points about them and why we should be cautious and I personally am quite thankful.

I am a red light user, have been for the last 4 months and I cannot say for sure whether it's working or causing harm or neither. My skin does seem calm afterwards with no visible redness, and cool to the touch. I'm wondering, Dr. Nase, if there are no obvious signs of damage (flushing, redness warm skin ect...), do you think I am ok or do could I be doing harm to my skin at a deeper level?

I purchased it from www.acnelamp.com and I have no idea what the output is. I use it for about 20 minutes a day (divided) and make sure to stay 6 inches away and wear goggles.

Tricia

[prryjones]

IowaDavid,
It was very, very courageous of you to post the pics. We all appreciate the effort. Your skin looks great now, a 180 degree turn from your earlier ones. I mean, that is just fabulous.
I envy you and hope for your continued improvement (though doesn't seem you need much more improvement).
Regards,
Perry Jones

[drnase]

David,
As to categorically stating that these machines are not for rosacea right now. I stand behind that 100%. The simple fact cannot be contorted or misplaced -- photobiomodulation significantly increases blood flow to millions of cellls that it is trying to heal. You cannot get away from this fact. This increase in blood flow can last for hours. If your veins and lymphatic vessels are not working properly, the blood cannot be removed and hence progression of rosacea.

These are all sound facts with no agenda. Just factual information.

Again, Dr. Nase, I ask you: What devices were used, what wavelength was used, and how much energy was delivered to these patients' skin that were harmed?

You're not stating facts here, you're making statements and assuming we'll take your word for it. Facts would be if you showed me some sound references and specifically stated the details I asked for (device used, wavelength, energy level).

I'm getting a little tired of this repetition--it seems like an effort to obfuscate the debate rather than clarify it.

Thanks,

David



This will be the last time because no one likes to see this kind of back and forth useless banter:

David ....... it does NOT matter what device, wavelength or energy level used because these all have photobiomodulative actions. Period. My goal before I left here was to simply leave one message of caution to people that this form may turn into an LED LLT forum and that many reports are not good.

Again David, my degree was actually obtained at the Department of Physiology and Biophysics at IU School of Medicine. Biophysics. Exactly what these machines are and do. My post doctorate in this area.

Every single device that I have seen will increase blood flow to the surface of the facial skin. Some will be lucky and it will dissipate quickly and help ........ others will stay red and inflamed ....... and progress to the next stage of rosacea. If you are using a low energy system than the point is mute because it does not have a biological action on a cell and thus does not signal a blood flow response. You dont have to make a very simple system seem hard and complex -- at this level, you should be making hard and complex systems simple. We can do that with these machines across the board (we are not talking about acne lamps).

Looking back David, we have been friends on three boards for at least 4 years. I like you. I think your a heck of a guy. But, my reporting bad reactions to these lights caused an instantaneous split. So be it. I wont please all the people all the time. But, I will always look out for rosacea sufferers as a whole. Always.

You also need to really emphasize that the lamp system was NOT the main cause of your improvement as I can document great changes well before the lamp -- this can be misleading.

I have chosen to continue to be a leader in this field and keep on climbing that rung. I am personally heading up oral and topical rambazole studies on rosacea patients at IU School of Medicine with a famous Dermatologist. There is a saying that is well known -- when you are at the top of the game or pop your head out to help continually there is a basic principal of percentages on how many will like you.

33% will love you
33% will be indifferent depending on the day
33% will dislike you

There does not have to be any reason. But, for 8 years, my levels have been off the charts and continue to. 7,102 members now for the forum. Almost a hundred new members in my forum every day now. I have a job to do and Im going to do it. I am no ones yes man, I work for no one, I earn my own keep and I have already added Neuropathic Rosacea officially into the rosacea books single handedly. This gets the burners known and opens up thousands of doors for laser and treatment coverage. These systems that you are detailing will help few and hurt more.

By the way, Dr. Crouch and I are good friends and we have discussed everthing that has happened in detail up front. He knows whats happening. We already have a UK party set up this summer when I travel out to Dr. Crouch to perform a laser study to help enhance results. I will be meeting many of my friends from the UK there. The dbs have had no effect on my life, profession and have started pushing more people to my site -- thank you.

My job here is done. Remember that when the famous duo come back on once I leave it will be all about these lights. Buyer Beware. You burn your face and there are few things that can reverse that on rosacea skin.

[IowaDavid]

So, you have no data? No studies? No specifications on the devices used?

What you're doing is asking us to take your word for it because you have a degree? Even people with degrees need to be kept honest and provide data.

Otherwise, you could be selling the same sort of snakeoil or false claims like the stem cell researcher in Korea who recently stepped down to national disgrace. He had a degree. He made claims. But he was wrong.

I can't see any reason to believe anything you are posting right now because you are providing no evidence.

David

[redhotoz]

So, you have no data? No studies? No specifications on the devices used?

What you're doing is asking us to take your word for it because you have a degree? Even people with degrees need to be kept honest and provide data.

Otherwise, you could be selling the same sort of snakeoil or false claims like the stem cell researcher in Korea who recently stepped down to national disgrace. He had a degree. He made claims. But he was wrong.

I can't see any reason to believe anything you are posting right now because you are providing no evidence.

David

When one has a professional standing in a large community, one does not need to provide actual data. One can simply rest on one's laurels.

[IowaDavid]

Light Emitting Diode-Based Therapy

William Abramovits, MD; Peter Arrazola, BA; Aditya K. Gupta, MD, PhD, FRCP(C)

SKINmed. 2005; 4 (1): 38-41. ©2005 Le Jacq Communications, Inc.
Introduction

Several lamps that generate visible light, many of them using light-emitting diodes (LEDs), have recently found their way to the dermatologic armamentarium. Claims of their value in the treatment of a variety of conditions ranging from cosmetic (antiwrinkle) to acne, rosacea, and skin cancer are made to market them. The literature promoting these claims is limited and often questionable, however, dermatologists who own these units often report demand for their use, high customer satisfaction, and a sense that they deliver on their promises, despite a lack of clinical evidence from properly controlled studies. This article reviews promotional as well as relevant scientific literature (indexed on Medline) regarding LED-based devices and other units that deliver visible light at sub-intense fluences. Both types of literature were evaluated for their scientific validity of content. Photodynamic therapy used with exogenous photosensitizers such as aminolevulinic acid is beyond the scope of this review.
Acne/Rosacea

Blue light (407-420 nm) and red light (633- 660 nm) are promoted for the treatment of acne. They work by exciting high amounts of intracellular porphyrins naturally generated by Propionibacterium acnes (P. acnes). These endogenous porphyrins (mainly coproporphyrin III[1]) photosensitize the bacterium and, upon illumination, result in the formation of singlet oxygen, which combines with cell membranes to destroy the P. acnes. This process is dependent on the rate of production of excited porphyrin molecules, which is influenced by the concentration of porphyrins, the concentration of photons, the temperature, and the wavelength of the photons.[2]

