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This study was performed in order to evaluate the safety and efficacy of a new handheld home-use multisource radiofrequency device on facial rejuvenation. Forty-seven male and female subjects were enrolled. All subjects received a NEWA®3DEEP™home-use device (EndyMed Medical, Caesarea, Israel) to be used on facial skin three times per week for the first four weeks and then reduced to two times per week for the following eight weeks. Assessments included expert clinical grading for efficacy, instrumental evaluation, image analysis, and photography. Forty-five subjects completed the study; all subjects reported the treatment to be painless with only mild erythema lasting up to 15 minutes post-treatment. No other adverse events were reported. Statistically significant improvements were noted in the appearance of marionette lines, skin brightness, elasticity, firmness, lift (facial), lift (jawline), texture/smoothness, tone, and radiance/luminosity by expert visual assessment. Statistically significant improvements in skin firmness and elasticity were found using a Cutometer MPA 580, as well as in collagen and hemoglobin content of the skin using a SIAscope. The results of this study indicate that the NEWA®multisource radiofrequency home-use device is effective in self-administered skin rejuvenation. [ABSTRACT FROM PUBLISHER]

In the last decade, Radiofrequency ( RF) energy has proven to be safe and highly efficacious for face and neck skin tightening, body contouring, and cellulite reduction. In contrast to first-generation Monopolar/Bipolar and 'X -Polar' RF systems which use one RF generator connected to one or more skin electrodes, multisource radiofrequency devices use six independent RF generators allowing efficient dermal heating to 52-55 °C, with no pain or risk of other side effects. In this review, the basic science and clinical results of body contouring and cellulite treatment using multisource radiofrequency system (Endymed PRO, Endymed, Cesarea, Israel) will be discussed and analyzed. [ABSTRACT FROM AUTHOR]

Objective. Acne scars are one of the most difficult disorders to treat in dermatology. The optimal treatment system will provide minimal downtime resurfacing for the epidermis and non-ablative deep volumetric heating for collagen remodeling in the dermis. A novel therapy system (EndyMed Ltd., Cesarea, Israel) uses phase-controlled multi-source radiofrequency (RF) to provide simultaneous one pulse microfractional resurfacing with simultaneous volumetric skin tightening. Methods. The study included 26 subjects (Fitzpatrick's skin type 2-5) with moderate to severe wrinkles and 4 subjects with depressed acne scars. Treatment was repeated each month up to a total of three treatment sessions. Patients' photographs were graded according to accepted scales by two uninvolved blinded evaluators. Results. Significant reduction in the depth of wrinkles and acne scars was noted 4 weeks after therapy with further improvement at the 3-month follow-up. Conclusion. Our data show the histological impact and clinical beneficial effects of simultaneous RF fractional microablation and volumetric deep dermal heating for the treatment of wrinkles and acne scars. [ABSTRACT FROM AUTHOR]

The thermal effects of monopolar and bipolar radiofrequency (RF) have been proven to be beneficial in skin tightening. Nevertheless, these effects were frequently partial or unpredictable because of the uncontrolled nature of monopolar or unipolar RF and the superficial nature of energy flow for bipolar or tripolar configurations. One of the hypotheses for lack or predictability of efficacy of the first-generation RF therapy skin tightening systems is lack of adaptation of delivered power to differences in individual skin impedance. A novel multisource phase-controlled system was used (1 MHz, power range 0-65 W) for treatment and real-time skin impedance measurements in 24 patients (EndyMed PRO™; EndyMed, Cesarea, Israel). This system allows continuous real-time measurement of skin impedance delivering constant energy to the patient skin independent of changes in its impedance. More than 6000 unique skin impedance measurements on 22 patients showed an average session impedance range was 215-584 Ohm with an average of 369 Ohm (standard deviation of 49 Ohm). Analyzing individual pulses (total of 600 readings) showed a significant decrease in impedance during the pulse. These findings validate the expected differences in skin impedance between individual patients and in the same patients during the treatment pulse. Clinical study on 30 patients with facial skin aging using the device has shown high predictability of efficacy (86.7% of patients had good results or better at 3 months' follow-up [decrease of 2 or more grades in Fitzpatrick's wrinkle scale]). The real-time customization of energy according to skin impedance allows a significantly more accurate and safe method of nonablative skin tightening with more consistent and predictable results. [ABSTRACT FROM AUTHOR]

