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. 2008 Oct 20;24(4):180–189. doi: 10.1016/S1607-551X(08)70115-3

Low‐Energy Helium‐Neon Laser Therapy Induces Repigmentation and Improves the Abnormalities of Cutaneous Microcirculation in Segmental‐Type Vitiligo Lesions

Chieh‐Shan Wu 1,2, Stephen Chu‐Sung Hu 1, Cheng‐Che E Lan 1,2, Gwo‐Shing Chen 1,2, Wen‐Ho Chuo 3, Hsin‐Su Yu 1,2,✉
PMCID: PMC11917754  PMID: 18424354

Abstract

Segmental vitiligo (SV) is a special form of vitiligo occurring in a dermatomal distribution, and an abnormality involving the sympathetic nerves supplying the affected dermatome is known to underlie this disorder. Previously, we have shown that SV is associated with an abnormal increase in cutaneous blood flow and adrenoceptor responses in the affected areas. Since SV is resistant to conventional forms of therapy, its management represents a challenge for dermatologists. Low energy helium‐neon lasers (He‐Ne laser, wavelength 632.8nm) have been employed as a therapeutic instrument in many clinical situations, including vitiligo management and repair of nerve injury. The purpose of this study was to evaluate the effectiveness and safety of He‐Ne lasers in treating SV, and determine their effects on the repair of sympathetic nerve dysfunction. Forty patients with stable‐stage SV on the head and/or neck were enrolled in this study. He‐Ne laser irradiation was administered locally at 3.0J/cm2 with point stimulation once or twice weekly. Cutaneous microcirculatory assessments in six SV patients were performed using a laser Doppler flowmeter. The sympathetic adrenoceptor response of cutaneous microcirculation was determined by measuring cutaneous blood flow before, during and after iontophoresis with sympathomimetic drugs (phenylephrine, clonidine and propranolol). All measurements of microcirculation obtained at SV lesions were simultaneously compared with contralateral normal skin, both before and after He‐Ne laser treatment. After an average of 17 treatment sessions, initial repigmentation was noticed in the majority of patients. Marked repigmentation (> 50%) was observed in 60% of patients with successive treatments. Cutaneous blood flow was significantly higher at SV lesions compared with contralateral skin, but this was normalized after He‐Ne laser treatment. In addition, the abnormal decrease in cutaneous blood flow in response to clonidine was improved by He‐Ne laser therapy. Our study showed that He‐Ne laser therapy is an effective treatment for SV by normalizing dysfunctions of cutaneous blood flow and adrenoceptor responses in SV patients. Thus, the beneficial effects of He‐Ne laser therapy may be mediated in part by a reparative effect on sympathetic nerve dysfunction.

Keywords: cutaneous microcirculation, He‐Ne laser, segmental‐type vitiligo, sympathetic adrenoceptor response