Blue light and blue-red combinations have demonstrated efficacy in mild to moderate inflammatory acne, having a physical modality comparable to treatment with topical clindamycin but inferior to benzoyl peroxide plus clindamycin.[3] The viability of 24-hour in vitro P. acnes cultures was reduced by four and five orders of magnitude after two and three illuminations, respectively, with intense blue light (407-420 nm).[4] In a randomized controlled trial evaluating the use of blue light (peak at 415 nm) and mixed blue and red light (peaks at 415 and 660 nm, respectively) in the treatment of mild to moderate acne vulgaris, a mean improvement of 76% in inflammatory lesions was achieved by the combination blue-red light phototherapy after 12 weeks of daily treatment. This result was statistically superior to that achieved by blue light at Weeks 4 and 8 ( p =0.02); benzoyl peroxide at Weeks 8 ( p =0.02) and 12 ( p =0.006); and white light at all assessments ( p <0.001)[5] (See Table 1 for sources of blue and red light).
Wound Healing/Antiaging

The wound-healing process has been used in the rejuvenative model. This process consists of overlapping phases of inflammation, proliferation, and remodeling. During inflammation, neutrophils, leukocytes, monocytes, and/or macrophages migrate to the site of the wound; monocytes differentiate into phagocytic cells to phagocytose debris and secrete growth factors. Complement system proteins are activated, stimulating mast cell degranulation and attracting more neutrophils. Macrophages release platelet-derived growth factor, which stimulates the chemotaxis and proliferation of fibroblasts. Leukocytes and macrophages also secrete fibroblast growth factor, which promotes the recruitment and growth of more fibroblasts, establishing the proliferative phase of the wound-healing process.[6,7] Leukocyte numbers decrease, and macrophages begin to diminish slowly as fibroblast levels peak days later. The remodeling phase begins with a fall in the number of fibroblasts; active fibroblasts either differentiate into myofibroblasts or dedifferentiate into dormant fibrocytes. The fibroblast plays a key role in the dermis during the second and third phases: it not only synthesizes collagen and elastin but also regulates the homeostasis of the ground substance in addition to maintaining the collagen fibers. Myofibroblasts position themselves along collagen fibers and exert a longitudinal force that tightens and aligns the latter. Remodeling may take 3-6 months or longer. The end result is the deposition of new collagen fibers in a better organized cellular matrix accompanied by elastogenesis and angiogenesis. A layer of new, tightly-organized collagen runs below and is attached to the basement membrane of the dermoepidermal junction.

Red light (633 nm) may aid in effectively healing long-term torpid ulcers and may enhance angiogenesis in the rabbit ear chamber model.[8] Six hundred thirty-three nm light significantly stimulates a faster and better linearly-oriented monolayer formation of fibroblasts in vitro as compared with controls. It accelerates mast cell degranulation and increases the synthesis of fibroblast growth factor from photoactivated macrophage-like cells.[9,10] Irradiation with low-level narrowband 660 nm red light induced the release of growth factors from macrophages in vitro and significantly improved postoperative wounds in vivo.[11,12]

Red light, in the absence of a wound, may be beneficial as an antiaging therapy. Mast cells are always present in the dermis; 633 nm red light may have the same effect on them regardless of their involvement in the inflammatory process. The surrounding tissue recognizes this degranulation as inflammation, and so the wound healing process is jump-started. Visible yellow light (588 nm) may also be beneficial as antiaging therapy through mechanisms similar to the action of red light (see Gentlewaves, Light BioScience, LLC, Virgina Beach, VA; please see Table 1 for sources of red light).
Instruments

The Omnilux system (Alderm, NA, LLC, Irvine, CA) uses a panel of 2000 focused diodes in interchangeable heads to deliver 408 nm blue or 633 nm red light. These two can be used alone or in sequence. The red module may be beneficial in aging via the preferential degranulation of mast cells; release of glucosamines, heparin (a glycosaminoglycan) and histamine, which induce vasodilatation; the "strengthening" of capillaries; increased tissue oxygenation; promoting epithelial remodeling; and stimulation of fibroblasts to produce collagen and elastin. Glycosaminoglycans replace water between collagen and elastic fibers, firming the skin. The use of the blue and red modules concurrently is claimed to be beneficial in acne as the red light module targets deeper-seated lesions. Treatment usually consists of two sessions per week for 4 weeks. A typical session takes ≈20 minutes.

The Delphia del SOL (Edge Systems Corp., Signal Hill, CA) is a three-in-one system that combines microdermabrasion, lymphatic massage, and LED light therapy. The LEDs can emit light at 430 nm (blue), 600-700 nm (red), and 700-1000 nm (infrared) in a nonpulsed, continuous wave. The LEDs are positioned on two handpieces.

TheMax7(Flip4Inc.,Sainte-Julie,Quebec,Canada) unites LED technology with an automated robotized arm. It can deliver seven wavelengths of visible light, ranging from 420 nm to 700 nm. The manufacturers claim that each chosen wavelength has a customized modulation program that ensures maximum skin rejuvenation. It has seven programmed polychromatic treatments and seven programmed monochromatic treatments designed for various skin types and various skin treatments, respectively. Manufacturers recommend a minimum of six treatments for most common skin conditions.

The Medilite (Inner Act LLC, Reno, NV) system delivers 405 nm blue light for the treatment of acne and 627 nm red light for skin rejuvenation in a tabletop unit. The light modules are removable and interchangeable with mixable blue and red wavelengths. The red light module is used to increase new tissue growth, speed healing, stimulate collagen, and reduce lines and wrinkles. It incorporates a computerized controlpanel for ease of use.

Gentlewaves is marketed as a photomodulation device that uses low-intensity LEDs in a proprietary pulsed "code" as antiaging therapy. It delivers pulsed visible yellow light (588 nm ± 10 nm) from two contiguous LED panels. It is claimed to "energize" mitochondria, send cell signals to cell receptors, increase/decrease gene activity in DNA, and thus reverse the appearance of aging and photoaged skin. It incorporates a skin care kit designed to enhance and maintain the results of the treatment, which includes a cleanser, a daily facial lotion, a nightly facial lotion, and sunscreen. The effectiveness of this device is documented by histology exhibiting new collagen formulation, high resolution ultrasound, and PRIMOS digital surface profilometry.[13]

The LumiPhase-R system (OPUSMED Inc., Montreal, Canada) features 18 linear LED array modules that deliver high power density 660 nm visible red light for skin rejuvenation. It uses a proprietary sequential mode that is claimed to trigger significantly higher procollagen secretion vs. control in human reconstructed skin models. It also claims to improve skin roughness, depth of rhytides, skin tone, texture, pore size, dyspigmentation and erythema; pre-and posttreatment PRIMOS 3D-micro-topography was used for these measurements. It has an optical positioning system to ensure optimal placement of the LED modules.

