Source: Gay Wardle Education
Trevor Neale, Gay Wardle
Gay Wardle 00:04
Welcome everyone to Skin Connections Podcast. I am your host Gay Wardle.
Gay Wardle 00:11
In Skin Connections, I interview some of the most amazing thought leaders, influencers and educators in our industry and talk to them about everything, skin and science. My first guest needs no introduction. If you’ve ever heard of the Aesthetic Bureau, I am sure you have heard of Trevor Neale.
Gay Wardle 00:32
Trevor is a well-recognized thought leader, educator and engineer within the local anaesthetic industry. Trevor has written and delivered the laser and IPL component of the Bachelor of Health Science Dermal Therapy degree at Victoria University, and has been a regular presenter at Aesthetic Plastic Surgery society conferences on laser, IPL and radiofrequency. With over 30 years experience as a technical support engineer, and over 20 years experience in clinical training for various manufacturers. Trevor’s practical understanding of devices allows him to drive the development of superior technologies to produce devices of the highest quality, where most suppliers are TGA device to sponsors that overseas companies, Trevor and his team at the aesthetic bureau are now the only TGA recognised Australian manufacturer of IPL and LED. Today to talk to us about LED – Trevor Neale. Welcome, Trevor.
Trevor Neale 01:45
Gay Wardle 01:46
So I’m very excited to be talking to you about this topic, because LED is one of my favorite tools to have in the clinic. You know, people often ask me, you know, if you’re going to be on a deserted island with nothing else, what would you want to have with you? And I always say my LED, I couldn’t live without it. I just believe in it. I’ve seen so many amazing results. So to talk to you, the expert about LED, today is simply amazing. So can I ask you what is LED?
Trevor Neale 02:19
Well, firstly, I thank you for that. Great introduction. LED, as everyone knows, is an acronym. You know, it is light emitting diode. But I think you know, it really is not that it’s LED, it’s about what it does and what it delivers. And there’s many different ways we can look at this.
Trevor Neale 02:40
But the whole significance of it, is it’s delivering an energy, and energy in the form of light. Now, we all use different technologies already about this. So in actual fact, the discussion is, you know, what is light? And, you know, there’s a whole big background going on, but, you know, where are you using light in so many different things these days, such as our lasers, our IPLs, and within the LED to get different things happening. So for most people, when they think about light they’ll actually sort of go well, okay, light is something that allows us to see things. And yeah, that’s true. I mean, through evolution we’ve generated, you know, senses in our body that allows us to interpret this particular form of energy and be able to see things
Trevor Neale 03:28
But more fundamentally, light is energy. And because of eyes, it’s energy that we can see. And I’ll really want to cover this point of energy, because at the end of the day, that’s what the whole therapeutic process, whether it’s therapeutic, whether it’s thermal, electrical, chemical, all those processes that we know are photothermal, photochemical, photoacoustic, all those sorts of things. It is all about this light energy. So really to drive the point home about how significant it is, well, light is basically all energy – 100% – of the energy that we need to live. And I can drive that.
Trevor Neale 04:03
We go further into it. That light energy comes from the sun, so it comes, it gets absorbed into plants. We get a situation with plants. What do they do, they convert all the CO2 in the world to oxygen, that’s part of the process. Let’s save the forest if we can, but they’re converting all that lower form of energy of CO2 to a higher form that we know our cells need to live in terms of breathing. So oxygen is a substance actually has been delivered to us through energy from light.
Trevor Neale 04:37
You know, if I add that to hydrogen or two parts hydrogen, I get what’s called H2O. And I think most of us know that is water. Now, I’m going to say think about what’s going on inside your body and yourselves. I mean, how important to us is water and oxygen to our whole cellular process. Even just living we have to have all those substances and they all derived from light as our initial source. So those great big swimming pools out there called the Pacific and Indian Oceans are just massive pools of energy which are made up of hydrogen and oxygen.
Trevor Neale 05:11
The reason why we didn’t have LED around back in the early 90s is because at the time, there wasn’t an LED light emitting diode that had a great enough efficiency, to give us the intensity that we need without creating a lot of excess heat in the air. Now, that particular delivery mechanism got so damn hot, that it was very impractical to use in a in a sort of more bigger therapeutic application.
Trevor Neale 05:40
Low level laser back in the day when they were doing this many years ago was because a laser device was the only way we can get the intensities of energy to deliver the dosages into the tissue to give us those therapeutic effects that we’re looking for. And when you think about the old incandescent globes, I mean those things, they’re only about 3% efficient. What that basically means is that 3% of the energy coming in came out as light, and the other 97% generated heat. And I know from my childhood, you touched a light globe that had been on for a while it got damn hot.
Trevor Neale 06:14
So you know, we know now that even a 60 watt incandescent globe gives out probably a similar amount of light to a 7 watt LED. Now why is that? It’s because the LED in a standard light globe is going to be about 30% efficient, so we’re getting less heat generation. And as we move further and get more efficient, we can put more and more intensities out with less heat.
Trevor Neale 06:38
So for us in terms of development, we’re moving on from the SMD to the COB on our – we manufacture obviously – the Xen LED. And we’re using that COB to allow us to pack in around about 10,500 LEDs onto our array. And that’s how we’re able to do that, because of those massive efficiencies that we’re getting better and better and better at.