The last few years have shown an increased demand for non-invasive skin tightening to improve body contour. Since light (lasers or intense pulsed light sources) has a limited ability to penetrate deep into the tissue, radio frequency (RF) modalities were introduced for the reduction of lax skin to achieve skin tightening and body circumference reduction. This study presents the use of the novel 3DEEP™ technology for body contouring. 3DEEP is a next generation RF technology that provides targeted heating to deeper skin layers without pain or other local or systemic side effects associated with the use of the earlier generation RF systems available today. The study included 30 treatment areas on 23 healthy volunteers at two sites. The treatment protocol included four weekly and two bi-weekly ( n= 6) treatments on different body areas. Results were evaluated by standardized photography and by circumference measurements at the treatment area, and were compared to changes in body weight. Significant improvement could be observed in wrinkles and skin laxity, and in the appearance of stretch marks and cellulite. Some changes appeared as early as after a single treatment. Circumference changes of up to 4.3 cm were measured. [ABSTRACT FROM AUTHOR]

Background: A major cause of skin aging is a chronic micro-inflammation triggered by UV radiation and external pollutants. It has been demonstrated that blue light diminishes inflammatory conditions and near infrared light enhances circulation. Objectives: To assess the effectiveness of a non thermal dual wavelength - blue (405 – 420 nm) and near infrared (850 – 900 nm) - light source in skin rejuvenation, in the reduction of the duration of post skin resurfacing erythema and in the acceleration of healing of post surgical conditions (face lift and breast augmentation). Methods: We have utilized a non contact, hand free dual wavelength light source (iClearXL and Clear100XL, Curelight Ltd) to treat over 60 patients and perform three controlled studies in four centers. Follow up duration was three months. Control group for photorejuvenation consisted of patients treated with Glycolic peeling and daily appliance of vitamin C Control group for post skin resurfacing erythema duration consisted of patients untreated by the light source and control group for post surgical healing consisted of patients untreated by the light source or treated by the light source on one side only. Results: Post skin resurfacing erythema duration is reduced by 90%. The healing of post surgical conditions is substantially accelerated and discomfort is reduced. The anti aging effect of the light source includes: reduction of pore size in 90% of patients with stable results at three months follow up, enhanced skin radiance in 90% of patients with stable results at three months follow up and smoothing of fine wrinkles in 45% of patients with stable results at three months follow up. The control group showed poor results which were stable for a duration of less than one month. Conclusions: A non thermal, non contact / hand free light source emitting at 405–420 nm and 850–900 nm considerably enhances aesthetic and surgical aesthetic procedures without consuming user time. [ABSTRACT FROM AUTHOR]

The prolonged crusting and erythematic phases following chemical and laser skin resurfacing create discomfort and aggravate patients. Depending on the aggressiveness of the procedure, post-procedure erythema may last from three weeks to several months, iClearXL (CureLight Ltd) is a non-contact, non-thermal blue (405–420 nm)/near infrared (850–900 nm) dual-band light source emitting up to 60 J/cm² on a 30 cm by 30 cm treatment area. The blue component of the light source has been proven to have a significant anti-inflammatory effect, whereas the near infrared component enhances vascular circulation as well as lymphatic drainage in the thin, necrotized papillary layer. Facial skin laser resurfacing was performed on twelve patients. Starting one day after resurfacing, six patients received a daily 20-minute treatment of blue (405–420 nm)/near infrared (850–900 nm) light for six consecutive days, and six control patients were treated with the usual topical care protocol. Twelve days after the procedure, the treated group had a weighted average erythema score of 0.33 as compared to 1.33 in the control group. Two months after the procedure, the treated group had a weighted average erythema score of 0.16 as compared to 0.83 in the control group. Twelve days after the procedure, the treated group had a weighted average discomfort score of 0.33 as compared to 0.83 in the control group. The tested combination of non-thermal blue (405–420 nm)/near infrared (850–900 nm) dual-band light was found to significantly shorten the duration of post-laser-resurfacing erythema and discomfort with no side effects. [ABSTRACT FROM AUTHOR]

BACKGROUND: Available topical treatments are slow and frequently irritating. Oral therapies may be associated with increased bacterial resistance (antibiotics) or possible severe side effects (oral isotretinoin). In vitro and in vivo exposure of acne bacteria to 405-420 nm ultraviolet (UV) free blue light results in the photo-destruction of these bacteria through the effects on the porphyrins produced naturally by Propionibacterium acnes. A novel, high-intensity, narrow band 420 nm UV free blue light has been shown to decrease inflammatory acne lesions after eight bi-weekly treatments. OBJECTIVES: To examine the effects of high-intensity, narrow band 420 nm UV free blue light (ClearLight™) on inflammatory acne lesions. METHODS: Three studies were carried out to examine the clinical effects of high-intensity, narrow band blue light on papulo-pustular acne: the split-face dose-response study, the full-face open trial and the split-face, double-blind controlled study. The studies enrolled 10, 13 and 23 patients respectively. RESULTS: The data show more than an 80% response to 420 nm acne phototherapy with a significant reduction of 59-67% of inflammatory acne lesions after only eight treatments of 8-15 minutes. The reduction in lesions was steady in the follow-ups at 2, 4 and 8 weeks after the end of therapy. Prolonged remission was evident in the 8 weeks after the end of therapy. No adverse effects or patient discomfort were noted in any of the patients. CONCLUSIONS: Acne phototherapy by high intensity, narrow band 405-420 nm light is proven to be an attractive, fast, effective, non-invasive alternative to current topical and parenteral anti-acne remedies. [ABSTRACT FROM AUTHOR]