The Revitalight system (Skincare Technology Inc., Chicago, IL) claims to be a safe and effective way to help diminish the visible appearance of fine lines, wrinkles, and age spots on the face, neck, and hands by promoting collagen firmness by using LED photo pulsation technology. It delivers four specific wavelengths of light (420 nm, 590 nm [yellow], 625 nm, and 940 nm [infrared]) via handheld "pulsators." It uses an optical lens to focus the LEDs.

The Soli-Tone system (Silhouet-Tone, St. Albans, VT) is a two-in-one system that includes LumiLift and LumiFacial. LumiLift involves delivering 640 nm red LED light from handheld pieces placed on the skin. These pieces also deliver a "micronized current" and a "high-frequency polarized current" via electrodes placed in the handpieces. LumiFacial is comprised of a 400-LED panel situated above the skin. This panel can deliver four wavelengths of light: 470 nm, 525 nm (green), 590 nm, and 640 nm. It has a computerized control panel with preprogrammed treatments.
Conclusions

The level of evidence for the use of sub-intense fluences of visible light in dermatology is weak. As few randomized controlled trials have assessed the safety and efficacy of these devices, the dermatologist is left to infer the worthiness of incorporating LED-based technology from in vitro observations, anecdotal evidence, and commentaries appearing in trade (mostly non-peer-reviewed) publications.

The uncontrolled proliferation of services based on these devices at cosmetic/aesthetic locales where the personnel have little if any knowledge of dermatology and photobiology may be dangerous. Regulations that apply in many states to the use of lasers and intense pulsated light sources should be expanded to include these devices as the benefits (and risks) of their use in acne, rosacea, wound healing, aging, etc. (mostly medical diagnoses) relate to altering the structure and function of the skin, which constitutes the practice of medicine.



____________________________________

While there's no specific data for rosacea, I don't see any clear evidence for what Dr. Nase is maintaining, either. Of course, this was hunted up by someone over at the r-s site.

David

[redhotoz]

Fascinating read, thanks David. I was interested in the mention of yellow light too. Have you looked into yellow light at all youself? The antiaging effects sounds appealing.

Red

[scrumptious]

David that looks so sore, you look amazing now and i think you were very brave to post your photos publicly.

[MARPUSBEAN]

Peter, I do not want to get into the argument side of these posts but as a matter of interest I noticed in your long post you mentioned converting to tubes as opposed to LED, are you saying you are having better results this way than LED?? AS LED looks a bit fierce??

[MARPUSBEAN]

Peter, yet another question, as I am really looking at this product.
I went to the Dermalux site, it mentions the work done by Tony Chu with acne patients, it details the effect of the lamp on acne which is bacterial in origin, but I was surprised to see Dermalux do not mention Rosacea.
Because we have a disease which is vascular in origin, which creates a hypersensitive skin are we not more at risk from damage than an acne patient?
Please do not think I am taking sides in the argument, I would really would consider using this!!

[redhotoz]

Peter, yet another question, as I am really looking at this product.
I went to the Dermalux site, it mentions the work done by Tony Chu with acne patients, it details the effect of the lamp on acne which is bacterial in origin, but I was surprised to see Dermalux do not mention Rosacea.
Because we have a disease which is vascular in origin, which creates a hypersensitive skin are we not more at risk from damage than an acne patient?
Please do not think I am taking sides in the argument, I would really would consider using this!!

Hi Marpusbean

I have only recently started reading old threads in the Forum for information on red light because it had been something that interested me for some time. Actually I started looking into blue light first and discovered red light was the better choice.

Other than having an interest in light therapy, I had been reading up as much as I could about the actual cause of Rosacea. I figured, that if the cause could truly be found, a cure wouldn't be far behind. Amongst other theories I had running around in my mind, I read in more detail about the inflammatory process and the fact that red light therapy was purported to have an anti-inflammatory effect on the skin.

The cause of Rosacea is not known. Is it a skin disorder, vascular disorder, inflammatory disorder? It's even called a disease. So bearing this in mind, for any company to claim that their product will cure someone who suffers from Rosacea, could well be construed as irresponsible. Heck, we all know of hundreds of web sites that claim to have the absolute miracle cure for Rosacea! Isn't it a more responsible approach not to lay irresponsible claims, especially since we don't actually know for sure what causes Rosacea?

On another point, red light is something that has been introduced to us by every day people who suffer from Rosacea for no other reason than it has worked for them. Sure, there may be people that it doesn't work for but we all know that what works for one Rosacean may not work for another.

I'm not saying that you should rush out and buy a new machine or make one yourself. I am most certainly considering it and from what I have read so far, apart from the first few posts in this thread (which I am highly skeptical of...I have my reasons) I think it is something worth considering.

I might suggest, that this thread was not created to talk about the pros and cons of red light. I believe there was an agenda at hand and this is why there has been some 'politics' involved because people feel so strongly about the underlying issues at hand.

Anyway, I for one am going to read more about this option because I think it has merit.

Red

[redhotoz]

Regards,
If you guys (who tout the efficacy of these light tx devices) want to convince others of their validity, then I'd suggest before and after pics.
I would also advise you to convince other, local (to you, that is) rosacea sufferers to do this. Also before and after pics. A sizable patient population showing good results would really and credibility to your claims.
Also wouldn't be a bad idea to dig up some studies on this type of thearapy and its effects on rosacea (any done?).
If you sincerely want to spread the word, then get in touch with a local Derm and plead your case. If he won't listen (prob. not), then maybe he can put you in touch with someone who will.

There was a gentleman once (maybe he is still around) who touted the "cure" for rosacea as being the industrial solvent DMSO combined with the anti-fungal drug fluconazole. Of course, he was a layman and no studies, valid or otherwise had been done. (Sort of like this case, no?)
Anyway, he expected to just proclaim this "cure", and that everyone would just "trust" him...although he had not pics, evidence, or even professional credentials to give him some credibility. Just like this.

You can't expect, considering this situation, any more positive response than that.

Hi Perry

Just to clarify (and I just re-read the entire thread, other than the posts that were deleted today, with only one reference left to them) there has been no claim of a "cure" in this thread. It may work for some, it may not. But I believe that it is worth considering and spending more time reading about.

My personal feeling is that when someone mentions something that is working for them, you give it a once over. If it looks interesting, you take the time to read more about it. This Forum is not the only source of information available to Rosaceans. Whenever I have decided to consider something new, I do take the time to read as much as possible on that subject. Bit like my reading on the inflammatory process.

Red

[Bradley]

No worries, I am also a General (Family) Practitioner and a Forensic Medical Examiner. As I consult locally as a laser physician, if people attend our local A&E Dept or GP out of hours service or see our local dermatologists with a laser/IPL problem then it is likely that they will be referred to me for an opinion as a local laser specialist. I receive many referrals a month from our local dermatologists and GP Dermatology specialists.

Thanks for explaining that Dr. Crouch. Wow, Forensic Medical Examiner, now that does sound interesting!