Trevor Neale 06:59
So LED is a light source. It wasn’t around earlier because we didn’t have the technology available to deliver it without creating a lot of heat. And it was something that we knew about. You know, it was there. People were using it with low level – your hairdressers, that had their little ultraviolet booths that they were using the destroy bacteria, all those sorts of things. So you know, that’s probably a bit bigger explanation in terms of what LED is. But you’ve got to think of it as a light source generator. And it’s all about light. And that’s what we’re sort of talking about.
Gay Wardle 07:38
That’s amazing. Like, when we think of energy, we think of turning on a switch or turning something on. It’s incredible that it’s all around us, you know, to imagine that energy is around us. Everywhere we go, we’ve got this amazing energy that’s surrounding us. Trevor you mentioned the word diode, can you just really quickly explain what a diode is, please?
Trevor Neale 08:01
Well, a diode basically, we can call it a p-n junction, it’s just an electrical component. As an electrical component it allows us to convert electrical energy into a frequency. And that frequency that we have coming out, obviously is in a frequency that our eyes are able to detect. I’ll talk about that probably a little later if we get there. But you know, we are able to detect that. And, you know, depending on how that electrical component is made, the gaps, the doping of the the p-n junctions, determines what particular wavelengths that we do get out of these items. So, what particular colour we’re getting out of a diode. So it’s just an electrical component that allows us to convert electrical energy to light.
Gay Wardle 08:48
So now you mentioned the word wavelength. So what is a wavelength? What does that mean?
Trevor Neale 08:54
Energy is very similar to sound. And I usually relate the fact that I remember my teacher during music, they had a tuning fork, they bang that down on the table. And of course, we’ve got these vibrations of the tuning fork. And as they’re moving backwards and forwards, and traveling through space, we have these oscillations going on. Those vibrations would basically then come in and, depending on the intensity (intensity is obviously the volume of it); depending on how frequent those vibrations were it would then determine what the pitch was. So if I had a high frequency, I can go quite like a high frequency – I’d have a high pitch. If I had a low frequency then it would be a low pitch.
Trevor Neale 09:38
Now what we’re doing there is if I can sort of, and I usually use the analogy of just moving my hand up and down and I’ve got these vibrations going on in my hand and that’s sort of setting up an oscillation. And then I start moving my hand in a direction. Then, what I find when I do that, is my hand makes these little waves. Now, we have all these frequency changes in amongst all that. Same thing as in sound. Obviously, as the oscillations are going up and down and traveling at the speed of sound, I can actually now measure the distance between two peaks of oscillations or two troughs of oscillations.
Trevor Neale 10:14
And because the frequencies are so high now we actually refer them to as a distance, and it’s a wavelength in the term of nanometers. Now, nanometer is, it’s a very small portion in a very short distance, but we tend to measure our wavelengths in terms of our nanometers for ease of interpretation. But really, for most people out there, the interpretation is, just think of the colour. That’s how our brain will pick that up.
Gay Wardle 10:39
You know, when I started working with LEDs, you know, and this is quite a long time ago, we didn’t worry about the intensity of the LED. We just had a machine we programmed into the wavelength that we want to use, and we let it go. And now with the LEDs that are on the market, there are different intensities. So can you explain how important that is? And how that’s sort of developed?
Trevor Neale 11:04
Yeah, absolutely. So with the intensity, look. And I’ll put it down. I hate to get into the physics. Who would’ve thought here in the aesthetics industry, when we were all at school, that we got into aesthetics, and now we’re doing physics. It’s a subject that I don’t think a lot of therapists may have chosen when they were at school, thinking, “This is going to be really important to what we do moving forward.” But, you know, intensity.
Trevor Neale 11:31
When you look at light, you’ve got to think of dosage. Now light energy, its energy. Like anything, it’s energy, it’s a substance. You know, we talk about medications, you know, it can be like a chemical peel. You have a low dose and a high dose in medications. And I use quite often an example of, you know. You’ve got a headache, do you take a low dose panadol, or high dose panadol? A low dose panadol may have a bit of an effect, that’s okay. But a lot of us tend to opt towards something a bit stronger. It depends on the severity of the headache, and those sort of things. But, when we think about it, we’ve got to think about dosage.
Trevor Neale 12:07
Dosage is how much energy we need to put into the cells to have this whole therapeutic structure going on. And there’s many studies going on about that. Now, realistically, when we look at the studies, we talk about red, for example, as a color that is 633 nanometers. We talk about how we need 60 joules per cm2 as the optimal dosage of energy delivery to get the optimal outcome. Now, if you deliver 10 joules per cm2. You will have typically some outcome, but not anywhere near what you’ll see at 60 joules. So, to deliver that dosage, it’s actually a situation where it’s like…
Trevor Neale 12:49
Dosage is like a bucket full of water. You know, you’ve got a five liter bucket. The faster I deliver that energy or the water into the bucket, the faster it fills. So it’s going to be intensity times duration – so how bright it is times the duration. So how many joules per second you’re delivering. And joules per second actually is a term for watts. How many wattage (joules per second) that you deliver, and how long you’re delivering it for will give you your total dosage. So the larger the hose, or the faster the hose, the faster the bucket fills.