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References

  • 1. Basford JR. Low‐energy laser therapy: controversies and new research findings. Laser Surg Med. 1989; 9: 1–5. [DOI] [PubMed] [Google Scholar]
  • 2. Yu W, Naim JO, Lanzafame RJ. The effect of laser irradiation on release of bFGF from 3t3 fibroblast. Photochem Photobiol. 1994; 59: 167–170. [DOI] [PubMed] [Google Scholar]
  • 3. Babapour R, Glassberg E, Lask GP. Low‐energy systems. Clin Dermatol. 1995; 13: 87–90. [DOI] [PubMed] [Google Scholar]
  • 4. Goldman JA, Casay H, Bass N, et al. Laser therapy of rheumatoid arthritis. Lasers Surg Med. 1980; 1: 93–101. [DOI] [PubMed] [Google Scholar]
  • 5. Lyons RF, Abergel RP, White RA, et al. Biostimulation of wound healing in vivo by a helium‐neon laser. Ann Plast Surg. 1987; 18: 47–50. [DOI] [PubMed] [Google Scholar]
  • 6. Kemmotsu O, Sato K, Furumido H, et al. Efficacy of low reactive‐level laser therapy for pain attenuation of post‐herpetic neuralgia. Laser Ther. 1991; 3: 71–75. [Google Scholar]
  • 7. Yaksich I, Tan LC, Previn V. Low energy laser for treatment of post‐herpetic neuralgia. Ann Acad Med Singapore. 1993; 22 (Suppl): 441–442. [PubMed] [Google Scholar]
  • 8. Khullar SM, Bordin P, Barkvoll P, et al. Preliminary study of low‐level laser for treatment of longstanding sensory alternation in the inferior alveolar nerve. J Oral Maxillofac Surg. 1996; 54: 2–7. [DOI] [PubMed] [Google Scholar]
  • 9. Mohammed IF, Al‐Mustawfi N, Kaka LN. Promotion of regenerative processes in injured peripheral nerve induced by low‐level laser therapy. Photomed Laser Surg. 2007; 25: 107–111. [DOI] [PubMed] [Google Scholar]
  • 10. Pötinen PJ. Indications for LLLT and results. In Pötinen PJ, ed. Low Level Laser Therapy as a Medical Treatment Modality. Tampere: Art Urpo Ltd. 1992, 116–141. [Google Scholar]
  • 11. Abergel RP, Lyon RF, Castel JC, et al. Biostimulation of wound healing by lasers: experimental approaches in animal models and in fibroblast cultures. J Dermatol Surg Oncol. 1987; 13: 127–133. [DOI] [PubMed] [Google Scholar]
  • 12. Haas AF, Isseroff RR, Wheeland RG, et al. Low‐energy helium‐neon laser irradiation increases the motility of cultured human keratinocytes. J Invest Dermatol. 1990; 94: 822–826. [DOI] [PubMed] [Google Scholar]
  • 13. Yu HS, Chang KL, Yu CL, et al. Low‐energy heliumneon laser irradiation stimulates interleukin 1 alpha and interkeukin‐8 release from cultured human keratinocytes. J Invest Dermatol. 1996; 107: 593–596. [DOI] [PubMed] [Google Scholar]
  • 14. Young S, Bolton P, Dyson M, et al. Macrophage responsiveness to light therapy. Lasers Surg Med. 1989; 9: 497–505. [DOI] [PubMed] [Google Scholar]
  • 15. Yu HS, Wu CS, Yu CL, et al. Helium‐neon laser irradiation stimulates migration and proliferation in melanocytes and induces repigmentation in segmental type vitiligo. J Invest Dermatol. 2003; 120: 56–64. [DOI] [PubMed] [Google Scholar]
  • 16. Lan CC, Wu CS, Chiou MH, et al. Low‐energy helium‐neon laser induces locomotion of the immature melanoblasts and promotes melanogenesis of the more differentiated melanoblasts: recapitulation of vitiligo repigmentation in vitro. J Invest Dermatol. 2006; 126: 2119–2126. [DOI] [PubMed] [Google Scholar]
  • 17. Koga M. Vitiligo: a new classification and therapy. Br J Dermatol. 1977; 97: 255–261. [DOI] [PubMed] [Google Scholar]
  • 18. Wu CS, Yu HS, Chang HR, et al. Cutaneous blood flow and adrenoceptor response increase in segmental‐type vitiligo lesions. J Dermatol Sci. 2000; 23: 53–62. [DOI] [PubMed] [Google Scholar]
  • 19. Fox RH, Edholm OG. Nervous control of the cutaneous circulation. Br Med Bull. 1963; 19: 110–114. [DOI] [PubMed] [Google Scholar]