[redhotoz]

As I previously posted:

BTW, I have checked out how to purchase a commercially made machine from the company mentioned. There is no little box that asks for the name of the person referring you to them. How in the heck is someone going to know if I buy one or not? I’m not going to put a post up advertising my name and when I purchased it, so that someone can ring the company and get commission for my purchase. Come on, it’s absolutely ludicrous to even suggest this!

[Callien]

I like to see both sides to ALL treatments - good reports and bad. This lets me make decisions, one way or another, with a balance of information - which way I choose to go is up to me.

Is it so much to ask that someone simply say "I disagree with this and this is why" and state the facts? Share your personal experiences and any facts and leave it at that - let us all support one another by giving information so we can all make the decisions best for us.

Here's to a good year for all Rosacea suffers!

Diane,

I agree with your sentiments. I'm afraid they might have gotten lost in the crossfire. Let's face it, there is so much about this disease that we don't understand. Some, like myself, have had excellent results with accutane and others can't tolerate it at all. There are those who benefit tremendously from lasers, some who are laser "resistant" and others like Natalja who, unfortunately, suffer severe setbacks as a result of treatment. But does anyone really know why? I can't tolerate Zinco but others swear by it. And so on.
In spite of the fact that David and I don't always see eye-to-eye, I am thrilled with his results and believe that he is sincere in trying to help others. Likewise, I think Geoffrey is sincere in trying to warn others that red light treatment could be harmful to rosacea skin. But these "debates" are so laced with animosity that they painful to read.
Such intelligent, passionate, and dedicated people, it's a shame.

[GJ]

This discussion has, at least, given us the expression, 'heart of a physicist.' I am very grateful for that! (This is not to impugn the author, who does sterling work elsewhere).

Are we saying that the therapeutic benefits of red light (in other afflictions) are attributable solely to its tendency to increase blood flow?

(Surely a chap riddled with wounds could sit in front of a fire if this is this case? Or does this prompt only superficial blood flow?)

Or, has red light properties which are healing per se?

Dr Nase, when you touch down in Blighty, be assured that Scrumptious has promised to pick you up and ferry you about. Safe travel.

[drnase]

I like to see both sides to ALL treatments - good reports and bad. This lets me make decisions, one way or another, with a balance of information - which way I choose to go is up to me.

Is it so much to ask that someone simply say "I disagree with this and this is why" and state the facts? Share your personal experiences and any facts and leave it at that - let us all support one another by giving information so we can all make the decisions best for us.

Here's to a good year for all Rosacea suffers!

Diane,

I agree with your sentiments. I'm afraid they might have gotten lost in the crossfire. Let's face it, there is so much about this disease that we don't understand. Some, like myself, have had excellent results with accutane and others can't tolerate it at all. There are those who benefit tremendously from lasers, some who are laser "resistant" and others like Natalja who, unfortunately, suffer severe setbacks as a result of treatment. But does anyone really know why? I can't tolerate Zinco but others swear by it. And so on.
In spite of the fact that David and I don't always see eye-to-eye, I am thrilled with his results and believe that he is sincere in trying to help others. Likewise, I think Geoffrey is sincere in trying to warn others that red light treatment could be harmful to rosacea skin. But these "debates" are so laced with animosity that they painful to read.
Such intelligent, passionate, and dedicated people, it's a shame.


Callien and Redhotz,

I have been placed in a situation which is a tough one. Whether I like it or not, many rosacea sufferers come to me with their personal experiences with all sorts of treatments. I receive 300 to 500 emails every day on different subjects. I never asked for this position and it is not a very popular position.

My role in the rosacea community is 99% posting information about promising new treatments, clinical study results that no one has access to way before it is published (9 to 15 months sometimes), performing clinical studies now, and letting people know about potentially dangerous treatments. I have never focused on just one treatment for rosacea because there is no such thing as one treatment for rosacea. I discuss topicals. orals, medications, treatments, lasers and many over the counter treatments with potential.

Most rosacea sufferers know that it is just as important to stay away from aggravating treatments as it is to find the proper treatments. Is it my job to report or recommend that something may be dangerous if there are four or five bad reports on it. No. How about around 110 to 125 reports where some are physically burned. Yes, I do think it is my job. Let me ask you one question. If you received all of these long three to four page emails that detail the pain rosacea sufferer are now in, would you report it to other rosacea sufferers so that they know they should be careful. If you received well over 100 reports would you not post anything. Seriously, would you? Or would you just let it go because you knew that two or three people would start an endless debate with you. People come to me for help and also to release information. I never asked for that position but when you are given the degree of information that I am given, I feel that I have a responsibility.

To the best of my ability I have posted accurate information from people I have known for years. People who I trust and now are in pain.

Let me just give you one example of the situation I am in. Dave Flemming has been touting a DMSO + Fluconazole cure for over two years. Topical DMSO on rosacea skin and eyes is as caustic as diluted hydrochloric acid. In my lab we use two pairs of thick gloves whenever we use the DMSO ampoules. NO ONE reported the dangerous side effects for over a year. Not one person. The main reason -- anytime a person even hinted that DMSO may be dangerous he would post long rebuttals that would tear the person down. So everyone stayed away from warning all unsuspecting rosacea sufferers from this bogus cure. I even kept my mouth shut because I did not have the energy to deal with the aggressive debates that would ensue. Freakin shame on me. Three people have damaged their corneas with two confirmed corneal melts which will require major eye surgery. I said nothing and I feel responsible for doing nothing.

I always try to start out any debate in a constructive fashion. That is how I was trained and its the best approach. But after the first couple rebuttals, things never stay constructive. That is the real problem -- on both sides. Someone figure out how to debate over the Internet and that will solve a tremendous amount of angst.

[scrumptious]

Dr Nase, when you touch down in Blighty, be assured that Scrumptious has promised to pick you up and ferry you about. Safe travel.

I heard that! :mrgreen:

Sadly i have no car, sorry.

[drnase]

This discussion has, at least, given us the expression, 'heart of a physicist.' I am very grateful for that! (This is not to impugn the author, who does sterling work elsewhere).

Are we saying that the therapeutic benefits of red light (in other afflictions) are attributable solely to its tendency to increase blood flow?

(Surely a chap riddled with wounds could sit in front of a fire if this is this case? Or does this prompt only superficial blood flow?)

Or, has red light properties which are healing per se?

Dr Nase, when you touch down in Blighty, be assured that Scrumptious has promised to pick you up and ferry you about. Safe travel.



GJ,

Be gentle with me. Blighty???? I am trying to learn from my friends as quickly as possible.

The LLT and LED have two mechanisms of action that are proven:
1. Increases blood flow to the area under exposure
2. Heals individual cells

One thing that is absolutely fascinating is using the treatment for diabetic ulcers in the feet. These are open wounds that sometimes go down to the ligaments or bones and never heal. They just stay open. Treatment with these systems does a great job at healing these cells -- after 4 to 6 weeks of treatment the hole in the foot actually has a matrix of skin over it. Further treatment combined with copper peptide technology helps grow skin and close the hole. Now, you can easily measure skin blood flow in the foot and in diabetics there is very little blood flow. When you use these devices blood flow increases by 400% to 600% and stays that way for many hours.