Trevor Neale 13:24
We have a situation that, you know, for most of us, we know that sort of sweet spot time for treatment for a lot of people is around about 20 minutes. Beyond that, they start getting a little bit toey. And I understand people are time poor. And obviously, the higher the intensity you can go, then the faster you can get those treatments done. So that’s where intensity comes into play.
Trevor Neale 13:47
Now I’ll give you a bit of an example, we manufacture two units. We manufacture the Pearl Xen face mask, and I will say our face mask is an SMD style, so it’s nowhere near as intense as our Xen. And also, we don’t have cooling on it. So you don’t have fans in the background running and taking the heat out of the LEDs. There is a limitation to how much intensity you can put out of a face mask because of that. And it comes fairly close to the face, so that there’s a lot more heat, and we do have to minimise the amount of heat. We’ve got to keep our treatment area below 45 degrees Celsius. So we’ve got to minimise that amount of heat.
Trevor Neale 14:25
So technologically speaking there’s a maximum limit we can have out of a face mask. Now even with our face masks, we’ve actually added a few little things like ceramic heat sinks at the back of our LEDs. It does add around about 70 grams to the weight of it, which means that we now put it onto a a stand so that it doesn’t go off the client’s face sort of thing. So it gives more of a clinical sort of feel to it. But even then we were able to turn the intensity up because we do have more heat sinks. But that unit is still 1/15th the intensity of our Xen LED with our newest COB (chip-on-board) LEDs.
Trevor Neale 15:03
And what that basically means, is if I’m delivering a 10 minute treatment with the Xen, and delivering my full dosage of 60 joules… To do exactly the same with a face mask, or any of the flexibles, all those other panels… You’re gonna have to multiply it by a factor of 15. So 10 by 15, is 150 minutes, is that correct? And I think what’s that, that’s 2.5 hours, you know? And no one’s going to sit underneath them for 2.5 hours to get the same outcome. A lot of people talk about, you know, “I’ve got the maximum intensity panels, and these ones are the most powerful.” I’ve got to relate back to my own light globe analogy earlier on with the 60 watt lights that we used to have.
Trevor Neale 15:48
Unfortunately, in the industry, most people relate to the intensity of their LEDs and all that sort of things in terms of that input power. Remember that the light globe, only 3% of that 60 watt came out as optical energy. So you know, I have all these systems out there that we sort of come up against the sort of going, “oh, we’ve got this massive power coming out.” But when they relate their settings and their parameters to you, they talk to you about their actual input power and not what they’re getting out optically.
Trevor Neale 16:17
What I find interesting about that, Gay, is that when we start talking about our treatment intervals, when we use 60 joules per cm2… because what we do is we can get to a point where we can overdose. Even with reds and near infrareds. It’s called biphasic dose response. And we want to dose them up to around that 60 joules. If I come back too soon, I may overdose. If I overdose, I retard the effect. So I need to have that interval. And I’d sort of say to people, look, if you do have, for example, even our Pearl Xen or one of those smaller ones, where you’re not getting as much dosage. Sure, you could use that on a daily basis without any risk of biphasic dose response. Unless you’re sitting under it for 2.5 hours per session, then go ahead.
Trevor Neale 17:03
One of the other things I want to talk about was just how the wavelength affects the skin. Fundamentally, they work within the mitochondria. There’s two actual theories that come in, but the most common one we talk about is photodissociation. It’s all about increasing ATP within the cell out of that the cytochrome c oxidase in in the mitochondria. Now, that is really the prime thing, the photodissociation of mitochondria and nitric oxide. The secondary outcome is an increase of adenosine triphosphate or cellular energy. And then there’s a reduction and regulation of reactive oxygen species, which is free radicals or oxidative stress. So, you know, we’re having all these particular processes.
Trevor Neale 17:47
So what does that mean? Well, that basically means that cell has more power now to do what it needs to do. It has the power to heal faster. It has the power to divide quicker or draw in nutrients, dispose of waste. All of these processes that a cell needs to do to function, to heal. So in some regards, when I talk to a client about, you know, what’s the expected outcome of this?
Trevor Neale 18:23
Well, look, we’re putting light energy into the cell. What it’s doing is increasing that cellular energy so that cell can perform as good as, if not better than, it did when you were way younger. You’re bringing it back to that youthful type of cell that can heal quickly, it can deal with any issues and ailments and, and respond to those particular issues quicker, even stem cells. But you know, we even get into the pathway there that it does migrate, so it affects lymphatics, so we get reduction of edema as a result of improved lymphatics.
Trevor Neale 18:40
So that’s our red and near infrared. And as I indicated, within our process, we tend to use red for our skin types 1, 2 and 3. And then we change frequency. So we now go to blue. I love blue. It’s interesting how one particular frequency range or wavelength range now reacts with bacteria. And it reacts with bacteria to create singlet oxygen – we’re talking p. bacteria, or p.acnes – to create singlet oxygen, which destroys that bacteria. So blue as a wavelength is antibacterial. So and yes, the blockages of melanin and, and oxyhemoglobin, obviously, you’re going to mean and it’s more superficial. So you’re just getting onto those sort of things there, what you need to look at, and it plays a big part on how we use these systems within clinics.
Gay Wardle 19:25
Beautiful. Trevor, can I just ask just a couple of things? Just going back to like your face masks and their handheld devices and things like that. People are actually saying, because they’re really close to the skin, almost touching the skin, that the energy is just as powerful as the bigger devices. You said that’s not true. And I do believe that, but can we just kind of clarify that again, please?
