DrFritz PDT Omnilux

Photodynamic Rejuvenation
comparison of LLLT with

10% and 20 % ALA PDT
Carmen Solavastru and Klaus Fritz

University Carol Davila Bukarest (Ro) and
Dermatology and Laser Center Landau (D)
Background:
Ageing skin ageing is caused significantly by photoageing,
actinic keratoses occur.
PDT Treatment effects :
Reduces signs of exogenous

skin ageing such as AK,
pigmentation, always
improves skin texture, too Light sources themself
may decrease
pigmentation,solar
Induces collagen
lentigines and
neogenesis resulting in
teleangiectasia
smoothening and tightening
of the skin
Background device/ light source
Omnilux light Technology

1.
2.
Light Emitting Diode

matrix
LEDs are chips that
directly convert
electricity to light
Omnilux blue
415nm wavelength
with 5 ALA for Actinic Keratosis
Omnilux revive
633nm wavelength
for primary skin rejuvenation alone or in

combination with 5 ALA for photodamage
Omnilux plus
830nm wavelength for wound healing
Types of light reaction
1. Activation of cell receptors

in the mitichondria or on the cell membrane lead to
increased cell metabolism = photobiostimulation:
Skin rejuvenation, wound healing, , tissue regeneration
2. In combination with ALA as a topically applied
photosensitiser
For the treatment of non melanoma skin cancers, acne
and photodamaged skin
Background device/ light source LLLT alone
Role of LLLT
(Low level light therapy)
data of Randomised Clinical

Trials and laboratory based
research show improved
Collagen synthesis
Anti bacterial
o
o
o
o
o
Wound healing and tissue repair

angiogenisis
Relief of inflammation
neuroregeneration
Cytoprotection

633nm (Visible red light) alone
Right
(Treated)
Left
(Covered)
National Medical Center

Republic of Korea
Before treatment
12 weeks after treatment

Change in the severity of wrinkles (Visiometer Results: profilometry value)
< R3 value = The Average Roughness >
Percentage reduction
105%
100%
Control group
95%
90%
85%
80%
633nm
alone
75%
70%
830nm alone
65%
830nm+633nm
60%
55%
(- 36%)
50%
Before
Treatment
2 weeks
4 weeks
8 weeks
12 weeks
post treatment post treatment post treatment post treatment
Time
Treatment Results
67% (4/6)significant treatment response
Reduction in fine lines and wrinkles
Skin softness improved
Lowe N. Lowe P (2005) J. Cosmetic and Laser Therapy volume

7 issue : Pilot Study to determine the efficacy of ALA-PDT
photorejuvenation for the treatment of facial ageing
The effect of combination Omnilux

phototherapy on fine lines and wrinkles
Reduction in valley depth (st) or wrinkles at

week 12.
83% and 81% reporting a softening of fine lines
and wrinkles at weeks 9 and 12 respectively.
Russell B. Journal of Cosmetic and Laser Therapy. 2005; 7: 196200
Background light source + ALA
ALA +Light
Studies and case reports on rejuvenation

Touma DJ, Gilchrest BA.
Topical photodynamic therapy: a new tool in
cosmetic dermatology.Semin Cutan Med Surg.
2003 Jun;22(2):124-30.
Gold MH, Goldman MP.5-aminolevulinic acid
photodynamic therapy: where we have been and
where we are going. Dermatol Surg. 2004
Aug;30(8):1077-83; discussion 1083-4.
Zakhary K, Ellis DA.
Applications of aminolevulinic Acid-based
photodynamic therapy in cosmetic facial plastic
practices. Facial Plast Surg. 2005 May;21(2):110-6
Touma D, Yaar M, Whitehead S et al.

A trial
of short incubation, broad-area
photodynamic therapy for facial
actinic keratoses and diffuse
photodamage.
Arch Dermatol 2004; 140:33-40.
Ruiz-Rodriquez R, Sanz-Sanchez T,
Cordobo S. Photodynamic
photorejuvenation. Dermatol Surg
2002; 28:742-744.
Gold MH. Intense pulsed light therapy
for photorejuvenation enhanced with
20%
aminolevulinic acid photodynamic
therapy.
J Laser Med Surg 2003; 15(S):47.
Photos courtesy of Mark S. Nestor, M.D., Ph.D.

studies have also demonstrated
increased fibrosis and

New collagen formation in the dermis several months
after 5 ALA~PDT for the treatment of basal cell and squamous

cell carcinomas.
Fink Puches R, Soyer.H.-P.,Hofer A et a. Long-term follow-up andhistological changes of superficial
non melanoma skin cancers treat-ed with topical delta-aminolevulinic acid
photodynamic therapy, ArchDermatal. 1998;134:821-826.
Touma DJ,Szeimis RM:Topical PDT in Krutmann Skin Ageing2006 (157-166)

Photorejuvenation induced by 5-aminolevulinic acid
photodynamic therapy in patients with actinic keratosis:
A histologic analysis
Min Young Park, MD, Seonghyang Sohn, PhD, Eun-So Lee, MD
and You Chan Kim, MD
Journal of the American Academy of Dermatology
Volume 62, Issue 1, Pages 85-95 (January 2010)
14 patients with actinic keratoses treated twice with ALA-PDT by using a 1200 W
metal halogen lamp at 1-month intervals.
Skin biopsy before and 1 month after the PDT
routine and immunohistochemical staining
parameters associated with photoaging by using image analysis.
Mean expression of TGF-, TR II, procollagen I,

procollagen III, and total collagen volume
increased with each session of ALA-PDT.
TGF- does not only upregulate procollagen

synthesis,
but it also downregulates the
expression of MMPs
Source: Journal of the American Academy of Dermatology 2010; 62:85-95)