Hope that answers your question.

Blighty??

[scrumptious]

Blighty??

It’s a relic of British India. It comes from a Hindi word bilayati, foreign, which is related to the Arabic wilayat, a kingdom or province. Sir Henry Yule and Arthur C Burnell explained in their Anglo-Indian dictionary, Hobson-Jobson, published in 1886, that the word was used in the names of several kinds of exotic foreign things, especially those that the British had brought into the country, such as the tomato (bilayati baingan) and especially to soda-water, which was commonly called bilayati pani, or foreign water.

Blighty was the inevitable British soldier’s corruption of it. But it only came into common use as a term for Britain at the beginning of the First World War in France about 1915. It turns up in popular songs There’s a ship that’s bound for Blighty, We wish we were in Blighty, and Take me back to dear old Blighty, put me on the train for London town, and in Wilfred Owen’s poems, as well as many other places.
In modern Australian usage, Old has been added, as in Old Country and Old Dart, as a sentimental reference to Britain.

[drnase]

Blighty??

It’s a relic of British India. It comes from a Hindi word bilayati, foreign, which is related to the Arabic wilayat, a kingdom or province. Sir Henry Yule and Arthur C Burnell explained in their Anglo-Indian dictionary, Hobson-Jobson, published in 1886, that the word was used in the names of several kinds of exotic foreign things, especially those that the British had brought into the country, such as the tomato (bilayati baingan) and especially to soda-water, which was commonly called bilayati pani, or foreign water.

Blighty was the inevitable British soldier’s corruption of it. But it only came into common use as a term for Britain at the beginning of the First World War in France about 1915. It turns up in popular songs There’s a ship that’s bound for Blighty, We wish we were in Blighty, and Take me back to dear old Blighty, put me on the train for London town, and in Wilfred Owen’s poems, as well as many other places.
In modern Australian usage, Old has been added, as in Old Country and Old Dart, as a sentimental reference to Britain.


Allright Scrumptious -- I need the truth from you. Did you get that out of a book or did you just right that off your head. If you did it off the top of your head you are in the wrong business -- move over one sector to travel please. :D

[scrumptious]

how i wish that was from my head 8)

Out of an online encyclopedia, its just a slang term for Britain basically. Always good to know these terms origins though :wink:

[Peter]

Geoffrey

Ok lets get this thread back on track to your first post where you made some very serious allegations about me. Do not underestimate that these are very serious. Since that first post you have been challenged to provide evidence but nothing has been forthcoming.

To me: No evidence = No proof = Allegation void

Simple equation really.

Below is a statement from Adrian Warburton - Director of Dermalux who has kindly given me permission to post this on the Forum. You may remember in the past when you made similar allegations against me I gave you his address and telephone number but you have never made contact. When I spoke to Adrian today he had never heard of you. I think the first line of his statement is very pertinent.

----- Original Message -----
From: Adrian Warburton
To: Peter Waters
Sent: Monday, January 23, 2006 12:15 PM
Subject: Re: Can you help please !

Dear Peter

What a tirade! most unscientific and not helping the situation at all - why is he so vindictive?

I cannot recall any unit that has been returned from a Rosacea sufferer either a tubed or LED version.

I can also state that as a Company we have never asked you to promote our products or that you have ever received any payment for same. We have tried to help people who have contacted us with the best of our knowledge and experience. We always point out that there has never been a Clinical trial done with regards to Rosacea although, I seem to recall that Tony Chu is about to start a trial with redlight (it might be worth having a word with him)

The problem with the argument about Rosacea is that the cause has not been defined with absolute certainty.

Simplisticly it it appears to be an exaggeration of a natural condition that occurrs normally as the result of embarassement which dialates the capilliaries in the surface of the skin to cause a blush

I know that some researchers think that its cause could be p.Acnes manifesting itself in a different way

As you know we have never pushed the DermaLux as a treatment for Rosacea but lots of people suffering from the condition seem to be getting benefit by using all red versions. The Red LED unit was developed as a wound healing unit for recalcitrant leg ulcers. We have only sold a relatively few all Red LED units for Rosacea to people who wanted to try them and they seem to be doing OK. They will certainly tell you that the quality of their skin has improved which may be a cause of the improvement in the Rosacea but untill we have a controlled Clinical trial on any system of treatment we can only go on peoples experiences.

The understanding of light Therapy is growing fast but it is all relative. I once spoke to a Nobel Prize winning Proffesor of Medicine who told me that the sum total of the knowledge of the functioning of the human body is 15% and most of that is mechanics and plumbing so we have a long way to go with the biochemistry. That is the reason that some treatments in all facets of Medicine work for some cases and not for others. So the only advice given must be if it works for you use it if does not don't

regards

Adrian Warburton
Director DermaLux

Over to you now Geoffrey but please keep this thread fixed back to theme in your original post. You are very skilfull at avoiding the issues when it suits you. Lets have the evidence please ?

Thank you

Peter

[MARPUSBEAN]

I have been intrigued by the LED arguments, and by the note from Adrian
Warburton.
The problem is we are in no-mans land!!
I have no doubt that when people say red light has helped, that it has helped them, but there are so many variables in rosacea!!!!
People with papules, and even pustules, others with extremely red peeling skin, others with erythema, others withs skin so sensitive even water stings!!
Adrian does not market this product for rosacea, nor does his company have insructions or a protocol for treating rosacea, how should the lamp be used for aparticular sufferer??
Playing devils advocate, I can see people deriving benefit from the lamp, and equally some users damaging their faces.
The sooner qualitative tests are done , and these are published, and some kind of protocol established the better.

[IowaDavid]

How about around 110 to 125 reports where some are physically burned. Yes, I do think it is my job. Let me ask you one question. If you received all of these long three to four page emails that detail the pain rosacea sufferer are now in, would you report it to other rosacea sufferers so that they know they should be careful. If you received well over 100 reports would you not post anything. Seriously, would you? Or would you just let it go because you knew that two or three people would start an endless debate with you. People come to me for help and also to release information. I never asked for that position but when you are given the degree of information that I am given, I feel that I have a responsibility.



For the love of god, man!

Where are these people? What machine did they use? What are the specifications on the machine--wavelength, energy output?

You continue to refer vaguely to "people" and "devices" but have 0--yes, that's right--_ZERO_ specific citations, studies, or information for us.

You are seriously undermining your credibility by continually avoiding producing anything to back up your claims.

Please, show us some proof here, or stop scaring people. It's disgraceful. If you call yourself a Ph.D., surely you know what specific evidence is and what the standard is for evidence to be acceptable.

If people are not smart enough to understand what scare-tactic claims are, and what evidence is, then they deserve what they get. This is silly, Dr. Nase.