Trevor Neale 19:52
Look, we have an array our Xen LED, we’ve got in actual fact 3,500 LEDs running for our red for example. And even if you get beam divergence from those they actually cross over. And any gap that’s created is filled in by beam divergence from others. So it’s a fairly even distribution of energy, except when you get right out to the peripherals. So the intensity is going to be maintained right through it.
Trevor Neale 20:22
Even on our face masks, where we’ve got 800 LEDs on that, but we’ve only got about 400 red LEDs. So there’s a lot of red LEDs in there. And we’ve got to run them at a lower intensity, because we don’t have the ability to draw the heat out of them like we do with the heat sinks and fans on the bigger units. The answer is, we’re not running them as intense, we don’t have the same densities of LEDs.
Trevor Neale 20:52
So it doesn’t matter whether you’ve got them closer or further away in that particular regard, the intensity is just not there. And, you know, quite frankly, we can easily stick power meters and, you know, put them right up against the mask and pull them out of the therapeutic level, whether it’s 5 or 20 centimeters from our arrays and, and just show that on meters. So it’s just not the case, you know, the problem being is that they just don’t have the intensity as if they did they would start getting too hot.
Gay Wardle 21:21
That’s amazing. And yeah, I do believe that myself as well. So just one other question. With the blue light, what’s your take on that too much of that can can create post inflammatory pigmentation?
Trevor Neale 21:35
Absolutely. It’s a very well-known sort of side complication associated with LED. And I’m surprised most people aren’t aware of it. And I dare say, it’s because if you’re running some of the upper level LEDs, you’ve probably would have seen this.
Trevor Neale 21:53
I mean, two things occur with blue, not only do we get potentially a little bit of heat, because we know blue absorbs into melanin quite well regardless of whether it’s skin type 2 or 3. We’re also causing trauma to sebaceous gland. We’re not at that UV part of the spectrum, we’re very safe. We run at the 415 nanometers, plus or minus 2nm to either side of that. So we’re pretty precise with that. We’re not in that UV, so we’re not worried about melanoma, but the problem is that you’re still getting some melanin stimulation.
Trevor Neale 22:33
So on your darker skin type, I know on our protocols, we’ve actually reduced the intensity when running on a darker skin type. And we actually reduced the dosage as well. So there’s that. The second thing is, as I said, we get trauma in the sebaceous glands. So what you’ve got to look at when running blue, is that in a lot of regards, the skin gets dry, and they might get some fine lines and wrinkles. So while they’re getting rid of acne, most people aren’t necessarily as concerned about trends in hyperpigmentation, or PIH. But, you know, ideally, you want to try and minimise that.
Trevor Neale 23:07
Now. It’s interesting when we talk about my whole feeling regarding utilising LED for treating pigment, you know. We can have lots of discussions about this. But if we’re adding ATP into a cell, and that’s the whole premise of a lot of these particular wavelengths… The issue is, is melanin a cell in trauma that needs more ATP? And if I do put more ATP in there, does that mean the melanin is going to get lighter? And I would probably say, no, it’s not going to change it at all.
Trevor Neale 23:35
However, if I’m doing a treatment with blue, for example, and I wanted to reduce that risk of PIH associated with it, then I would like to use a wavelength that could help calm the melanocytes and even calm that whole area around the melanin so that we don’t have that risk of PIH. So if I’m looking at treating melanin with with LED, quite frankly, the best wavelength which would not absorb into, specifically, the melanin layer, would be the NIR – it’s not going to create any heat.
Trevor Neale 24:04
So we sort of recommend if you do have this risk of PIH, you combine your blue with NIR. And the reason why NIR instead of red is because the red can still absorb into the melanin, whereas NIR tends to pass through it a little bit and just gives the cells that energy as opposed to creating heat or trauma within those particular components. So yeah. Very well known, very common. And as I said, just use a moisturiser ideally as well.
Gay Wardle 24:33
Beautiful. So Trevor, we have to be so careful today with all the options that we have for treatments of adverse reactions. You know, the treatments that we perform, there’s a very real reality that there are more adverse reactions around now more than there ever have been. So we think of LED as being a very safe device. And in many ways, it’s used as a rescue remedy for some of the treatments that may have been performed where there have been adverse reactions. What sort of reactions or contraindications do you see with LED?
Trevor Neale 25:07
Well look, I agree with you. One of the great things about LED is it’s- and I’m sorry, I can’t bring myself to say it- it’s safe. I mean, even TGA is not a big fan of people using the word “safe”, I will say, but you know. It’s a very low risk type of technology. What we find is the complications, quite frankly, are more along things as you indicated- PIH post inflammatory hyperpigmentation, which is more common with blue.
Trevor Neale 25:38
I will say, with red we do sort of see a little bit of a spike of ROS before it subsides, which can be handy if we’re doing stuff where we’re going dermally with a treatment where we need a little bit more perfusion or blood flow such as needling. So there could be a little bit of redness before it quickly subsides. There’s a few other things that, you know, I’ve seen come up recently, such as blurry vision.
