Light-emitting diode (LED) therapy is a popular treatment in medical aesthetic clinics. There are a number of these treatment systems available at a relatively reasonable cost. A significant number of patients with dermatological problems will have had or enquired about this form of treatment. In aesthetic practice, these treatments are often used as an adjunct to other treatments, such as non-ablative laser, but can be used as a standalone treatment. The advantages include being cheap and easy to administer, they can be used on all skin types and they have minimal side effects. Clinics tend to use more powerful lamps, rather than face masks (Figure 1). The author could find no studies comparing masks with LED lamps, nor any academic articles confirming the efficacy of LED face masks; however, some anecdotal evidence of positive effects exists.
Figure 1. Medical aesthetic clinics tend to use more powerful light-emitting diode lamps, rather than face masks
LED treatments usually consist of blue light around 415 nm; red light around 630 nm and near infrared light around 830 nm. These are often combined to maximise the effects of the treatment. LED therapy is a low-energy light delivery system.
Indications for treatment
Acne
Acne is a common condition that can have a significant physical and psychological effect on patients. Treatment options include topical retinoids, benzyl peroxide, oral antibiotics and oral isotretinoin (Mayo Clinic, 2020). These treatments are usually effective; however, they all have side effects.
Blue or red light are both used in the treatment of acne, either alone or in combination. Blue light is considered to have antibacterial properties and is effective against Propionibacterium—also known as Cutibacterium—acnes (Morton et al 2005). A combination of red–blue light produces even better results (Papageorgiou et al 2000). Goldberg and Russell (2006) showed microdermabrasion, followed by twice-weekly red–blue LED treatment over 4 weeks, demonstrated a significant improvement in acne by 12 weeks. Other studies have confirmed these results. Using blue light and the photosensitiser 5-ALA, Melnick (2005) showed a significant improvement in cystic acne.
It appears that LED treatments are potentially a useful addition to traditional acne treatments, particularly in those where other treatments might be contraindicated, such as in pregnancy.
Psoriasis
Psoriasis is a relatively common condition. Treatment is usually focused on topical applications, followed by light treatments and, for more severe cases, systemic treatments. It is increasingly difficult to obtain phototherapy via the NHS, due, in part, to the COVID-19 pandemic. Some patients may turn to medical aesthetic clinics for assistance as a result. Ablon (2010) and Kleinpenning et al (2012) demonstrated the effectiveness of red and near infrared LED treatments in plaque and guttate psoriasis. Therefore, LED treatment may be offered to patients with psoriasis, due to its demonstrable effect and minimal side effects. However, most clinic machines are configured to cover an area of the face, so may not be practical for treating larger areas.
Photorejuvenation
LED light works by non-thermal photobiomodulation, leading to fibroblast proliferation, collagen synthesis, growth factors and extracellular matrix production by activating cellular mitochondrial respiratory pathways. (Heiskanen and Hamblin, 2018). The result is lifting and tightening lax skin and the reduction of rhytids. In the aged, photo-damaged skin, collagen synthesis is reduced with elevation of matrix MMP expression (Fisher et al, 2002).
Bhat et al (2005) used 633 nm light treatments three times per week for 3 weeks, which showed an improvement in fine lines and wrinkles and a softer, smoother skin.
Another study, by Russell et al (2005), included 31 patients, and they concluded that a combination of red and near infrared LED therapy represents an effective and acceptable method of photorejuvenation. They suggested that ‘further study to optimise the parameters of treatment is required’ (Russell et al, 2005).
Additionally, Lee et al (2007) compared sham LED with red and infrared LED treatment and found that the combined red and infrared light improved wrinkles significantly more than the control and was better than red LED alone. However, red LED treatment alone reduced melanin in the skin more. Tissue assay confirmed increased collagen throughout the dermis.
When LED treatment is used for photorejuvenation, optimal results tend to occur 3–6 months after treatment.
Wound healing
Red light significantly increases cell growth in a diversity of cell lines, and accelerated healing and greater amounts of epithelialisation in skin grafts was demonstrated by Conlan et al (1996). Using red and infrared LED, Trelles et al (2006) showed 50% better wound healing post-ablative laser treatment at 3 months than the control group, but there was little difference in wrinkles after 6 months. However, the side of the face that was treated with LED appeared to look younger (Trelles et al, 2006).
Sunburn and photoprophylaxis
The treatment of sunburn is potentially a new use for LED treatment. Shorter healing times have been reported in small studies using LED treatment post exposure (Barolet, 2008). There is also some impression based on in vitro studies that LED treatments could be used to stimulate skin resistance to UV damage without the drawbacks of traditional sun protection factor (SPF).
Conclusion
According to the evidence, LED therapy appears to be safe and easy to administer, with no reported side effects or downtime. However, there have been concerns regarding normal LED lighting, particularly in regard to blue spectrum causing retinal damage (Shang et al, 2017). However, no evidence could be found that related to controlled clinical treatments. Evidence for its effectiveness is often from small studies, but these have shown a clear benefit, particularly in photorejuvenation, acne and wound healing. Many medical aesthetic clinics report significant patient satisfaction when using LED treatments post-procedure to reduce erythema and aid healing or to brighten photo-damaged skin. Clinics report that patients tend to return for further courses, which are a sure sign of benefit.
Key points
- Light-emitting diode (LED) treatment is safe and easy to administer
- LED treatment appears effective in photo-rejuvenation and acne in particular, and may have positive effects on wound healing and psoriasis
- LED light systems are likely to be superior to masks
- LED systems use a variety of wavelengths typically blue, red and infrared.
CPD reflective questions
- What are the most common light frequencies for light-emitting diode (LED) lamps?
- What are the potential uses for LED lamps?
- What is the efficacy of LED masks versus lamps?