David

[IowaDavid]

One thing that is absolutely fascinating is using the treatment for diabetic ulcers in the feet. These are open wounds that sometimes go down to the ligaments or bones and never heal. They just stay open. Treatment with these systems does a great job at healing these cells -- after 4 to 6 weeks of treatment the hole in the foot actually has a matrix of skin over it. Further treatment combined with copper peptide technology helps grow skin and close the hole. Now, you can easily measure skin blood flow in the foot and in diabetics there is very little blood flow. When you use these devices blood flow increases by 400% to 600% and stays that way for many hours.



Okay. So these are devices you are familiar with. :D What is the energy delivered by the red light devices used to help diabetic ulcers? What wavelength is used? How long, and how frequently, are treatments administered?

Thank you,

David

[drnase]

how i wish that was from my head 8)

Out of an online encyclopedia, its just a slang term for Britain basically. Always good to know these terms origins though :wink:


Thanks Scrumptious -- anyway you gathered the info. is great.


Everyone now has a fair amount of information to make a decision -- the possible side effects and the possible benefits. That's all we are here for. I have a crunch time for the clinical rambazole study on rosacea sufferers and this debate has long been over -- please everybody, use common sense.

[IowaDavid]

Common sense and facts are the best choice, I think.

For the record, if anyone has been scared off by Geoffery's recent posts about those burned by red LLLT, consider this chronology of his related quotes:

June 11
I finally looked into the LLT and see benefits of using it in certain cases. In most cases, its use should be adjunctive to other treatments to get the best results.

By itself, it is probably best used to MAINTAIN clearance or rosacea remission.

Please keep us posted on its ability by itself to knock down the rosacea inflammatory response.

They are indeed now using the LLT for treatment of hair loss -- it stimulates healing and reduces fibrosis in the scalp.........if this had an anti-fibrotic effect on the scalp then it should also have that effect on the facial skin and may explain, in part why it may be effective. Aso, another possibility is the wound healing aspect -- this theoretically goes to the epidermis and helps it heal. Epidermal thinning, inflammation and ability to heal is off kilter in rosacea. So, it does start to make sense why LLT may work.

Keep us all informed please and thank you for the post.


August 6
I did not contradict myself on this system -- I stated that the professional medical models ($15,000 to $20,000) have shown clear evidence that it helps many patients; however, I never commented on the condensed $200 version and its abiliity. When you take a professional medical grade model and condense it down in size, it does lose a lot of strength, healing ability, penetration of light and a whole myriad of other changes.


January 9
This is the way to get to better treatments. I will need to borrow the books as we used many systems -- one light, combination light, etc. I will also try to give you the range and the medical indication. With this information David, I would expect nothing less than a time machine built in your garage!

January 21
If there are 5 or 6 good reports (and these people are using 4 to 5 other medications which makes it impossible to locate the beneficial variable), I have received well over 110 to 125 reports of blister skin, 1st degree burns, and increased flushing. We should kindly ask Dermalux how many rosacea sufferers returned their machines within the first 30 days -- that would speak for itself.


January 21
Every single LED and LLT will cause dramatic increases in blood flow. Every one, every wavelength, and every self made system.

January 23
David ....... it does NOT matter what device, wavelength or energy level used because these all have photobiomodulative actions. Period. My goal before I left here was to simply leave one message of caution to people that this form may turn into an LED LLT forum and that many reports are not good.

Again David, my degree was actually obtained at the Department of Physiology and Biophysics at IU School of Medicine. Biophysics. Exactly what these machines are and do. My post doctorate in this area.


Just a few questions, then.

Geoffery, if your post-doctorate degree was in Biophysics, why didn’t you tell the us the information you posted after January 21st, during the period June 9th – January 9th? If that was your post-doc degree, surely you would have been aware of the dangers of LLLT all along?

On January 9th, you seemed playful and unconcerned about LLLT. Then, amazingly, between January 9th and January 21st you received between 110-125 personal emails from rosacea sufferers, ALL telling you that they had been burned by red LLLT devices?

And I thought your Ph.D. was in Microvascular Physiology, not Biophysics. --but I don't know your department or its curriculum, that may be a technicality. Microvascular Physiology is just what it says on your book.

This progression of ideas--everything is fine with red light, you are encourgaging me for 6 months--and then a sudden “awareness” about the negative effects of red LLLT--just 2 days after I posted an exultory anecdotal experience--strains your credibility to the extreme. I have severe doubts about the veracity of your claims. Especially as you have repeatedly refused to provide any concrete facts or data or studies to support your recent statements.

Those are the facts--your facts, your statements. So, yes, people can make up their minds for themselves.

Regards,

David

[drnase]

Geoffrey

Ok lets get this thread back on track to your first post where you made some very serious allegations about me. Do not underestimate that these are very serious. Since that first post you have been challenged to provide evidence but nothing has been forthcoming.

To me: No evidence = No proof = Allegation void

Simple equation really.

Below is a statement from Adrian Warburton - Director of Dermalux who has kindly given me permission to post this on the Forum. You may remember in the past when you made similar allegations against me I gave you his address and telephone number but you have never made contact. When I spoke to Adrian today he had never heard of you. I think the first line of his statement is very pertinent.

----- Original Message -----
From: Adrian Warburton
To: Peter Waters
Sent: Monday, January 23, 2006 12:15 PM
Subject: Re: Can you help please !

Dear Peter

What a tirade! most unscientific and not helping the situation at all - why is he so vindictive?

I cannot recall any unit that has been returned from a Rosacea sufferer either a tubed or LED version.

I can also state that as a Company we have never asked you to promote our products or that you have ever received any payment for same. We have tried to help people who have contacted us with the best of our knowledge and experience. We always point out that there has never been a Clinical trial done with regards to Rosacea although, I seem to recall that Tony Chu is about to start a trial with redlight (it might be worth having a word with him)

The problem with the argument about Rosacea is that the cause has not been defined with absolute certainty.

Simplisticly it it appears to be an exaggeration of a natural condition that occurrs normally as the result of embarassement which dialates the capilliaries in the surface of the skin to cause a blush

I know that some researchers think that its cause could be p.Acnes manifesting itself in a different way

As you know we have never pushed the DermaLux as a treatment for Rosacea but lots of people suffering from the condition seem to be getting benefit by using all red versions. The Red LED unit was developed as a wound healing unit for recalcitrant leg ulcers. We have only sold a relatively few all Red LED units for Rosacea to people who wanted to try them and they seem to be doing OK. They will certainly tell you that the quality of their skin has improved which may be a cause of the improvement in the Rosacea but untill we have a controlled Clinical trial on any system of treatment we can only go on peoples experiences.

The understanding of light Therapy is growing fast but it is all relative. I once spoke to a Nobel Prize winning Proffesor of Medicine who told me that the sum total of the knowledge of the functioning of the human body is 15% and most of that is mechanics and plumbing so we have a long way to go with the biochemistry. That is the reason that some treatments in all facets of Medicine work for some cases and not for others. So the only advice given must be if it works for you use it if does not don't

regards

Adrian Warburton
Director DermaLux

Over to you now Geoffrey but please keep this thread fixed back to theme in your original post. You are very skilfull at avoiding the issues when it suits you. Lets have the evidence please ?