Trevor Neale 26:01
And, you know, we experienced blurry vision quite a while ago, and it was actually one of our people on the ground who was having it and she sort of went through and googled it all and did research. And we found that, you know, we weren’t the first. It has been happening with many other LED systems and it tends to pop up from time to time where people have blurry vision. And it was mainly on the blue. Now we have had people report, we sort of tend to get one every round about 12 months where someone’d report, they had a client with blurry vision, which held up for now. So we’ve looked into that, you know. We haven’t been able to explain exactly why it happens.
Trevor Neale 26:41
We do feel it tends to be more with darker skin types. But we’ve actually modified our settings on our system to absolutely minimise that. And we’ve also changed our eye shields to ensure we maximise the eye protection so that, you know, we don’t see that. So that’s one thing that can catch people out, that suddenly someone’s got blurry vision. And of course, that’s a bit disconcerting for them, and the operators. But now it’s been out there for years and is transient. So they’re the two bigger ones. But I mean, there’s other things that I can bring in- dehydration, claustrophobia, all those sorts of things can be considered.
Trevor Neale 27:21
Now when we look at contraindications, what I find is we’re sort of fairly lucky with LED that most people who have issues such as porphyria or solid motor carrier, or they have a sensitivity to light as a result of lupus… or any of those sorts of things. They know straight up that they shouldn’t be in an area where they’ve got intense light sources. So while your question is you’re looking for anyone with porphyria, which is an overproduction of porphyrins, which is exacerbated by intense light exposure to make it worse, so they can get neuralgia and stuff.
Trevor Neale 27:58
You know, I don’t necessarily want to treat them. Well, I know that so we don’t typically see them. But it’s good to know, what I find is one of the more interesting ones that I’ve found recently, and it came up through, you know, long story right now got to a bit, you know, it’s called photophobia. And I hadn’t heard of this through any of the even the big name groups before as a contraindication. But when you look at photophobia-
Trevor Neale 28:20
You can’t diagnose it as photophobia or something like that. But there may be something there and you need to pay attention to that. So the only way that you can look at treating them either a reduce the intensity, the again, move on to NIR if you’re using red, or if they’re still feeling with NIR then discontinue treatment. So, you know, the risks are quite low.
Trevor Neale 28:20
Photophobia is actually not a fear of light, it just means that some people have a massive sensitivity to it, and it manifests itself as actually pain. I feel it in their eyes in terms of, of pain. So I sort of indicated even when we do our training, I sort of go, look. If anyone’s even with the big eye shields that we’ve got on and even with the light shields on, they are uncomfortable, then don’t just sort of sit there and go “big cry baby”. You know, you’ve got to be aware
Trevor Neale 29:02
The improvement of ATP and the outcomes where you know, we we sort of look at all of those sorts of things, are quite high. And as we can see how the markets are you know, taking these on and everyone, you know, we get in there is raving about their results. You know, the the it’s such a big pick up for this technology and it it really does give you a passion when you get into it and you get into it at the upper end.
Gay Wardle 29:28
I can hear that from you. Like that’s, that’s really important listening to what those contraindications one is the blurry vision because I think so many times we are very complacent with LED. And we tend not to use eyewear on people that are underlying D and I think the importance of that and bringing that home that there is a condition that can be caused that’s very high. And I think you know, it’s really important that we really do protect our eyes when we’re using devices or devices including led I just ask you, you’re like, I’ve seen amazing results with the LCDs treatments. And I’ve given over the years. And like I said, I couldn’t leave home without it really. So what results have you seen with LED?
Trevor Neale 30:13
Well, look, I mean, the results that we tend to have coming in, you know, we’re really looking at, when I talk to a client, you know, at the end of the day, because we’re now getting those cells more rejuvenated, and we’re, even if it’s collagen, we’re strengthening collagen. So we normally related to a client is a more youthful appearance. I mean, if if, when you go on it, you’ll see what I mean.
Trevor Neale 30:35
But it’s a more youthful appearance, you know, and more luminosity to the skin. So as just as a rejuvenation treatment, that’s the sort of outcomes that we’ll see. And I mean, you know, it also strengthens the skin so that, you know, even if you’re about to take a holiday overseas, and you’re going to be in the sunlight, if you do get, you know, strengthen those cells in print, and I know you’re going to use topicals for your vitamins and enzymes on the on the dermal epidermal layers, but do a bit of LED work as well.
Trevor Neale 31:04
Get them all prepped, so that you can tolerate that sun way more effectively. So that’s so there’s that skin tolerance, but we start moving into areas such as acne, you know, we’ve got a great reduction in acne because of that, that, you know, bacteria reduction. And typically, I do highlight, however, that acne may be a multi-pronged approach. But in some regards, we do see a significant reduction. And it’s that redness reduction that we have coming on, whether it’s you know rosacea, or that that redness from that, that actinic skin or whatever it may be that we sort of see that coming in.
Trevor Neale 31:38
But on top of all that is the faster recovery. So you know, not only are you getting a situation, when you do augment it with something, the skins prep, the deeper tissue was prepped, so it’s going to actually recover better. And you get a better laydown of collagen and all this sort of things, if we’re going through things like fractional or whatever. But it heals faster, the redness goes quicker, you know, there’s just that luminosity and they look better.
Trevor Neale 32:04
By the way, the red is one of them, we get an endorphin release. So they feel better from it too, and by the way, if you’ve got one of these in the clinic, and you are feeling a little stressed, dive in there and that’ll calm you down. You know, I warm all this staff have anything if the boss suddenly disappears for an LED treatment, you’ve probably pissed them off, and they’re trying to recover.
