General Information
Power 100mW
Wavelength 660nm
The red laser probe is now available, having undergone rigorous ergonomic and clinical testing over the past three years. This addition will complement the already existing 75mW and 200mW infrared laser probes.
During the early 90s, we developed a 25mW red laser probe which we utilized extensively in our clinics, but did not promote in the marketplace as the demand was limited, except by acupuncturists and dentists.
Several were acquired by users who understood the importance of this probe. Most consumers felt that the cost could not be validated and we always choose to allow individuals to make their own informed decisions.
At the same time, we continued to use the 25mW red laser probe in our clinics, with substantial benefit in many situations. In view of this, in 2004 we decided to explore the impact of a 100mW red laser probe which we have now tested extensively under controlled circumstances.
Application:
The probe can be operated from low levels, i.e. 1mW to its 100mW maximum output. Developed primarily for utilization in treating dermatological conditions and wound healing, it may also be used for the treatment of epicondylitis, rotator cuff injuries and other pathologies.
From a clinical perspective, the red laser probe may replace the use of the infrared probes in the treatment of superficial lesions. It may also be combined with the infrared probes in cases that have plateaued or are slow to respond. As always, clinical judgment must prevail in its utilization.
The length of application will be in the 1-10 minute range, depending on the extent of the underlying pathology. As with all BioFlex treatment arrays, the probe can be used in both continuous and pulsed mode.
Synopsis:
Power can be set from 1mW to 100mW
The 100mW Red Laser Probe can be used in stand-alone configuration or in combination with any other arrays and probes
In some dermal conditions, wound healing, epicondylitis, rotator cuff injuries, temporomandibular joint dysfunction, etc., it can supplant or be used in combination with the infrared probes
Length of treatment depends on the extent of the lesion and the clinical response with previous applications
It can be used as an add-on prior to the infrared probe application or in place of same
Time factor of application should be less than 10 minutes in all instances, again depending on extent of area to be treated
Without considering economic implications, we feel the 100mW Red Laser Probe adds another significant dimension in effective Low Intensity Laser Therapy (LILT)
Meditech is continuing research regarding power settings, etc. as is the case with all arrays and probes
This probe is designed for the clinician who is creative and observant with regard to clinical response in the application of LILT
After extensive testing, we have found that the 100mW laser probe can be a most useful adjunct in cases that have plateaued or when more productive approaches are required.
Summary of Applications:
For use in superficial pathologies
In stand-alone configuration
In combination with other arrays and probes
Particularly useful in acupuncture, dentistry, dermatology, etc.
As we continue our clinical evaluation and develop new protocols, we will forward these to all therapists as the data becomes available
Dermatological Utilization
The most common condition that we treat in dermatology is eczema. It is therefore incumbent for the therapist to understand the various aspects of this pathological entity.
Eczema is frequently referred to as atopic dermatitis or non-specific dermatitis. This condition has a genetic basis. It often has no specific etiology, but results from the interaction of multiple genes and is triggered by external environmental factors. The greater the number of atopic genes that are present, the less environmental initiators are required to activate the disease.
The cells at the centre of the inflammation are called T lymphocytes. Their presence represents the immune system's reaction to the trigger factors.
Increased T-cell activity occurs in response to various antigens. Excessive stimulation of T-cells is secondary to the activity of genetically altered atopic Langerhans cells (Langerhans cells are resident in the epidermis and are responsible for presenting antigens to lymphocytes).
Genetic defects in the epidermal barrier make the skin susceptible to breakdown, permitting entry of numerous irritants including detergents, mites and other foreign materials. All of these permit increased penetration of antigens.
Acute flare-ups occur when the immune system in the dermis over-reacts to environmental or emotional triggers, resulting in clinical symptoms characterized as dermatitis or in lay terms, a "rash".
Different individuals have unique etiologies or triggers that result in a breakout of the rash. Some of the more common triggers include:
Changes in temperature or humidity
Chemical irritants (pesticides, alcohol, astringents, perfumes, soaps, detergents, etc.)
Physical irritants such as clothing, particularly wool and rough fabrics
Allergies (dust, pollen, mold, etc.)
Stress (emotional)
A significant aspect of therapy is to determine the trigger factors and delete them from the environment.
If this is not effective, LILT presents a new therapeutic approach.
As we continue to treat more eczemas, psoriasis and other dermatological conditions, we are experiencing significant variations in response to laser therapy. As previously indicated, these are based on genetic, environmental, allergic and unknown factors.
The ability to customize protocols is essential in treating these lesions, in addition to other conditions. Whereas it is somewhat less important in treating musculoskeletal problems, in the dermatological sector it is of paramount importance.
For instance, when a patient presents with a generalized dermatological problem i.e. profuse lesions scattered over various body surfaces, we can initially treat four or more lesions utilizing different protocols for each.
We might begin treating one area with red continuous for 5-10 minutes depending on the extent of the lesion, another area with infrared pulsed at 50/50 for a similar length of time, a third area with infrared and red superluminous arrays combined and some areas utilizing only the laser probes, particularly if they are relatively small.
The application of four or more different protocols initially and observation of the reaction of the lesion on each visit will quickly point to the most effective approach. This permits each therapist to develop protocols appropriate for that particular patient and these may be incorporated in the treatment of similar conditions in other patients. The net result is that each therapist will learn how to develop protocols most suitable for each problem, regardless of the type of pathology that exists.
Case Profiles:
Recently, a patient presented with severe chronic psoriasis in two areas. One area was treated with the large surface array at red continuous for 7 minutes. It disappeared completely after two treatment sessions. At the other site, we utilized infrared 100/80. It improved about 60% after two treatments.
Conclusion - Both protocols were applicable but red continuous was superior. After five sessions, both areas had cleared completely using the protocols that were most effective.
Another recently assessed patient had severe eczema of all the extremities. Again, we used the red large surface array at continuous wave setting with a rapid response. In another area we used infrared continuous, also demonstrating a rapid response. In the other sites we used a combined approach. In this instance, the combined approach was superior to the other two. Again, this clearly indicates the need for an individualized approach to provide the foundation for therapy.
At this point, based on our experience, we have reached some firm conclusions and provide the following guidelines:
1) Duration relates to the extent and severity of the lesion i.e. dimensions, elevation, degree of inflammation, etc.
2) With more chronic type lesions, the duration of treatment required may be longer than with relatively acute lesions that generally respond more rapidly.
3) Changes in protocol may not be required frequently, however must be instituted as appropriate.
4) Protocols must always be correlated with clinical response.
5) Initial protocols for eczema: red array continuous wave (cw) may be followed with red pulsed at 10/60 and increase gradually to 100/80 as indicated. If this is not effective, include infra red initially at 50/50 with gradual increase to elicit a positive cellular response.
Additional information will be provided as we proceed. Finally, it should be noted that the flexibility of the BioFlex System permits the unlimited development of protocols and therefore the device can also be described as a "clinical laboratory". The importance of this particular feature should be apparent.
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Fig. 1 
Fig. 2 Exceptional control and flexibility of treatment parameters. 
Fig. 3 
Meditech Rehabilitation Centre is the largest provider of Low Intensity Laser Therapy in North America. The original clinic operated at Ryerson University from 1993 – 1999 by which time it had outgrown its physical dimension. 