EP 5: Red Light Therapy 101 | DEEP FOCUS

In this episode, I break down the science of photobiomodulation, the difference between red and near-infrared wavelengths, and how light impacts your cells, skin, recovery, sleep, and overall health. You’ll learn how to choose the right device, how to dose it safely, and the most common mistakes people make so you can get real results without wasting time or money.
 
CONNECT WITH HOST 
Website: https://clinic5c.com/ 
Instagram: https://www.instagram.com/chesnut.md/ 
YouTube: https://www.youtube.com/@chesnutMD 
LinkedIn: https://www.linkedin.com/in/cameron-chesnut-a6910baa/ 
 
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TIMESTAMPS 
00:00 — Intro
01:00 — Backstory
04:37 — Understanding Wavelengths (Red vs Near-Infrared)
06:12 — Deep Science
13:26 — Clinical Applications
20:29 — Safety
22:58 — Blood Glucose Response + Metabolic Effects
28:36 — Recovery and Performance
29:31 — “Light Diet”
33:11 — Why Time of Day Matters
34:38 — LEDs
37:11 — Red Light Devices: What’s Right for You?
41:46 — Red Light Is Hormetic: Dose Matters + Follow Instructions
44:00 — Lasers vs LEDs
45:06 — Masks vs Panels
49:44 — Pulsed Light
51:00 — Outro
 
ABOUT HOST 
Dr. Cameron Chesnut is the host of the Five Codes podcast and the founder of Clinic 5C, where he leads a team dedicated to integrative cosmetic surgery, regenerative medicine, and functional health. An internationally recognized facial plastic surgeon, Dr. Chesnut is known for producing natural, refined results that enhance rather than alter one’s appearance. His approach blends surgical precision with biological optimization and disciplined restraint, drawing patients from around the world who value excellence, longevity, and holistic care. On Five Codes, Dr. Chesnut uncovers the mindsets and evidence-backed strategies he lives by, helping high performers perform better, recover smarter, and feel their best in every area of life. 
 
DISCLAIMER 
The views shared on this podcast are my own and are not associated with, affiliated with, or representative of my clinical teaching role at the University of Washington School of Medicine. This content is for general educational purposes only and should not be considered individualized medical advice.

Transcript

0:00

Welcome to the Five Codes podcast where we discuss evidence-based methods to elevate yourself to the next level through optimizing the way you look, move, perform, feel and connect. Welcome to today's episode of Five Codes, which is all about red light therapy. This is something I'm really excited to talk about. I've been using it my entire career, but it's really exploded lately. So I want to talk about what red light is, how it's used in medicine. And I want to get into the applications and physiology and how all those things tie together, because that can help you in your quest for peak performance, just like it does with me and with my patients as they're getting ready and recovering from surgery. I also really want to jump into red light devices. What they do, how they work and of course how to pick the right one. These are really common questions and there are some very simple answers and there are some nuanced complexities to it that we're going to boil into today so that you can take this into your life and whatever capacity, even utilizing natural light like the sun and use that to optimize your performance. Very recently I was at a major medical meeting and I heard a talk on red light for the first time in my career in over a decade. And this was this floored me basically because when I think back to when I first became interested in red light or photo bio modulation, if we break down that word, it's the way that light interacts with our biology to change things, photo bio modulating. It was something that was very much fringe science. It was crushed. It was called bogus and it wasn't ever true, but it's got a really interesting backstory as to why that happened. So if we look back to even the early 2000s when interest was starting to build in photo bio modulation or basically how red light or longer wavelength light interacts with our biology, it was crushed. It was pushed down. Good publications about it were not happening. And in the early 2000s, a big red light researcher was at a major medical meeting and he sort of mentioned red light as part of a talk that he was giving. And the next speaker up was a really big thought leader in the field of photo medicine or laser medicine, like probably the most respected person that has existed in that field who's still active today. And he talked about the red light that had been presented in the talk before him and essentially called it bogus science, even had a slide in his presentation about the definition of the word bogus, which is apparently as a cocktail or something too, but also how it applied to the science. So with that very influential person talking about red light being bogus science, it was essentially quieted from all medical publication and literature. So this researcher had some really strong, really good studies that he had done that were worthy of publication, but for years they were being blocked and not published, which I think is a really interesting thing to think about when we talk about peer review literature in general and how it can be so influenced by the opinions of key leaders as this was. So flash forward to about 2008, 2009. This is when I was in my residency training now, so I'm at the biggest phase of information consuming that I'm in. I'm still a big fan and believer in photo biology and photo biomodulation in red light. And finally, some of these studies start coming into light, quite literally, being published and showing some of the major benefits that red light can have. The first big publications for this, which makes sense, were published around our skin and our hair. And if we look at those now, red light has really strong grade one, grade one, a medical evidence like the strongest type of literature that you can have supporting how beneficial it is to some of these key areas of our biology, specifically related to hair and skin. So when I step back in 30,000 foot view, look at that entire story, I'm looking at really good, simple interventions like red light, how they were being applied and how it was viewed as fringe science because it wasn't pharmacologic. It was very much on the more natural side of things. And it was essentially quieted for a period of time by key opinion leaders who didn't believe in it. And that kept that part of medicine from progressing forward. So it was doing so in the background, but the information wasn't coming out. I think that we can apply this to a lot of different things where finally, when the data started getting published, it was very positive. And a little bit eye opening as to what it was doing. So the areas that red light has really, really strong medical evidence are the areas that we would think of predominantly with our skin, our hair, things that are exposed to natural light or red light and even with our eyes. So when we get into the really strong data, hair growth with red light has