Gay Wardle 32:22
I’ll be underneath it all day long. Just a really quick question here. So much controversy around this. LED before or after needling treatments. Before or after, you know, any kind of laser treatments. Your quick thoughts on that please.
Trevor Neale 32:41
Needling in that regard, it causes two things and I didn’t have time necessarily to go through it. But as I said.
Trevor Neale 32:47
Two things happen. We get an increase in ATP. But with red for example, we also have an increase of ROS. So in other words, we have a bit more oxidative stress and mitochondrial nitric oxide, so we have a little bit of a short term inflammatory response. So we get a much greater blood flow in the area short term.
Trevor Neale 33:04
So ideally, we would like that through so that we can when we do end needling, if we can get that pre-, what happens here is we can get to our endpoints quicker, and we can have a better outcome. Now again, I don’t care whether you do it pre- or post- in a lot of regards, because that ATP production is going to stay around.
Trevor Neale 33:23
But if I can do it pre-, get that increase of of our waste and get their blood flow through it does that and you pre-prime the skin a little bit as well for that healing process. So that’s for needling. And of course, obviously the big concern there is if I do needling and then shove them under an intense radar afterwards, suddenly, I’m getting this spike of heroism, this this this increase of profusion, even momentarily, which you’re trying to actually now hope will calm down a little bit.
Trevor Neale 33:49
And if they’re a darker skin type, and you’ve got a lot of redness in there, what may happen is that it may also I know, it’s rare to get reflections and things like that, but we do find it picks up a little more, and you may get a little bit more heat generation so it doesn’t- it’s not great in terms of minimizing PIH, so quite frankly, we prefer to do any you know, historically we used to say any dermal treatment and I don’t care whether it’s needling or any other deeper fractional or whatever it may be.
Trevor Neale 34:20
We prefer you to do a pre-. And then we use to say anything epidermally, so it’s surface. So you’re not worried about that increase of ROS. You could do it pre- or post-, so do it post-, but I think for ease of use out there these days we typically go you know what? We actually prefer a pre-. Now there are a couple of other reasons and the other reasons are: never do LED over or after a peel. Now I know you’re gonna say to me, “Oh we cleaned the substance off the skin.” But it’s still absorbs into the cell, you don’t get all of it.
Trevor Neale 34:50
So I know there’s going to be there’s there has been incidences where the LED has reactivated the peel and they’ve had an overreaction from that. I know there’s been incidences where, you know, even with needling, we’ve got situations where we have, you know, these little spots of PIH as opposed to reduction. All of these sort of things occur. So our protocol is pre-.
Trevor Neale 35:13
Now, we can argue over the point of having that inflammatory response. But I can then turn around and go, look how bad if I put more energy into the cells by having greater ATP, does the cell have the capacity to produce all those enzymes that it would be normally getting out of the blood, or does it now have the capacity to do itself.
Trevor Neale 35:29
So why not take away those free radicals and that oxidative stress, and then let the cells heal by needling? So give all the goodness to it without having to have all that stress that would need to go on to feed the healing process when you can actually get the cells to do that function themselves. So we recommend pre- across the board.
Trevor Neale 35:48
And I do know some people say, “Well, do I put a topical anesthetic on prior do we do it over the topical?” The answer’s no. “Do I do it before the topical?” No. If you’re gonna do a post, guys, that’s where NIR comes into play. That’s where I feel that you know, if you run into NIR, you’ll find that the ROS drops off quite quickly. And you can do NIR post-. But for us across the board, our standard protocol is LED prior. And again, unless you’re doing something where you’ve got a topical or something like that, and if you do have to run it post-, it needs to be in IR.
Gay Wardle 36:28
Amazing. So if someone’s doing the shopping around for an LED device, what are some tips that you could give to them? What should they look for? What should they avoid? What the questions they should ask?
Trevor Neale 36:41
Well, look, I mean, if they’re looking at a system, the first thing is the wavelength, you know, and I hate to throw it out there. But that little example of the phone where we put the light torch on and you put your thumb over it, I mean, I throw those little bits and pieces up about greens, and yellows, and all those other fancy colours. Now look, I can get you to go on. And if you look at light therapy, if you even Google light therapy, you will find that there are seven different wavelengths associated with light therapy. Now, it’s not about what it does to tissue, it’s actually how you feel mentally. And you know, yes, the blues and the greens or sorry, the greens, and yellows, and all these sort of things and purples give you a certain mental perception. And I relate it to things like if you look at a blue sky versus a grey sky, how do you feel if you go green field versus a brown field? How does that make you feel?
Trevor Neale 37:27
So colour is important mentally but in terms of therapeutic in the cell – the fact that we’re not getting… and the whole function of LED, I mean, I can use topical substance on the surface of the skin, you know, you’ve got your vitamins and your enzymes and all those sort of things that absorb into the epidermis.
Trevor Neale 37:43
But the whole function of LED is that deeper work, and I’ve got that blood barrier there. So I need to look at wavelengths that are really going to give me that penetration to get those deeper cells. And to be quite frank, we focus, like one of the bigger name brands out there, we focus on red, and NIR, red for typically your lighter skin types because we get great ATP production, but NIR because we’re going to deal with darker skin types, or you’re dealing someone’s a lot of redness on the skin. So we use NIR. Or we want to minimise PIH, you know, then we have blue in there for for bacteria. A lot of those other wavelengths aren’t overly appropriate.