Thank you

Peter



Peter,

Your lack of attempt to discuss or debate any point on this subject with civility ...... and your private attacks on many people with language that is worse than a street bully, especially on females, are the main reasons nothing constructive has come from this thread. Just two sides cut down the middle.

The email from the producer means nothing to me as his first sentence sets the tone for the entire post and is truly unprofessional. And the second sentence is untrue. I tell you that dozens of rosacea sufferers have returned machines to Dermalux (and other companies too). "I dont recall" lets him get out of any strong statement. I state that "There have been MANY rosacea sufferers that have returned their machines to them within the 30 day guarantee due to facial redness, burning, blurred vision and inflammation. That is a statement and a quote. Please tell him to just look up a half dozen Australian purchases and over a dozen UK purchases in the last 12 months. There is no ambiquity there. I state that as fact and not as "something I cant recall, but then may recollect later". If this needs to go farther, we shall set up some type of system so that these people can state their facts without absolute fear of your language and attacks. Peter, you could have handled this a thousand times better and I would have replied in kind. This has potential down the road, but in no way can any non-heated discussion take place.

David, yes. I have a Doctorate in Medical Physiology. I have a Post-Doctorate in Neurovascular Physiology with emphasis on Microvascular Physiology and Bio-physics.

Peter, if you ever want to come to the table and discuss things in a couple months in a civilized fashion I will make my best attempts to do likewise.

[redhotoz]

OK fellow Rosaceans

I know we can all go back and read the entire thread (other than the posts that have been deleted) but I thought it may be helpful if the most pertinent points in this debate were summarised, so that we can focus on the questions at hand:

Geoffrey initiates thread to warn all Rosaceans about the dangers of LLT and LED use on Type I Rosacea, states that Type I Rosacea has an element of inflammation and that increased blood flow helps to reduce inflammation, yet LLLT should not be used on a Rosacean skin.

Geoffrey states that “some get commissions for each unit sold. They submit a name or the person buying it is asked to mention their name. That is what is behind many (but not all) of these "sellers" attacks”.

Geoffrey also claims:
· Having 110 –125 reports of blister skin, 1st degree burns and increased flushing
· 3 Laser Physicians who have treated over 12 burn cases
· A Dermatologist who has treated 3 cases
· 7 Australians have returned their machines to Dermalux
· 60 reports from Rosaceans “trying it” with 4 Laser Physicians treating these people for negative side effects from use of LLT or LED

Geoffrey states that he “knows more about both of these systems than almost everyone else”

Dr Crouch talks about 2 patients that came to see him in the same week with burns from a “home constructed super bright Infra red LED arrays.The LEDs were purchased from separare mail order electrical wholesalers”.

David points out that “light” and “LED light” are different and that LED light is non-thermal (do not produce heat).

David asks Geoffrey and Dr Crouch to a) “quote the energy outputs of the of the units that harmed these patients, and b) what the light source is.

Geoffrey states that 1. “Every single LED and LLT will cause dramatic increases in blood flow. Every one, every wavelength, and every self made system.” and that 2. “non thermal does not relate to blow flow increases.”

David disagrees with Geoffrey on point 1 above and again requests the energy level used by these patients.

Dr Crouch states that he has “absolutely no idea what the energy output of these (improvised) devices is” and states that he has “no problem with properly constructed/ tested / calibrated devices with FDA approval”

Geoffrey again mentions “an increase in blood flow” with these processes

David explains how he built his LED unit and that he “would very much like to find out what sort of device the people that were harmed were using so we could find some sort of benchmark or "limit" for red light therapy.”

Dr Crouch reiterates that “anything that increases blood flow seems to be counterintuitive with rosacea”

David objects to Geoffrey’s use of the words “ "all", "always", "any", "never", etc... that one should regard said statements with extreme skepticism.” and that he is “only here to express qualified statements regarding my anecdotal experiences with LLLT.”

Redhotoz asks Dr Crouch if he reported the said cases to the appropriate authorities and asks Geoffrey for confirmation about the inflammatory/anti-inflammatory benefit from using these therapies.

Bradley requests before/after pictures from David.

Dr Crouch reiterates that he “would not recommend red light therapy for rosacea”, explains that he was unable to report the said cases to the authorities because they were home made units, not commercially bought units and that he is a GP as well as laser specialist, so the said cases were referred to him for laser treatment.

Geoffrey states that his first post stated only “facts, numbers and warnings. Absolutely no vindictiveness.”, “that these machines are not for rosacea right now.” and that he has no agenda.

Prryjones requests before/after pictures, asks if any studies have been done and likens LLLT to a case where a “cure” was offered without evidence.

Redhotoz advises that Dermalux don’t have the option to offer a name for referral, so how could anyone get commission from the company?

David posted before and after pictures and again asks Geoffrey” What devices were used, what wavelength was used, and how much energy was delivered to these patients' skin that were harmed?”

Geoffrey explains that “it does NOT matter what device, wavelength or energy level used.” “Every single device that I have seen will increase blood flow to the surface of the facial skin.” “If you are using a low energy system than the point is mute because it does not have a biological action on a cell and thus does not signal a blood flow response.”

David asks Geoffrey if he has any data, studies or specifications of the devices used, if we are supposed to simply take his word for it and submits an article on “Light Emitting Diode-Based Therapy”.

Marpusbean mentions that the Dermalux site does not mention use of their units on Rosacea.

Redhotoz advises Prryjones that there was never a mention of this therapy being a “cure” for Rosacea.

RedHotCanuk questions Geoffrey “how do you know he sells this equipment? I don't think thats very fair to write unless you have facts to support it.” Geoffrey replies with “he did indeed tell other rosacea sufferers that he does and there is a huge market for them.”

GJ asked “Are we saying that the therapeutic benefits of red light (in other afflictions) are attributable solely to its tendency to increase blood flow?” “Or, has red light properties which are healing per se?”

Geoffrey claims “My role in the rosacea community is 99% posting information about promising new treatments, clinical study results…performing clinical studies now, and letting people know about potentially dangerous treatments”, mentions the “DMSO + Fluconazole” case and states that “The LLT and LED have two mechanisms of action that are proven: 1. Increases blood flow to the area under exposure 2. Heals individual cells”

RedHotCanuck again requests facts be provided in regards to someone selling Dermalux units. Geoffrey replies advising that he “cant give out names due to confidentiality under Rosacea Consulting Specialists.”

Peter Waters provides a copy of an e-mail from Adrian Warburton – Director Dermalux to Peter, stating that Adrian “cannot recall any unit that has been returned from a Rosacea sufferer either a tubed or LED version. …we have never asked you to promote our products or that you have ever received any payment for same. …We always point out that there has never been a Clinical trial done with regards to Rosacea although, I seem to recall that Tony Chu is about to start a trial with redlight…we have never pushed the DermaLux as a treatment for Rosacea but lots of people suffering from the condition seem to be getting benefit by using all red versions”

David again requests specific information about the said cases.


