Light is Light

After reading about Niels Finsen's 1886 research into the cure of lupus and smallpox through the use of light, I was intrigued to find out how this actually works. I have found an interesting article I would like to share with you regarding the use of red light to help heal chronic wounds and pressure ulcers. To find out more products that can help you with chronic hard to heal wounds please visit www.imagocare.com . For information on how to manage your wound please visit www.wita-imagocare.co.uk.

Light is Light Since Endre Mester and his colleagues first documented the therapeutic benefits of monochromatic light,1,2 a plethora of terminologies and acronyms have emerged and continue to evolve in describing light and laser therapy. Intended or not, each term, old or new, seems to advance the notion that therapeutic lasers and related monochromatic light—often with less than 150 mW cm2 irradiance—are innocuous and safe. Consequently, terms such as “cold laser,” “soft laser,” and “low power lasers,” which were used in the 1970s and 1980s to contrast therapeutic lasers from their high power counterparts, have since metamorphosed into low level laser therapy (LLLT),3–5 low energy laser therapy (LELT),6 low-intensity laser activated biostimulation (LILAB),low-power laser irradiation (LPLI), low power laser therapy (LPLT),8 etc. So much confusion has arisen from describing the same treatment in so many ways that some now resort to using the terms low-level laser therapy, low-energy, cold laser, low power and soft laser concurrently to ensure clarity. During the Cold War era of the 1960s and 1970s, lasers were considered destructive and, in military circles, powerful weapons appropriate for gaining technological advantage over potential enemies. The “Star War” mentality of that period only heightened the awe engendered by lasers. Therefore, the idea that the same tool could be therapeutic at low fluences seemed too far-fetched and remote from prevailing thinking that proponents of lasers as a form of therapy coined soothing terms, such as soft laser and cold laser to project a safe image, foster public acceptance, and distinguish therapeutic lasers from their high power counterparts. As terminologies have evolved, so therapeutic light technology has changed with time. Beginning from the mid-1990s bulky laser devices—mainly gas and dye lasers—were rendered obsolete as semiconductor- and diode-based lasers gained popularity. The evolution continues. Today’s therapeutic light source is as likely to be a superluminous diode (SLD), light emitting diode (LED) or polarized light (PL) as a semiconductor or diode laser, given the increasing number of papers reporting the beneficial effects of SLDs, LEDs and polarized light. This development renders the continued use of LLLT, LELP, LILAB, LPLI, and other terms and acronyms obsolete, and in some instances, inappropriate. A common term or terms recognizing lasers and emerging monochromatic or polarized light sources would seem appropriate to streamline things and minimize the on-going confusion. Therefore, it is recommended that the term “light therapy” or “phototherapy” be used to describe noninvasive interventions involving therapeutic light, as for example, situations involving cutaneous and subcutaneous tissue irradiation for tissue repair, light-based acupuncture, and transcutaneous irradiation for pain relief. The term photomedicine may be appropriate to describe these interventions. However, it broadly covers invasive light therapy such as direct irradiation of stomach ulcer, cardiac infarct, or fracture using a catheter. In addition, the wavelength of light used in each situation should be specified, given the implication of wavelength as an important determinant of treatment outcomes. When multiple wavelengths are used, as for example, treatments involving applicators with “multiarray,” “cluster probes,” and other multi-diode devices, details of the average power of each wavelength of light involved should be reported. Similarly, when multicolor or white polarized light is used, the wavelengths of light encompassed by such devices should be specified in the report. There are additional rationales for these recommendations. First, the terms light therapy, phototherapy and photomedicine are simple. Second, they seem appropriate for every form of light-based treatment—lasers, SLDs, LEDs, polarized light, etc. Third, they streamline therapeutic light lingo, stem the proliferation of acronyms, and minimize confusion. Fourth, there has been a 35year history of safe use of therapeutic lasers. The safety record seems excellent given the dearth of untoward effects in the literature. Therefore, it is no longer necessary to sooth public perception that therapeutic light may be unsafe. Indeed, such perception has diminished significantly; lasers have become an integral part of a wide range of consumer products. Fifth, limiting the terminology to “light therapy,” “phototherapy,” or “photomedicine” further emphasis the notion that light is light. The literature seems clear that the therapeutic effects ascribed to monochromatic light relate more to wavelength and doses than the source of light—lasers, LEDs, SLDs, polarized light, etc. In other words, the source does not have to be a laser in order to produce a therapeutic effect,but rather appropriate doses of light in the range of 600–1000 nm as contemporary reports continue to show.5 Sixth, there is nothing really fancy about being “low,” “soft” or “cold.” Indeed, given the volume of research supporting the clinical benefits of photomedicine, it seems demeaning to be considered “low” or “low level.” Chukuka S. Enwemeka, Ph.D., FACSM Co-Editor-in-Chief