grade one, a medical evidence, no question about how our hair follicles react to these longer wavelengths of light. When I'm talking about long wavelengths of light, I'm specifically talking about red light, which is in the visible spectrum. Let's call that like 630 to 660 nanometers. That's a red light. And then when we talk about near infrared light, we get just outside of the visible spectrum. And this is when we get to like the 800 or 810 to 850 or 860 nanometer wavelengths of light. I only mention those because they become important later on as we get into selecting devices to make sure that the devices have peaks in some of those key areas because different wavelengths have different interactions with our skin or with any tissue that they're hitting. This is really important with lasers. Lasers are by definition a single one wavelength of light. They're not a spectrum. They don't have a peak. They only have one actual wavelength. And that's the same way the lasers work. We know that this wavelength hits what we call a chroma for. It's target in skin or whatever soft tissue we're talking about. And we're talking about red light devices as we get into this or when we talk about natural light or light sources like LED, we're talking about the spectrum of light that those emit and where the peaks of those are. So we want to think about red and near infrared in that way. And so hair is one of those areas with really strong grade 1A medical evidence that red light improves hair growth. No question about it. Skin aging is another one of these. We see red light masks out there all the time. And the question is, do they work? Are they worth doing anything? There is strong medical evidence that red light when it interacts with our skin changes parameters that affect how the skin looks to our eye. But also when we get down to it, there are qualitative benefits in things like collagen and elastin. And if you hear me talk ever, you know how much I love elastin. Elastin is a delicate flower. It's very easy to lose and very hard to create. But red light helps create more elastin and hyaluronic acid. Hyaluronic acid we hear about because a lot of fillers are made out of a gel that's a cross-linked hyaluronic acid. But hyaluronic acid does naturally exist in our skin, different than fillers that's not cross-linked in our skin. But it lives outside of the cells, we call it the extracellular matrix and it's a glycosamino glycan. It's meant to attract water, the same thing that filler does, it attracts water. So when that lives outside of our skin it gives skin the trigger, it gives it the appearance that we really like. The way that red light does this is by interacting with a very specific cell in our skin, this called a fibroblast. And that fibroblast makes collagen, it makes elastin and it makes hyaluronic acid. And the way that that works is red light energy hits a very specific part of our cells called the mitochondria. This gets, we're getting into deep science here for a little bit, but it's important to know and it's kind of fun to nerd out on a little bit. So within the mitochondria, which is the energy production part of our cells called an organelle, it's a sub part of our cell, but that's where all the energy comes out of. There's a very specific part of something we call the electron transport chain and we all had to learn this in medicine and know this very elaborate chain in detail, but this chain is what pumps out energy and energy comes in the form of ATP. ATP is the currency of energy in our body that comes out of our cells and it's all made inside the mitochondria. And within that electron transport chain, there's one of the complexes, complex four, that is cytochrome C oxidase. So cytochrome C oxidase is very unique because it has these two copper binding sites and I only mentioned that becomes that, that becomes important with the way that red light specifically these longer wavelengths of light interact with the copper and cytochrome C oxidase. And there's usually these two copper binding sites, A and B, and they have something called nitric oxide that gets bound to them. Nitric oxide gets bound there in periods of cellular stress, it could be oxidative stress, anything like that makes this nitric oxide bind to the cytochrome C oxidase copper binding sites and red light interacts with those binding sites and releases the nitric oxide from them, which allows the complex of, and the electron transport chain specifically the cytochrome C oxidase to kind of get moving again and make more ATP, more energy within the cell. So processes that are very energetically demanding, like making collagen and elastin and hyaluronic acid, all of those parts of the mitochondria that drive these high demand cellular processes are more efficient when red lights on them. There's a side benefit to that as well because nitric oxide, when it gets released from these two binding sites, is now free to interact in other parts of our cell and this becomes really important when we're talking about our blood vessels because nitric oxide helps improve blood flow to key areas by causing relaxation of blood vessels which we call vasodilation. So it's good to have nitric oxide around, number one, and it's even better when that nitric oxide is not bound to the cytochrome C oxidase. So light has these multiple benefits, red light specifically, long wavelengths of light, have these very specific ways that they interact with our mitochondria. So what I just talked about there is deep science of cytochrome C oxidase, electron transport chain, and that has been the very traditional way that we have viewed light interacting with mitochondria to improve energy production. I want to put a pin in that for one second because that's been the traditional way that it works and if that's the case, it would, you know, stand to reason that red light, shined on a very specific cell, has a positive benefit to energy production and we get these beautiful outcomes from that. But the science has evolved from there a little bit and there appears to be some other mechanisms by which red light improves the way that mitochondria function. Mytocondria are surrounded by, let's call it a structured water and the structured water that's around there, it's like a zone of water that surrounds all the mitochondria and we have started to realize in medicine more recently that the water around the mitochondria is important to the way that something called protons move. We talk about electrons all the time but electrons are a negative charge that move around and protons are another way, they're a positive charge way that there can be some communication between the mitochondria through this area of structured water which sounds a little bit hand wavy in pseudoscience, I 100% realize that but this becomes really important as we get into the clinical applications later on because it's become very apparent that the mitochondria and our body communicate with one another. They're a very unique organelle in the way that they replicate even. For example, all of our mitochondria come from our maternal inheritance meaning all of your