EditorWe are writing this letter to draw the attention of the biomedical community to an unprecedented development in the field of cosmetic dermatology. If we insert the keywords facial rejuvenation and LED into Google's search engine, we obtain today (August 2011) more than 300.000 results, whereas in the time between March 2006 (first paper recommending the use of NASA LEDs for facial rejuvenation 1 ), and September 2008 (first report on the use of a handheld device based on NASA LEDs for facial rejuvenation 2 ) these keywords consistently produced less than 1000 hits. A regular Google check confirms that the development is totally out of control -why?Aggressive advertisements of LED-based irradiation devices by manufacturers -most located in Asia -promise miracles to their potential customers. By ignoring the basic irradiation parameters 'irradiance and fluence', the advertisements focus solely on the attraction of the high tech product LED. However, sometimes, manufacturers provide the colour of the light. Some of these irradiation devices operate with one central wavelength, e.g., orange or red, whereas others employ a mix of two wavelengths. In both manifestations the irradiation could be delivered continuously or in a pulsed mode. Unfortunately, the majority of these devices operate at irradiance and fluence levels far below the biological thresholds ascertained for in vivo applications, to produce a rejuvenating effect in the dermis. Apparently, the LED boom receives support from reports on the rejuvenative effect of LED-based devices operating at extremely low irradiance and fluence levels of 40 W ⁄ m 2 and 0.1 · 10 4 J ⁄ m 2 , respectively. 3 A closer inspection of the article reveals, however, that there are a number of interesting discrepancies. For instance, the authors claim that the in vitro experiments were previously confirmed in vivo: 'Photomodulation with a 590 ⁄ 870 nm LED array is effective for altering gene expression, collagen synthesis, and reduction of MMP-1 expression in vitro as described herein and in vivo by the testing of a device similar to the 75 ⁄ 25 : 590 ⁄ 870 nm ratio in a human clinical trial. This trial involved clinical evaluations and histology [1,8,9] …' Surprisingly, the references cited as in vivo confirmation of the study performed in skin fibroblasts by the variation of ratios of wavelengths 3 do not lead to a related in vivo study. Presumably, this lack of correlation between in vitro and in vivo is the rootcause of the out-of-control development by which the authors, although not deliberately, encouraged an armada of opportunists to take advantage of the unclear situation, selling unrealistic claims and ineffective devices to people.