Procollagen type I and
type III
The expression of collagen
precursors was also
increased, especially in the
papillary dermis and upper
reticular dermis.
The average increase was
significantly different
Source: Journal of the American Academy of

Dermatology 2010; 62:85-95)
Fig ALA
5
Background light source +
Mean expression of TGF-, TR II, procollagen I,

procollagen III, and total collagen volume
increased with each session of ALA-PDT.
TGF- does not only upregulate procollagen

synthesis,
but it also downregulates the
expression of MMPs
Source: Journal of the American Academy of Dermatology 2010; 62:85-95)
After ALA-PDT, the mean epidermal thickness and dermal inflammatory

infiltrate were reduced.
The total collagen volume in the dermis significantly increased with expression
of type I and III procollagen.
The level of transforming growth factor and transforming growth factor type
II receptors in the epidermis also increased.
The elastotic material with co-localizing fibrillin-1 and tropoelastin expression in
the dermis decreased after treatment.
The expression of matrix metalloproteinases-1, -3, and -12 also decreased.
Two sessions of MAL-PDT increases

immunohistochemical expression of MMP-9 in the
dermis at 3 months after treatment, and also of
Collagen type I.
Own results
Method: 10 patients each group
Group A
Group B
was treated with blue

light of 415 nm
+633 each side
( Omnilux ) 8-12
times 1x/week for 10
min each
wavelenghth and
side of the face
received classic ALA

treatment with
20 % ALA (prescription),
applied for 3 h and
treated with 415 nm 10
min +10min of 633 nm
Group C
received 10 % ALA for 30 min and
415 nm 10 min + 633 nm 10 min
Courtesy Dr Klaus Fritz
12 times Omnilux
= 415 nm + 633 nm
improved
significantly
radiancy ,
skin tone
and
pore size
classic 20 % ALA , 3 h and treated with
415 + 633 nm 10 min each/side
reduced
reduced
resulted
all signs
actinic keratoses more than 90 %,

dyschromia significantly and
in a smoother skin texture ,
of skin ageing reduced significantly
classic 20 % ALA , 3 h and treated with
415 + 633 nm 10 min each/side
reduced
reduced
resulted
all signs
actinic keratoses more than 90 %,

dyschromia significantly and
in a smoother skin texture ,
of skin ageing reduced significantly
10 % ALA for 30 min , 415 nm +

633 nm 10 min each/side
improved same parameters up to 70 % as

treatment No. B
but allowed less redness, crusting ,pain and
irritation .
10 % ALA for 30 min , 415 nm +

633 nm 10 min each/side
improved same parameters up to 70 % as

treatment No. B
but allowed less redness, crusting ,pain and
irritation .
conclusion and summary
modified application of PDT of 10% and 30 min

using the 415 + 633 nm Omnilux with its antiinflammatory effects are very effective in
rejuvenation of ageing skin .This protocol
allows both, a cosmetic improvement and the
preventive effects in actinic keratoses.
LLLT with 415 nm and 633 nm only can

improve radiancy and smoothness of the skin
even without ALA
conclusion and summary
Compared to other procedures such as lasers or

chemical peels PDT needs 1 2 sessions only
every 1- 3 years, need few visits ,and combine
highly effective cosmetic improvements with a low
risk of side effects at comparibly low costs.
Photodynamic Rejuvenation
comparison of LLLT with
10% and 20 % ALA PDT
Thank You
Carmen Solavastru and Klaus Fritz
University Carol Davila Bukarest (Ro) and
Dermatology and Laser Center Landau (D)

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Photodynamic Rejuvenation

comparison of LLLT with

Carmen Solavastru and Klaus Fritz

PDT Treatment effects :

Reduces signs of exogenous

Background device/ light source

Omnilux light Technology

Light Emitting Diode

Background device/ light source

for primary skin rejuvenation alone or in

830nm wavelength for wound healing

Background device/ light source

Types of light reaction

1. Activation of cell receptors

Background device/ light source LLLT alone

(Low level light therapy)

data of Randomised Clinical

Wound healing and tissue repair

Background device/ light source LLLT alone

National Medical Center

12 weeks after treatment

Background device/ light source LLLT alone

Background device/ light source LLLT alone

Lowe N. Lowe P (2005) J. Cosmetic and Laser Therapy volume

Background device/ light source LLLT alone

The effect of combination Omnilux

Reduction in valley depth (st) or wrinkles at

Russell B. Journal of Cosmetic and Laser Therapy. 2005; 7: 196200

Background light source + ALA

Studies and case reports on rejuvenation

Touma D, Yaar M, Whitehead S et al.

Background light source + ALA

Photos courtesy of Mark S. Nestor, M.D., Ph.D.

increased fibrosis and

after 5 ALA~PDT for the treatment of basal cell and squamous

Background light source + ALA

Background light source + ALA

Mean expression of TGF-, TR II, procollagen I,

TGF- does not only upregulate procollagen

Source: Journal of the American Academy of Dermatology 2010; 62:85-95)

Background light source + ALA

Source: Journal of the American Academy of

Mean expression of TGF-, TR II, procollagen I,

TGF- does not only upregulate procollagen

Source: Journal of the American Academy of Dermatology 2010; 62:85-95)

Background light source + ALA

After ALA-PDT, the mean epidermal thickness and dermal inflammatory

Two sessions of MAL-PDT increases

Method: 10 patients each group

was treated with blue

received classic ALA

Courtesy Dr Klaus Fritz

classic 20 % ALA , 3 h and treated with

415 + 633 nm 10 min each/side

actinic keratoses more than 90 %,

classic 20 % ALA , 3 h and treated with

415 + 633 nm 10 min each/side

actinic keratoses more than 90 %,

10 % ALA for 30 min , 415 nm +