mitochondria came from your mom, none from your dad whatsoever which is very unique when we talk about how humans reproduce basically. Every other part of us is 50/50 mom and dad but in this case your mitochondria coming 100% through maternal inheritance all coming from your mom and this has to do with why mitochondria exist in the first place coming from basically bacteria if we go way, way, way back in evolution becoming part of our cellular structure. So very, very unique to how mitochondria reproduce and how they communicate with one another and it's become very clear that there is a network of how mitochondria communicate and this idea of how the water, the extracellular water around the mitochondria helps them communicate with one another through this ability to move protons. So that becomes a new idea and it explains some of the systemic benefits that we can get with red light therapy even in areas that are distant to where the red light was applied. So we can talk about that a lot more later but this is affecting our overall metabolism. So we now know that red light interacts with cytochromcyoxidacine, electron transport chain, which is a production of ATP, it reacts with the cellular water or the transition zone water around how all the mitochondria interact with one another and water is a big absorber of red light. We know this anyway. If we look at the ocean, the ocean is blue because it absorbs the red light and reflects the blue. So we know it just sort of mechanistically makes sense that that red light is interacting with that structured water that exists around our mitochondria and helps them communicate. Even as far as clinical applications go, getting back to these fibroblasts, making a lot of collagen and elastin and hyaluronic acid in our skin, this starts to make sense. Okay, we have more energy available for these really high demand processes to happen with the way that red light is interacting. It's getting more blood flow because of the free nitric oxide. So now you have all of these increased capabilities to improve these areas of our skin and this is why red light on our skin improves the way that it looks. This is backed up by studies and I think the interesting part is it's a relatively low dose. It does not take much and when I'm talking about dose here, I'm actually talking about the time you need to treat and then the duration of that benefit over time, meaning in just several weeks of treatment with red light on our face, we can have an improvement in our skin appearance that lasts quite a bit longer than you would expect in four to six weeks of treatment. You can have months of benefit afterwards. Red light on our skin, which is strong medical evidence to support that. There's some other interesting parts of our skin where red light interacts and this can have everything to do with some more challenging immune situations, which could be like cold source. Actually, red light is a beautiful way to treat cold source if they come or keep them from coming in the first place or something called like oral mucositis. This is an inflammatory condition that people get in their mouth and they're having chemotherapy in something like red light, even in the mucosa of our mouth, has a massive benefit to the comfort and resolution of those types of things. Even in the oncology world where there's an overlap with the dermatology world a little bit, red light can have a big interaction there. Our eyes are specifically our retina if we want to get real specific. Our greatest source, our greatest density of mitochondria and any tissue on our body. What stands the reason that red light would benefit retinal function and this is very, very true. If we look at something like age-related macular degeneration, which is basically a senescence or a slowing down of the mitochondria in our retina, one of our leading causes of blindness, red light has a benefit to treating that. In some countries, it's approved to treat this age-related macular degeneration, very specifically dry macular degeneration. That's important to delineate. But even in very simple basic things, color differentiation, trying to discern a dark blue from a black, we know that a very short, light treatment of red light on our retina, meaning like think of holding a relatively weak flashlight in somebody's eyes, but that flashlight has red wavelengths for a very short period of time. Just a few minutes can improve our ability to discern colors, especially colors that are difficult to discern otherwise. We can improve our color vision for days, like five days after our treatment with a very simple red light treatment on the eye. There's good studies showing that we know that our eye health is improved when we're using something like red light in there. I think that just really shows some of this probably mitochondrial mechanism to this because a tissue that's so dense in mitochondria, the most dense, retina, experiences some of the greatest benefits of red light therapy, really, really interesting. Other, I think, really surprising applications of red light, or now we're starting to probably get into what's more of the near infrared spectrum. And that is penetrating through things that we wouldn't think that it penetrates through. So just in a basic nutshell here, red light is a longer wavelength than the visible spectrum than something like blue light. Blue light is a short wavelength. And when we think about wavelengths of light, they determine how energetic the wavelength is, or how energetic the light is. So blue wavelength at a shorter wavelength is more energetic than a long wavelength red light or near infrared light. And it also determines how deep it penetrates. So small wavelengths that are more energetic do not penetrate as deep into our tissue as long less energetic wavelengths, meaning that blue light or ultraviolet light will not penetrate as deep as red light or near infrared light. So that's one important delineation. So UV light, ultraviolet that we've all heard about, UVB and UVC do not penetrate as deep. They are also a type of ionizing radiation or ionizing wavelength of light. They're so highly energetic that they react with our DNA and they cause cross-linking of our DNA, very specifically these primidine dimers, they're called. And that can lead to mutations in the DNA that can lead to something like a skin cancer. So these are high energy short wavelength ionizing types of radiation. We're talking about ultraviolet, which are outside of the visible spectrum on the short end. On the other end, we have infrared light, which is long, can't be seen too long of a wavelength to fall in our visible spectrum, but on the red end and long low energy wavelengths. The reason that's important when we talk about depth of penetration is because red light and specifically near infrared light has a long enough low energy type of wavelength that it can penetrate through our skull. This has been very, very well shown through bone to the superficial parts of our neural tissue. Our brain can experience infrared light, near infrared specifically, in these longer wavelengths. So where that