BY Samuel Mathis MD, MD, MBA, CPE, Family Medicine, UTMB-Health and the John Sealy School of Medicine
Photobiomodulation (PBM) has been making headlines again over the past few months, and with it comes the normal request for more information and treatment. The underlying concept of this treatment is to use certain light frequencies (red light and near-infrared) to impact the body by causing apoptosis of certain cells, reducing wrinkles, promoting hair growth, and helping the skin look younger. Dermatology has been using these treatments for years to help treat certain skin cancers and treat conditions such as radiation dermatitis and various alopecia conditions (1). Photo-therapy treatments are non-invasive and relatively safe, leading to an increased number of applications for cosmetic purposes (acne, wound healing, skin rejuvenation, and scar reduction.
The evidence for PBM has numerous studies showing positive effects through consistent use. For hair growth, there are a few possible mechanisms of action. Red light therapy causes vasodilation in the superficial layers of the skin, improving hair follicle growth, much in the same way medications like minoxidil work. Low-powered lasers have been used in the treatment of acne to reduce inflammation, where researchers found that narrow-band ultraviolet B light was significantly effective at reducing symptoms of acne (1). This effect is believed to occur through the creation of reactive oxygen species within the bacteria causing acne, creating a bactericidal effect.
In wound healing, red light therapy works by impacting both the development of fibrous tissue and affecting bacterial growth. Research has found that blue LED therapy works on cytochrome C and cytochrome c oxidase to improve and enhance the production of ATP in mitochondria (1). Through its impact on fibroblast activation, phototherapy improves the rate of wound closure. It has also been shown to improve anti-inflammatory cytokine release, decrease bacterial load, and stimulate granulation tissue, thus making it a wonderful adjunct for wound healing (1).
New and emerging research is also looking at PBMs’ effect on chronic skin conditions such as plaque psoriasis and atopic dermatitis. In conjunction with standard therapy, PBMs may work synergistically to reduce inflammation and decrease the inflammatory response to psoriasis (1). PBMs also help reduce the number of lesions and excessive skin proliferation related to psoriasis. Phototherapy has been shown to provide some analgesic effect related to the significant itching associated with atopic dermatitis. Studies have found that PMB helps reduce the number of epidermal nerve fibers, which reduces the sensation of pruritus in these patients (1)
Red light therapy can be delivered in various forms. The most basic treatment is through a light-emitting diode. They come in numerous systems as either a wand, helmet, or even face masks that look like they belong in a certain movie genre (science fiction or horror, you pick). These are some of the safest delivery methods with little to no side effects (1). Another means of delivering red light therapy is through lasers. This is typically done with properly trained professionals in a clinical setting. Dermatology has been leading the way with the use of red-light therapy, and I recommend patients see a dermatologist for more intensive therapies.
There is significant opportunity for growth in this area and the ability for patients to use these treatments at home rather than in an office setting. Research needs to continue to help identify how PBM can be used to help improve other health conditions outside the field of dermatology. This therapy offers the ability for us to create personalized plans for specific patient needs and offer them safe and affordable treatments for applicable conditions. A final caveat: it is important to note that red light therapy for hair growth, wound healing, and skin rejuvenation is only good for as long as you use it. Once patients stop consistent use of the therapy, they may see the positive benefits wane over time. Patients should be informed of this before starting therapy to ensure full informed consent. Therapies using high-intensity PBM and lasers should occur with specialists trained in this field, such as dermatology. Photobiomodulation offers some exciting opportunities for patients to improve their quality of life, and I am excited to see the future development of these treatment options.
References:
- Hernández-Bule ML, Naharro-Rodríguez J, Bacci S, Fernández-Guarino M. Unlocking the Power of Light on the Skin: A Comprehensive Review on Photobiomodulation. Int J Mol Sci. 2024 Apr 19;25(8):4483. doi: 10.3390/ijms25084483. PMID: 38674067; PMCID: PMC11049838.