  • 20. Westerhof W, Nieuweboer‐Krobotova L. Treatment of vitiligo with UVB radiation vs topical psoralen plus UVA. Arch Dermatol. 1997; 133: 1525–1528. [PubMed] [Google Scholar]
  • 21. Plott RT, Wagner FR. Modern treatment approaches to vitiligo. Cutis. 1990; 45: 311–316. [PubMed] [Google Scholar]
  • 22. Njoo MD, Bos JD, Westerhof W. Treatment of generalized vitiligo in children with narrow‐band (TL‐01) UVB radiation therapy. J Am Acad Dermatol. 2000; 42: 245–253. [DOI] [PubMed] [Google Scholar]
  • 23. El‐Mofty AM, El‐Mofty M. Vitiligo: a symptom complex. Int J Dermatol. 1980; 19: 237–244. [DOI] [PubMed] [Google Scholar]
  • 24. Koga M, Tango T. Clinical features and course of type A and type B vitiligo. Br J Dermatol. 1988; 118: 223–228. [DOI] [PubMed] [Google Scholar]
  • 25. Hann SK, Lee HJ. Segmental vitiligo: clinical findings in 208 patients. J Am Acad Dermatol. 1996; 35: 671–674. [DOI] [PubMed] [Google Scholar]
  • 26. Mulekar SV. Long term follow‐up study of segmental and focal vitiligo treated by autologous, noncultured melanocyte‐keratinocyte cell transplantation. Arch Dermatol. 2004; 140: 1211–1215. [DOI] [PubMed] [Google Scholar]
  • 27. Rochkind S, Rousso M, Nissan M, et al. Systemic effects of low‐power laser irradiation on the peripheral and central nervous system, cutaneous wounds and burns. Lasers Surg Med. 1989; 9: 174–182. [DOI] [PubMed] [Google Scholar]
  • 28. Ekenvall L, Lindblad LE. Is vibration white finger a primary sympathetic nerve injury?. Br J Ind Med. 1986; 43: 702–706. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 29. Scherschun L, Kim JJ, Lim HW. Narrow‐band ultraviolet B is a useful and well‐tolerated treatment for vitiligo. J Am Acad Dermatol. 2001; 44: 999–1003. [DOI] [PubMed] [Google Scholar]
  • 30. Kovacs SO. Vitiligo. J Am Acad Dermatol. 1998; 38: 647–666. [DOI] [PubMed] [Google Scholar]
  • 31. Fitzpatrick TB. Mechanisms of phototherapy of vitiligo. Arch Dermatol. 1997; 133: 1591–1592. [PubMed] [Google Scholar]
  • 32. Mandel AS, Haberman HF, Pawlowski D, et al. Non PUVA nonsurgical therapies for vitiligo. Clin Dermatol. 1997; 15: 907–919. [DOI] [PubMed] [Google Scholar]
  • 33. Lepe V, Moncada B, Castanedo‐Cazares JP, et al. A double‐blind randomized trial of 0.1% tacrolimus vs 0.05% clobetasol for treatment of childhood of vitiligo. Arch Dermatol. 2003; 139: 581–585. [DOI] [PubMed] [Google Scholar]
  • 34. Grimes PE. Psoralen photochemotherapy for vitiligo. Clin Dermatol. 1997; 15: 921–926. [DOI] [PubMed] [Google Scholar]
  • 35. Forschner T, Buchholtz S, Stocjflesh E. Current state of vitiligo therapy–evidence‐based analysis of the literature. JDDG. 2007; 5: 467–476. [DOI] [PubMed] [Google Scholar]
  • 36. Pötinen PJ. The physics of laser. In Pötinen PJ, ed. Low Level Laser Therapy as a Medical Treatment Modality. Tampere: Art Urpo Ltd. 1992, 17–44. [Google Scholar]
  • 37. Walsh LJ. The current status of low level laser therapy in dentistry. Part 1. Soft tissue applications. Aust Dent J. 1997; 42: 247–255. [DOI] [PubMed] [Google Scholar]
  • 38. Shevrygin BV, Rybalkin SV, Pekli FF, et al. Correction of microcirculatory disorders with low‐energy laser radiation in children with vasomotor rhinitis. Vestnik Otorinolaryingologii. 2000; 2: 31–33. [PubMed] [Google Scholar]
  • 39. Mel'man EP, Del'tsova EI. Effect of helium‐neon laser radiation on restoration of the structure of the microcirculatory bed and neurocytes of the small intestine following experimental ischemia. Arkh Anat Gistol Embriol. 1987; 92: 39–45. [PubMed] [Google Scholar]

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