becomes important is in anything where the brain has a higher energetic demand. That could even be neuro-cognitive types of things, your capacity to think, but it's shown in medicine to have benefit in things like traumatic brain injuries. And that could be just like post-concussive or actual more significant types of traumatic brain injuries where the metabolic demand and the neural inflammation to brain go up in those circumstances. It could be in things like stroke. So when there's a stroke, there's a big injury in the brain and you can imagine that in healing that injury, the metabolic demand goes up. So using long wavelengths of light for brain injuries, for stroke recovery, even in neonates. And when I say neonates, I'm talking about brand new babies, fresh out types of babies. When they have hypoxic or low oxygen types of injuries to their brain, we're using the Royal Weave Medicine, are using wavelengths of red light immediately upon birth on these babies extra crannily outside of their head and their skull to penetrate to their brain. And these babies are having better outcomes after these hypoxic brain injuries when the red light supply to immediately birth. And I think that illustrates two main things. This is happening in London, for example, where these long wavelengths are treating these brand new babies. It demonstrates the efficacy of how that's working because if it didn't work, we certainly wouldn't be doing it and applying it to neonates to brand new babies. And in that same vein, I think it also shows the safety of red light, which we haven't really talked about yet, but red light is wildly safe to do. The side effect profile is solo. A barely-gent lot of devices barely generate heat even. And so we have something that is so safe and so effective and we're using it on brand new babies to help their brain injuries and it can be applied to adults as well for traumatic brain injuries and stroke recovery. I think about this in my practice where there is no data to support or back this up, but I think about it in my practice when I'm using anesthesia for my patients who are having surgery and one of my big things you've heard me talk about this probably before is post-operative cognitive dysfunction, which happens after certain types of anesthesia can be more prone to. But this is the brain fog that somebody has after surgery. It's the word finding. It's kind of a difficulty in just getting back to feeling like yourself. And a lot of this is driven by neural inflammation. So there is a higher demand in the brain after the brain has experienced anesthesia, especially a certain type. So I'm already heavily focused on not causing the type of neural inflammation that can lead to this post-operative cognitive dysfunction. But even after surgery, there are many types of modalities and techniques I'll use to improve our neural inflammation after surgery so that we're not having POCD. And red light is clearly one of those things. Red light can penetrate to the brain that has a higher metabolic demand. So again, this is theoretical. This is mechanistic for me thinking, well, there's no actual studies looking at this that show any efficacy of this. But when I start linking mechanisms to goals that I have, red light fits really, really well into that. And we're talking about a direct application there, meaning a direct application to the head penetrating through the skull to the neural tissue. But there's more to it. And as I think through other aspects of my recovery as well, this is where we get into that structured water part of the mitochondria communicating. There's been some really interesting research by a guy named Dr. Jeffrey who's from the United Kingdom. And he showed something that was just, I'm going to just say, profound. And kind of showed me or made a lot of other parts of what I've seen with red light in my practice make sense. Because the thought had always been that the red light worked where it was applied, not necessarily in other areas. And Dr. Jeffrey showed something different there. And what he showed was a patch of red light applied to somebody's trunks, specifically in their abdomen area. And when I say a patch, let's talk about like four by six inches or something like that, a decent size patch, but quite small overall could change somebody's insulin sensitivity or specifically their glucose response. And what he did was he gave a group a oral glucose tolerance test. And that is where you drink a bunch of glucose, a bunch of sugar and you get a big spike in your blood sugar. This test is used all over medicine to see how people react to it and to show how people are managing that glucose with their insulin sensitivity is basically. So it takes this group and he gives them the oral glucose tolerance test. He sees how they all react. Then this test is repeated later on after this group has gotten red light applied to their abdomen, just a part of their trunk that has enough that the red light itself is not affecting any organs like the liver or the pancreas or something like that that might have an interaction into what their insulin was doing. And then after that exposure in a remote area, the same group was retested with the same oral glucose tolerance test and they had like a 20% improvement in their blood glucose response, meaning that red light applied to a distant site improved an overall metabolic parameter for these patients. They were more insulin sensitive, which is wildly beneficial to our overall health. Number one, but then for me really started showing, okay, red light in distant areas can improve our metabolic function at all other parts of our entire body. And I have seen this in my own practice when I'm often using red light directly on areas that I've worked. Think of it as a surgery or a laser. We know that red light applied directly to the skin. This gets back into some of the skin mechanisms. Improves the way that incisions or scars heal. They tend to be less red when they're healed. They tend to be less thick, ropey and raised. So there's strong evidence showing that red light can improve that. And this is no surprise because even wound healing applications with red light, we're talking chronic wounds improve when they're treated with red light. So you can have a wound that's not healing, not changing. Nothing's happening with it. It's been stagnant for a long time. You show that wound some red light and the physiology of that local site changes pretty dramatically, which probably has ties into the immune function and the vascular reactivity. And of course the way that the mitochondria of these cells that are trying to heal are reacting to this. So we know that red light heals wounds better. Wounds that are refractory that aren't doing well. It also heals regular old surgical incisions better. They do better with it. So in my practice, you can imagine that's wild, the important. Most of the incisions that I'm placing are quite invisible anyway in places that you do not see very well. But if I can do something as simple as red light and near infrared light to improve the way that those incisions look in the long