So, in summary of the above:

Geoffrey adamantly states that LLT and LED light therapy is dangerous for Rosaceans with Type I Rosacea, that he has no agenda with this thread other than to worn Rosaceans of it’s danger.

Question: What about it’s use for other sub-types of Rosacea?

Geoffrey states that Peter Waters sells Dermalux units and gets paid a commission from the company to do so and that is why he keeps going on about them and that 7 Australians with Rosacea have returned their units to Dermalux. Peter provides a copy of an e-mail from the Director of Dermalux to refute both of these claim.

Dr Crouch talks of two patients he saw in the same week who had facial burns from their “home constructed super bright Infra red LED arrays”, that he was not able to report these cases to the authorities because they were home made units, not commercially bought units.

Several requests are made for the following information to be provided by Geoffrey or Dr Crouch in regards to said patients:

1. What devices were used?

2. What wavelength was used?

3. How much energy was delivered to the patients?

Reason for these questions, “so we could find some sort of benchmark or "limit" for red light therapy.”

Neither Geoffrey or Dr Crouch were able to answer these questions.

Several requests are made for data to be provided by Geoffrey on the following claims made by Geoffrey:

1. 110 –125 reports of blister skin, 1st degree burns and increased flushing

2. 3 Laser Physicians who have treated over 12 burn cases (no mention of how they got burnt)

3. A Dermatologist who has treated 3 cases (no mention of how they got burnt)

4. 60 reports from Rosaceans “trying it” with 4 Laser Physicians treating these people for negative side effects from use of LLT or LED

Geoffrey unable to provide any data due to “confidentially” of his patients.

Questions I have to Geoffrey:

1. Did you report all of the cases you have mentioned to the proper authorities? If so, which one?

2. If you are not able to provide any data due to “confidentiality” of your patients, are you able to provide more thorough scientific data in regards to the negative effects of LLT and LED on Rosaceans?

3. Have you conducted any studies on LLT and LED that you can share with us to back up your claims?

A debate is about discussing facts. The opening post contained a personal accusation, which could only bring an inflamed response.

So, let’s get back to facts and see if we can’t have an adult discussion about the pros and cons of LLT and LED.

Red

[Peter]

Red

Thanks for that because this thread keeps going off the subject. His first post is the one we should refer back to each time because that sets the tone and his accusations. Other material and subjects keep getting thrown in which have nothing to do with his original post.

I have provided clear cut evidence from a respected professional person to refute the accusations made against me.

I still have to see any evidence from Geoffrey Nase.

Unless he does provide evidence to back up all his claims I think he should retract the accusations he has made and withdraw all of his comments as any professional person would do in these circumstances.

Regards

Peter

[redhotoz]

What a disappointing response! This thread was supposed to be about LLT and LED. Or was it?

[Peter]

Good Morning Geoffrey !

I see once again you are going off track and you are making further allegations against me which have nothing to do with your original post in this thread.

It may well suit you to have this thread closed down but that is not my intention because I have a right to defend myself against your accusations. This is what I am doing and I have provided evidence. We are still waiting for yours.

Briefly as you can imagine after your original post in this thread over the weekend emotions were running high. As far as I am aware now I am back on good terms with the person concerned. I am sure you have lots of PM's on many people you could release, if that is your aim. I also have many e mails and PM's from you and others which could be interesting if I also made them public. They have nothing to do with this thread and I have no intention of releasing them here, if indeed I have any intention of releasing them anyway.

Please get back on track and answer the questions submitted by me and others plus support evidence to back up your accusations against me in your original post on this thread. If you cannot do this, then as I said previously please retract all the claims and accusations made against me and of course Dermalux. I suggest you read your original post again plus recent from posts from Red and David to remind yourself of the questions being raised because it is you who is missing the point.

I have to go to work now.

Thank you

Peter

[redhotoz]

Light Emitting Diode-Based Therapy

William Abramovits, MD; Peter Arrazola, BA; Aditya K. Gupta, MD, PhD, FRCP(C)

SKINmed. 2005; 4 (1): 38-41. ©2005 Le Jacq Communications, Inc.
Introduction

David

David

Do you have the web address of the site for this article, please? Save me the web search. I have an appointment with my Dermatologist next month and I am just writing a letter to him with ideas for us to discuss. I think it would be prudent to include a web address, so that he can also have a look.

My Derm is going to have a great deal of options to consider at our next appointment and I thought he should be pre-warned and have the time to do some research himself. He wasn't too knowledgable at our first appointment, so I thought I would give him a heads up. I have done way too much reading since my last appointment with him! Or is there such a thing as too much reading when it comes to Rosacea?

Many thanks

Red

[IowaDavid]

http://www.medscape.com/viewarticle/499713_print


Careful--you may get blank looks from your derm, unless they're one of the "cool" ones that is open to suggestions and learning. :o
I've come at some derms/laser docs with all sort of information and questions and overall, it's been a mixed bag. :lol:

Good luck, though. 8)

[redhotoz]

http://www.medscape.com/viewarticle/499713_print


Careful--you may get blank looks from your derm, unless they're one of the "cool" ones that is open to suggestions and learning. :o
I've come at some derms/laser docs with all sort of information and questions and overall, it's been a mixed bag. :lol:

Good luck, though. 8)

Thanks David

Yes, I expect that if I don't send my Derm a letter with things I propose to discuss, then it will be a waste of my money and his time...well...both of our time really. I would rather that he have a month up his sleeve to check things out and advise.

Tell me again why we go to the Derm? We take the info to them, or in my case send it early, so that we can ask for advice on what we have already read about?!

Red

[IowaDavid]

That, and we come in with studies that support the use of certain drugs and then we berate them until they write us a script.... :wink:

[Kelli]

I just always remember one thing when it comes to Dr.s

What do you call the guy who finished LAST in his class at medical school?

Dr.

[kohlrabi_Croce]

Well that was interesting. This is a real ambiguity - Dr. Nase is obviously
tops in his field and cares about what happens to Rosacea sufferers,
and yet.....

He doesn't seem to have a problem, from what I can tell, from all the
times that laser treatments go wrong when done by professionals.
I sitll don;t know much about those yet either, but it seems like
there are so many scare stories that one gets the feeling these
doctors are just using us for guinea pigs! Stories about people
feeling like the fat under their skin had been fried like a pork rind
just about, and then the rosacea just gets worse.

He himself told the story of how his own skin got burned really bad,
but it healed, and he just learned from that and kept on going until
he had somebody do it correctly on him. So he doesn't seem to
have such a problem with this kind of damage, if it's done by a
professional.

If there's any way I could help myself with this LED thing, I'd rather do
that, because being treated by somebody who acts like they know what
they're doing when they may or may not, is also rather scary.

I'm on clarythromycin now, and that's working pretty well for acne,
but my skin is still red, and I've got some broken blood vessels on
the chin. It's probably at an intermediate stage.