Trevor Neale 38:21
Now, on conjecture that yes, on our face masks, we do have a green, you know, I will sort of say, Yeah, okay, our green, my conjecture on this is that the high frequency may be able to generate a little bit more ATP in in the very epidermal layers. So I mean, you know, you could do that topically, but it does give you a little bit more for epidermal work. But that’s not really what a medical LED is there for, it’s more for deeper stuff. So wavelength is important.
Trevor Neale 38:49
Secondly, you know, intensity is a big one. Now, if I’m going to chuck this out to you quickly if I’ve got the time. I categorize the LEDs into two categories: the greater than $15,000 LEDs and the less than $10,000 LEDs. And our face mask, our Pearl Xen, is less than $10,000. Now understand, they’ll get an outcome from it. But you know, it’s an entry level device, you’re not going to get the same passion level that you will with the other ones. I understand that may be the only way that you can go, but that’s where they’ll fit.
Trevor Neale 39:23
I’ve had people say to me, it doesn’t matter, you can get a cheap one and expensive one and they all do the same. Well, they are reacting with the cells the same, but the dosages are very different. You get to the bigger units- to be able to deliver those intensities, the arrays and all the LED panels that we use are very expensive. So yeah, that’s why you see them up at those levels.
Trevor Neale 39:42
So you need the intensities you need the wavelength, you know, also the understanding of the providers. You need the education to come in. Understanding of what this is doing, how did it how to use it, when to use it. These discussions about pre-, post-. We have other discussions regarding I think one came out recently about narcolepsy. And, you know, we know that we haven’t sort of had any negative situation with that. And so we know, it’s not an issue. But even blurry eyes. I’ve seen that on Facebook. And I know, most out there are sort of going, I’ve got no idea. So, you know, I think you really need to sort of see, you know, people understanding what these particular systems are. So, I think that’s important as well. You know, we can move on to things such as TGA, as well, I mean, TGA is important, because especially if you’re getting up to that level to have that, that we are talking about some sort of cellular process going on. So it does need to be covered by TGA.
Gay Wardle 40:42
Absolutely. So yeah, that’s an interesting reaction is the same, but the dosage is different. And I think that’s something that we really do need to consider when we’re looking for these devices. Because you know, there is a huge price difference out there. But we really do need to understand what dose we’re actually looking for when we want to use these devices on on skins. Now, you just mentioned TGA. So first, I want to congratulate you on being recognised as the TGA, as by TGA, is the Australian manufacturer. So can you tell us what is the difference between being recognised by TGA as an Australian manufacturer, or being just a device sponsor?
Trevor Neale 41:28
Well, look, I mean, as a device sponsor, you’re just looking after and marketing a device for an overseas manufacturer. So, being a manufacturer in Australia, what it really means is that as a company, we have to comply to certain standards. And the first one that we’ve got to apply to is the ISO 13485. Now you sort of go, yeah, big numbers. International standards organisation. What that really means is that as a company, we have to have a lot of specific structures in place. We’ve got a whole reporting process. And by the way, actually, it’s happening this month. But, we get audited and inspected annually to ensure that we’re fully compliant.
Trevor Neale 42:10
So they’re going through all our manufacturing processes are going through all our documentation to ensure that we’re doing the right thing. So, you know, the trouble is, – well, I won’t say the trouble. As a sponsor, for an overseas manufacturer, well, yes, the overseas manufacturer gets audited. But you as a local supplier of a device, all you’re really doing- you can do what you like. I mean, you can say what you like, we actually get totally reviewed on our statements. Everything that we do comes under the spotlight to ensure that we are fully compliant.
Trevor Neale 42:42
I mean, if we had distributors overseas, as a sponsor, they wouldn’t, you know, need to comply. Not to say that people do go outside the boundaries. But you know, that sort of thing happens. But we are 100% compliant, we get audited every year, if we don’t- you know- if we’re non-compliant, we can get struck off. And on that, we also have to carry the CE, which is the electrical compliance and medical electrical compliance for our devices. So we carry that in Australia, as well, but we get that all done.
Trevor Neale 43:14
So again, we have to show all documentation for that we have to ensure that our equipment meets all the standards. And it’s not done by a third party group, anything that we do in terms of modification, we have to ensure that it’s still there. In some cases I’ll relate it to- it’s much like an education group. And I hate to put this to you, but it’s like comparing an RTO to just someone who does training. Not to undervalue that, I mean, it’s experience there. But you know, an RTO is held accountable. And as an Australian manufacturer, we’re now 100% accountable for the devices. And we’re audited and inspected annually to comply with those. So yeah, it’s a it’s a bit of work. But, you know, we really want to get to that point to ensure that people can have the trust and faith in the fact that we are producing equipment at the level that we do.
Gay Wardle 44:04
Congratulations. And that’s why your reputation is so so highly regarded in the industry, because of the way you do things. And to have that achievement, I know it’s a lot of work, but well done to you. So here I get to travel around like you do, we get to go into these amazing clinics where people have spent 1000s and 1000s and 1000s of dollars on equipment and equipments in the corner of the of the room. And you ask how often do you use that? And it might be all once a month or once every two weeks or whatever. And it’s just heartbreaking to think that you know, they’re purchasing these pieces of equipment, but they’re not using it. So what are some ways that we can maximize the LED machine in our businesses to incorporate into business with combinations of treatments?