term, it's an absolute no brainer for me to do that. So I've been applying that for a long, long time. But sometimes I'll wait until a patient is further into their recovery to do that just for logistic reasons. And in those same situations, I'm often treating my patients with full body red light in the areas that I did not even work at all. Did no surgery in those areas. They're just getting red light in their other parts of them. Maybe while they're getting their IV therapy or while they're on their post-electromagnetic field machine, whatever it may be, just as an ancillary treatment. And I'm noticing that patients are recovering faster when they're getting full body red light. Then if they're not getting it, this is just anecdotal, admittedly anecdotal with just my patients and my observations. And I've noticed this over this 10 year span. And it, not that it didn't make sense, but there wasn't a great mechanistic explanation as to why that was happening. And Dr. Jeffries' work really helps to explain what I've been seeing in clinical practice for a long time that systemic dose of red light, in this case, to a much larger body surface area, was having positive effects on my overall surgical recovery by improving that patient's overall metabolic health and their overall physiology. So I think that's really fascinating. And it gets really into that probably still theoretic mechanism of the structured water around the mitochondria being a key element of how we're seeing that benefit, how that's happening. So at this point, I think we've really tied into some of the key medical applications to red light. What it's doing on our skin, what it's doing in our eyes, what it's doing for our overall health, what it's even doing for our neurocognition. So I've been sitting in front of our red light every day before surgery. This is part of my preoperative flow state routine that I do. I've been sitting in front of this thing every day before surgery for my entire career. And it's kind of fun to know that I was also getting a cognitive benefit on top of all the other benefits on those days of surgery, getting more nitric oxide released in my brain, improving my cytochrome, sioxidase in my brain from the red light that I was already doing, usually as part of my son-a-session in that preoperative flow state and free routine. So really, I think really applicable things there for your peak performance as well. Sitting in front of a red light can change a lot of your physiology. It can change your neurocognition potentially. Change is even people's mood. This is one of those applications to the central nervous system through the skull that we know that people's mood improves when we're talking about depressive symptoms and even anxiety and things like that. It can improve with red light therapy. And so we now have some of these mechanisms as to how that happening. The red light is penetrating through the skull to the neural tissue, to the brain tissue itself. So as we switch gears there, it gets into a little bit of, okay, so now we have some very cool mechanisms. We have some very obvious applications that we can get to improve our peak performance. And in my world, some very obvious applications that can improve my patient's surgical recovery or sometimes even their preparation coming into surgery. And this is what my entire practice is about. How can I be at my best? How can I make my patients at their best before surgery? And how can I have them recover better? And this is where your applications come out of this as well because you will be able to pull parts of this out if you're recovering from any surgery. It does not have to be a facial surgery like I'm doing. Red light can be beneficial to your surgical recovery. Strong evidence to back that up and a lot of interesting and cool theoretical mechanisms to it as well. And if you are in your normal life, red light can improve your performance. It can improve your neural cognition. This has been especially important lately with the way that our, I'm going to call it, light diet has changed overall. And what I'm really referring to there is, if we really get back into human evolution, we only had one real light source at first. And that was the sun, which is the broadest spectrum, which contains a lot of longer wavelengths of light, a lot of red and near infrared light, especially around dawn and especially around dusk. Those are key areas and key times for us to be exposed to the sun, interestingly. In the middle of the day when the sun is a little bit more vertical, we tend to get a higher penetration of these more energetic wavelengths. Remember, that's the blue light wavelengths. And that's the ultraviolet wavelength. So it was really interesting at this meeting that I was talking about if we go back to the very beginning when I'm hearing red light be explained and show really strong data and really cool immunofluorescence of cells changing when they're exposed to red light. One of the undertones that came out of this, one of the people talking was a dermatologist. And maybe for the first time ever in my life, I heard them at least hint at the fact that the sun is good for us. And in the world of dermatology, specifically, I laugh a little bit because this tends to be a group that really is hiding from the sun and encouraging their patients to hide from the sun. And I don't blame them for that because they are seeing a lot, a sampling error, maybe of a lot of really bad things that can happen to our skin because of the sun. But it's these very specific wavelengths that are doing that, the UVA, the UVB and the UV C wavelengths, these ultraviolet wavelengths are changing our DNA and causing skin cancer and causing photoaging unquestionably. So while I may personally be an advocate of getting sun, especially early in the morning and late at night when it's a predominance of longer wavelengths of red light and near for a light, I still will fit in this middle section where there's no question that the sun also can have aging effects on us and it can cause skin cancer or at least be linked to avenues of skin cancer and that's going to be in those higher energetic wavelengths in the middle of the day. So that's getting into a little bit of a dermatologist on the podium at a major medical meeting hinting at the fact that these longer wavelengths of light are good for us. So the sun is the ultimate light source for us, right? And we are very sensitive to what the sun tells us. We have very specific photo receptors in our retina and their melanopsin receptors are called and their only job is to communicate with our brain basically what time of day it is based off of the light wavelengths that is getting. And this affects all different parts of our physiology, even our cortisol responses and cortisol gets this bad rapist's stress hormone, but it's also really important for us to be activated and get stuff done. So our eyes are paying attention to what wavelengths of light they're getting from the sun, presumably to our eyes. And it's telling us when our cortisol level should naturally rise and fall, really, really, really important