Propionibacterium acnes is a Gram-positive, microaerophilic bacterium that causes skin wounds. It is known to naturally produce high amounts of intracellular porphyrins. The results of the present study confirm that the investigated strain of P. acnes is capable of producing endogenic porphyrins with no need for any trigger molecules. Extracts from growing cultures have demonstrated emission peaks around 612 nm when excited at 405 nm, which are characteristic for porphyrins. Endogenic porphyrins were determined and quantified after their extraction from the bacterial cells by fluorescence intensity and by elution retention time on high-performance liquid chromatography (HPLC). The porphyrins produced by P. acnes are mostly coproporphyrin, as shown by the HPLC elution patterns. Addition of δ-aminolevulinic acid (ALA) enhanced intracellular porphyrin synthesis and higher amounts of coproporphyrin have been found. Eradication of P. acnes by its endogenic porphyrins was examined after illumination with intense blue light at 407–420 nm. The viability of 24 h cultures grown anaerobically in liquid medium was reduced by less than two orders of magnitude when illuminated once with a light dose of 75 J cm−2. Better photodynamic effects were obtained when cultures were illuminated twice or three times consecutively with a light dose of 75 J cm−2 and an interval of 24 h between illuminations. The viability of the culture under these conditions decreased by four orders of magnitude after two illuminations and by five orders of magnitude after three illuminations. When ALA-triggered cultures were illuminated with intense blue light at a light dose of 75 J cm−2 the viability of the treated cultures decreased by seven orders of magnitude. This decrease in viability can occur even after a single exposure of illumination for the indicated light intensity. X-ray microanalysis and transmission electron microscopy revealed structural damages to membranes in the illuminated P. acnes. Illumination of the endogenous coproporphyrin with blue light (407–420 nm) apparently plays a major role in P. acnes photoinactivation. A treatment protocol with a series of several illuminations or illumination after application of ALA may be suitable for curing acne. Treatment by both pathways may overcome the resistance of P. acnes to antibiotic treatment. [Copyright &y& Elsevier]

Photodynamic therapy (PDT) is based on the phototoxicity of photosensitizers, mostly porphyrins. Since systemic photodynamic therapy with 8-aminolevulinic acid (δ-ALA) causes prolonged whole-skin photosensitivity, topical photodynamic therapy was developed. We describe the histological findings and the results of immunohistochemical staining for bcl-2 protein in the basal cell carcinoma of a 71-year-old patient treated by photodynamic therapy with δ-ALA. After histological confirmation of the diagnosis, 20% δ-ALA in an aqueous cream base was applied to one lesion for 3 h. After 3 h the tumor was exposed to light emitted by a Kodak carousel light projector. Biopsies were taken before exposure and at days 3 and 21 after exposure. The specimens were stained with hematoxylin-eosin and with monoclonal antibody to bcl-2 protein. The intermediate histological response 3 days after exposure was characterized by "squamoid" transformation of the tumor cells along with signs of necrosis, loss of bcl-2 expression and an inflammatory cell reaction. Clinical and histological examinations 3 weeks after treatment showed no sign of residual tumor. [ABSTRACT FROM AUTHOR]

Objective There is accumulating evidence that in spite of the large campaigns against excessive solar exposure undertaken by dermatologists worldwide, children and adolescents are still spending long periods in the sun, and do not follow the recommended sun protection guidelines. The purpose of the present study was to evaluate sun exposure in a group of young Israeli adults and to compare it to their knowledge and application of the various sun protection methods. Methods 202 Caucasian volunteers, (mean age 21.4 ± 2.6), filled out detailed questionnaires on their sun exposure and suit protection habits. Results More than 80% of our study participants are regularly sun exposed for longer than 2 h per day whereas sunscreens are utilized only by 64.9%. Sunscreen use was significantly more prevalent in females than mates (81.3% vs. 46.5%). The majority of sunscreen users and nonusers believed that sunscreen could prevent skin cancer (94.3% and 82.0%, respectively) and that these compounds can slow skin aging (90.8% and 76.4% respectively). The understanding of the meaning of the "SPF" was significantly higher in the sunscreen users (85%) than in the nonusers (62.0%). The majority of sunscreen users utilized less than 150 ml of the compound per year which is probably an inadequate amount for a year for full body protection. The two most common reasons for not using sunscreens regularly, were that the application is time consuming, and that sunscreens prevent tanning. Conclusion Our data reveals a discrepancy between a considerably good understanding of the need for sun protection and the still deficient application of these measures especially in young adult males. [ABSTRACT FROM AUTHOR]