Trevor Neale 44:54
Look, I mean first thing is just get excited about it as I do. Read up about light, as you can sort of see with that passion it’s easy to translate across to people what effect it’s having. But, you know, realistically, and I’ll say, with our systems with the Xen, especially our users, we don’t tend to see that because they are seeing the outcomes from it. But I think you’ll find that once you start using it, adding it in, I mean, the biggest thing is add them into treatments. You can do, as you say, your needling where you can do all the other processes in there.
Trevor Neale 45:25
Start adding them in, you’ll actually see those results coming in your improvement results: faster healing, faster recovery. And, you know, that’s one way. The other way, I mean, start setting them up as a standalone rejuvenation and, you know, package them together. We talk about standard LED treatments have been two treatments a week over four to six weeks. That’s right over three to four weeks. My error. Yeah. So, you know, we talked about those sort of things, package them up.
Trevor Neale 45:55
So that you have a situation where you can put those offers to clients and start using the equipment. Because I find that, you know, when you start getting into it, seeing the outcomes from the technology, it really does speak for itself. But really, you know, at the end of the day, it’s to start looking at them as a combination treatment, add them into your needling, add them into everyone to be quite frank, everyone. Even younger clients can use that as a treatment, everyone can benefit from having LED in there. So it shouldn’t be one of those things that sits in the corner. And to be quite frank, I don’t know of too many people where LED does sit in the corner. And I do feel that’s because they’re utilising and they’re seeing those outcomes.
Gay Wardle 46:37
True. I used to in the past, use LED as an add-on to entice people to purchase packages and things like that. I don’t do that anymore. I actually sell it alone as a treatment. It took me a little bit of time, I always loved LED. But I think we have to believe and see the results to actually understand the value of an LED device, and to me it’s something that we should be charging for. Never reduce the price. And never use it as an enticement for people to buy packages. I’ve certainly changed my point of view on that in recent years. So final question, where do you see led treatments going in the future?
Trevor Neale 47:22
Oh, mate, it’s just what we go into it. And I wish I had another hour to talk about this. In terms of LED, I mean, as I’ve indicated already with in terms of intensity-wise. We know with our Xen, we’re at a point now that we’re, we’re coming up to that borderline between photobiomodulation and photothermal. And when we educate, we educate based on based on skin typing, because we know darker skin types, we have to change our parameters to minimise loss in heat. So we’ve got our treatment durations down to as short as we possibly can by by going to those sort of limits. So we’re now at a point where we can do a full dosage of red in around about seven minutes. So in terms of those sort of levels, that’s about as far as we can go in terms of delivering the energy.
Trevor Neale 48:13
The next step, where we sort of see it is that we’re going to see the the arrays getting bigger and bigger. And you know, I’m talking about moving on to the full body type of processes. Now, you know, we already see these things coming up in wellness, and we talk about seasonal affective disorder, there are studies going on in mental health. We even talked about motor neuron disease and those sorts of neurological disorders, where we’re able to get greater cognition. But mental health. And we’re talking about depression.
Trevor Neale 48:40
So you know, for me at my age, I got into the LED just. And when you contacted me earlier I was in the LED at the time to give me the energy to get through things because I was feeling a little bit sluggish this morning. But it’s true. You know, you’re getting that energy and you feel better. Your muscles are working better. And you know we talked about reduction of delayed onset of muscle soreness (DOMS) so we’re getting way into these bigger body areas moving into wellness.
Trevor Neale 48:40
So mental health, wellness and that whole particular process. I mean, you know, we’re also talking to groups and this is really off to the side of it regarding equine. So horses and horse racing. We know that’s already used in this sort of thing for, you know, cats, dogs and for healing. So there’s so many areas that it’s heading into that I think really in our domain, we’re moving into that wellness area that we’re starting to look at the bigger area of coverage such as your full body work.
Trevor Neale 48:42
So I know there’s studies going on regarding, you know, skin health, in conjunction with with depression and dealing with that in the therapeutic process. And the great thing about LED is that you’re also getting energy in the cell. So not only are you getting, you know that improvement of health and mental health so we say you’re getting that sort of skin strengthening and rejuvenation. And moving on with that. I mean, we see this happening where energy, you know, once you start putting energy into the muscle and getting more ATP, then it means that you physically you physically have more energy and I always relate back to the Nike team at the Barcelona Olympics and a lot of the grid iron football teams over in the US now use led as part of their recovery and and you know, to to also not only recover but that enhanced performance so it’s almost an enhancement process so that they can perform better.
Gay Wardle 50:29
Amazing. So Trevor Neale, it’s been an absolute pleasure and delight to speak with you. Your knowledge on the subject of LED is, without doubt the best in the country. If anyone wishes to contact Trevor, and he’s got amazing devices, if you are shopping around for an LED, please have a chat with him. You can email Trevor on Trevor@AestheticBureau. That’s aestheticbureau.com.au. And you could also go to their website. So thank you, Trevor. I really have enjoyed my time with you, and thanks for your knowledge.
Trevor Neale 51:10
Thank you very much. It’s been a pleasure.