stuff coming from what wavelength of light we're getting on our eyes and at what intensity that is happening. So when we think about the sun as kind of probably what we are built to utilize as information and what we're built to fuel ourselves and how our brain knows what to do at what time of day, the next kind of wavelength of light that would come along would come from fires, right? And the fires are also very similar. They have a very smooth spectrum to the wavelengths of light they admit and it tends to be very heavy on the longer wavelengths of red and near infrared light. And you can imagine how important to us fire was in our development as humans as well. And one important, I think, avenue to pull out of here, one important thing that is well, that is that we're going to have to get back to evidence back is when we get these wavelengths of light is important, the time of day is important is what I'm saying. Earlier in the morning, we are certainly more primed to be sensitive to the wavelengths of light that we're getting. So getting red light or seeing the sun rise with these long natural wavelengths is really important earlier in the day before noon, let's call it. What wavelengths of light we're getting, how they're communicating with our physiology, with our brain, kind of what to do and how to set up for the day. It's not that we don't have any reaction to them later in the evening, but we tend to be less sensitive to those signals when we're talking about things later in the evening. So as we get into red light therapy devices, how to use them, I'm prefacing this right now saying that the time of day matters, it's better to get those longer wavelengths earlier in the day. So that's sort of an interesting point to pull out of this and we're thinking about sunlight when we think about fire or candle light are even getting into incandescent bulbs, which are largely not in existence anymore. Incandescent bulbs have a very similar type of emittance or spectrum to what a fire would have, which is a very smooth wavelength of the heavy predominance on red wavelengths and longer wavelengths. The types of lights that we predominantly see now are LED lights, light emitting diodes and light emitting diodes are quite amazing because they can produce a lot of light very efficiently, meaning very low energy to produce light. The issue with this is that the LED lights tend to be very much on the blue spectrum. Like when you see a really white LED light, that is heavy, heavy, heavy on these short, rare energy wavelengths, very much on the blue spectrum and very low to none on the long wavelength red light ends and infrared ends. So we're starting to change the nutrition of the light we're getting, the spectrums that we're getting to these really short wavelengths and it tends to be instead of this nice, smooth emittance, it's very spiky when you look at the wavelengths in there. So basically a non-natural light. It's, if we really want to get into the analogy, it's almost like the highly processed, highly palatable packaged foods of light. It's efficient, it's fast, it's easy, but it certainly is not good for us. And we start to see that more and more. Dr. Jeffrey, who I mentioned before, you know, had a very interesting statement when he was talking about experts in the field of light photobiology, let's call it, talking about how LEDs are affecting us as humans and our overall health. And I think you made a very bold statement saying that it's somewhere on the order of, or in the same realm of the public health crisis as bestos was. So that like raises an eyebrow and at least makes you think really heavily around what we're getting from a nutritional standpoint and the balance with what we're getting on the other end, meaning how much blue light, spiky, high energetic blue light we're getting versus how much of the smooth spectrum long wavelengths red and near infrared light we're getting, which is very, very low now because we tend to be inside under LED lights a lot more than we are outside in natural light. So you may have heard about walking outside, getting light on cloudy days. It's how important that still is for you. And this is where it really comes in is balancing all the LED and blue lights that we're under. So some balance in your diet of light here is very, very important. We don't want only junk light junk food. We want healthy things as well. And this is where red light and red light devices can really come into your life right here. So we'll just start this by saying that when we're talking about red light devices, you really need to decide what your individual goals are. What are we after here? Are we after an anti-aging type of protocol? Are we after something that's more systemic in its benefits, although we know that there's an overlap with all of those anyway? What's your budget? Where is this light going to live? How much are you going to use it depending on what it's set for? If it's something that you can take with you and you're going to use it a lot more, it might be better to have a smaller device than a large panel that you're never going to use. If you're really focused on your anti-aging, that's where things like masks can come in. And if you're in more of a clinical setting like I am, that's where something like a full red light bed can be really beneficial because you can get a lot of red light exposure very efficiently in a shorter amount of time with a really optimal delivery, but those devices tend to be very expensive and quite limiting from even a space standpoint depending if you're not in a clinical setting. So, we really need to decide what your goals are. What do you after? Once we have some direction there, we start looking at, "Okay, what's the quality of the actual device I'm getting?" And this is where we get into what wavelengths of light these LEDs are releasing in the device that you have. And I'm back to that LED word, which I just sort of just said, these light emitting diodes when we're talking about overhead lights tend to be sort of junk light. Well, those are spiky blue, which is, you know, this idea of this clean white light from an overhead light, that's in this like junk light LED spectrum. LEDs can also, the beautiful part of them, is they can emit wavelengths all over and some really high quality LEDs can get into the red, red ratio or into the red wavelengths and they can release it over, they can be smoother. But these tend to be let's call them really high quality LEDs, high quality meaning the wavelengths that they put out, and then the irradiance or the energy that they put out. And we want to make sure that that irradiance is as advertised that it's consistent over time and that it's consistent from LED to LED. So if I were to really get into a nutshell here is there are very few manufacturers of high quality LEDs for red lights. And so you'll find that the brand qualities tend to cluster together, meaning the brands that are getting the LEDs from the same places tend to cluster in their quality. You can use something called a spectrophotometer. I have one of these. Next to my bed, I have my EMF meter and my spectrophotometer. So I'm literally using this to test the red lights. I got it originally to test the red lights that I was using on my patients because there's some very specific wavelengths that I want for very specific purposes, meaning like if I'm trying to treat their incisions for scars versus a hair wavelength that you might find in a helmet or something like that, that can be a little bit different. So I have a spectrophotometer and I use it on every device that I apply to my patients and to myself to look at what is the wavelength of light that's actually being produced? Is it as advertised? And then what is the irradiance? What's the energy of that light coming out? How does it change as the device is on for a long time? How does it change as the light changes temperature? And this is really important for me personally because I have red lights inside of my sauna, a lot of red lights inside of my sauna. And I want to know from different parts of the device, if I'm getting sort of equal readings all over. And so what I have found, and a lot of people have very similar experiences with this, and let's call it like third party testing, is that a lot of the LEDs are relatively accurate in the wavelengths that they state they're producing. So whatever they say, they're putting out and whatever that sort of peak, it's usually as the peak of a curve. So if it's 860 nanometers, it's also going to have 861 and 859 and kind of on down the curve, but the peaks at 860 say. That would be an example of a near infrared light type of spectrum or even lower, let's say a 10. But the point is that there is a curve to that. And the spectrophotometer show that those are relatively accurate and as advertised. What changes is the irradiance, the energy. And that is where you're going to get the most variation in your red lights. And I have personally found that almost LED to LED inside of these devices when I've had, say maybe cheaper devices, it's not necessarily the overall output isn't great. It's that there's such variation, almost like hotspots as you go throughout it. So I found some great devices from different companies that are very spot on to what they advertise. And I think that's important to know because when you get into how to use these devices in the protocols, it's really best to follow what the manufacturer is telling you. And what I mean by that is if they're saying to be a certain distance away, it's often pretty close to the device, which is really important to know when we're thinking about applications, that the closer you are, the more that energy is going to work. And if they're telling you to be three inches away or six centimeters away for 15 minutes, that's a really good protocol to follow because we do have to remember that red light is a whoremedic dose, meaning it is a small stress that at low dose is really beneficial. This would be like exercise or the sauna at low doses, those whoremedic stressors are very good for us. They make us stronger. But at high doses, they can be toxic. And this is what the whoremedic part comes in is that low dose is good at higher doses, they can be less beneficial. And red light certainly follows this at low dose. It's good at medium dose, it starts to get questionable and it really high dose, it can be cytotoxic, which means killing cells toxic to ourselves. So it doesn't always mean I'm certainly guilty of this in many areas of my life, including red light where I get into if it's worth doing, it's worth overdoing. But that's not necessarily what you want with red light because really high dose can be cytotoxic, like higher doses than you necessarily should be getting according to manufacturer's recommendations are not necessarily better. But that's really dependent on is the device producing what it says it's producing. So when you have a reliable device that gives you good parameters, my suggestion is to follow the parameters of that particular manufacturer for that specific device. A panel might be different than a mask, etc. On down the line. So I think that those are really, really important things to know about the LEDs, how to find quality LEDs. I would guess that most of your influencers out there who are supporting a brand are not using a spectrophotometer on their devices to do it. I use actually different brands for different applications. And when you hear me talk about those, I am not getting paid by any of those companies for any of those things. I'm quite literally just telling you guys what I'm using when you ask. The devices that I use are all LED based, those light emitting diodes, which again is like different wavelengths mixed together. You will also see red light lasers. Back to the very beginning, laser is a very specific by definition, a single wavelength of light that gets produced. And that single wavelength is amplified. Laser is actually an acronym for light amplification by stimulated emission of radiation, L-A-S-E-R. So you have an amplification of the single wavelength of light. And I would just tell you there are lasers for at home use in the red light spectrum, meaning the single wavelength that it produces is in the red light spectrum. And I would just say, I do not think that any home laser device is a good option or good choice. I think lasers should be reserved for very specific purposes by professionals, people who know what they're doing with them. So I would just say to stick to the LED based devices and to look for those high quality parameters within there. And then in the follow the directions as to what you're doing. When we get into, do you have a small panel, a big panel, the face mask, whatever it would maybe, I would say again, find that application that's right for you. Something like a face mask is I have and use and my family uses it. I even put it on my kids. I like something like a face mask because it's portable, which means like quite literally last night I was reading in bed wearing my red light face mask before bed. I take mine has some like eye protectors that I take out because I want some of that red light on my retina for reasons explained earlier. Now that is different. So when I talk about this, we have to be really careful. This is not medical advice by any means to put red light on your retina. That is not what I'm saying here. You do not want to be staring at a strong LED from too close. But what I am saying is that just like I described earlier, backed by the medical literature, red light hitting your retina can be really helpful for it. So you also don't need to vehemently avoid it. Even just closing your eyes in front of a red light source, you are going to get red light on your retina. Just like it penetrates through your calvarium through your skull, the bone of your skull, it's going to penetrate through your eyelids as well. So if you're looking at something and it's too bright, you can put goggles on. You can close your eyes. You do not want it to be overly intense, but you also don't need to be overly afraid of getting less energetic red light on your eyes. Like I was talking about the idea of a little red light flash light. Those are actually quite low energy that showed the ability to differentiate color better afterwards. It doesn't have to be highly energetic. So something like a mask is portable. You can wear it around while you're doing stuff. But while you're reading, whatever it may be, it can get a little bit in your eyes if you want as well. And it's a direct application to your skin of your face. So if anti-aging is one of your benefits or your main thing, a mask is probably a great idea. You also know that you're going to get an overall metabolic and physiologic benefit. When I wore my mask last night reading, my insulin sensitivity was better. Fantastic. So that's a great option for it. Something like a big panel is going to be a little bit more powerful. And it's going to be a larger body surface area. So this is where you get into shining red light in all different parts of your organs. Penetrate's quite deep as we just talked about. So if you want benefits sort of all over, you can stand in front of a red light panel. You can put your face in front of a red light panel too. The downsides of that is that the panels tend to be a little bit more expensive. They take up a little bit more space in your living area or wherever you have them. And they're not as portable. I mean, you're sort of anchored to that position. And again, I would just tell you, that's not all bad. If you're going to follow along with me, you know that I'm very much into being present, being mindful, breathwork, breathing exercises, even just a gratitude practice. These are all things you can do in front of your red light while you're getting the physiologic benefit of the red light itself. You can journal in front of it. You can do it every one like I said. I was reading with mine last night. So a panel is not all bad and I might argue for if you think you don't have the time to do a panel, you're probably the one I challenge to. You should probably get a panel because if you don't think you have the time to, you know, do 15 minutes for your health, you know, a few times a week, you're probably the one who needs it the most. So panels can be really great in that. I personally have panels, a red light face mask, even the compression boots that I use. Let's work out, have red light in them. The ones I use on my patients in the operating room have red light in them. So I get to actively treat my patients with red light while I'm operating on them. So I get to improve their physiology while I'm operating on them with their compression boots, something we regularly use in surgery to keep blood flowing in the legs anyway. But I also have panels inside of my sauna, which is very unique. And it's part of my quest for peak performance because I'm often in the sauna. I like being in there. It's an incredible, I call it my red light sanctuary. And I'm usually naked when I'm in there. So I'm getting a lot of the exposure from that. It makes it a very, very special way to do it. So I would also say if you're into your sauna, that red light is a great option to consider inside of your sauna itself. You just have to really think about what the sauna parameters are, how hot it gets, how the red lights are going to perform in that heat. The ones that I have, I've tested them with my spectrophotometer at all the different temperatures, all the way up to almost 100 degrees Celsius. And they can still produce sort of as advertised levels of, levels of radiance and the wavelengths that they're at. So I will also talk about sort of the ability of light to pulse. And this gets a little bit into the nuance and the weeds of the devices themselves. But there is some evidence in various forms of medical application showing that if the light pulses from the red light LED, now pulsing, in an overhead LED can be actually detrimental to us when we're talking about blue light. But when we're talking about red light, some of the pulsing can have more of a metabolic and physiologic benefit and it's interaction with the mitochondria. And there's some theories as to why that happens. And so you'll see this often as we compare red light and blue light. A lot of things that red light shows benefit for, blue light is inhibitory of. So I think it's a really interesting bit when we start talking about the balance of how these things work and why getting red light, long wavelength light, near infrared light is so important because it can balance some of the negative effects. We talked about asbestos, essentially being on the same level. The question that's unanswered and remains is, well, can a deliberate exposure to red light offset some of those major potential consequences that LEDs are having on us from a public health perspective? So I have a lot of information I'm throwing at you there from what type of devices, how to choose them, how to use them, what the medical applications are. There's a lot in there, but I just think my overall take home advice is that our light diet has changed. In our quest and my quest for peak performance, knowing about the type of light that I'm getting, knowing what type of, what time of day I'm getting it, how that exposure is affecting me overall. And how I'm applying it to being ready versus recovering, a quick example of that is I have a system in my home that we would call circadian friendly lighting. It changes temperature throughout the day, meaning in the evening my house looks essentially like it's fire light inside. It's very orange and red and it follows the natural patterns of the sun. But I live in the Pacific Northwest. And that means right now, it's winter time as I'm recording this. When I wake up in the morning and I'm getting ready for surgery, there is no light. I have nothing available to me. So I have a light protocol that I do that includes a 10,000 lux light that's very full spectrum that I'm using. The light in my home is activated differently on a surgical day than it is on a recovery day. So I have, you know, we talked about those melanopsin receptors earlier that are turning on my cortisol response via how my eyes are communicating with my brain about what time it is, what time of day it is. So I'm leveraging that on my surgical days to be at peak performance and surgery based off the light diet that I'm getting. The wavelengths, the intensities and the timing. And I'm balancing all of that with my red light exposure that I'm getting before surgery, which may enhance my neurocognition for the surgery itself. But definitely helps to balance me out through the day and give me all those physiologic benefits offsetting all the blue light that I'm getting throughout the day. Even when I'm in the operating room as well, when I'm very intensely focused on what I'm doing with operating room lights that are LEDs. That's a whole nother topic of discussion, how I select the lighting in my clinic and in my operating room in addition to how I selected in my home. But I just want all of that to be information for you and your quest for peak performance for you and your family. All the things I talked about here, I'm using with my kids as well. They know about red light. They know about junk blue light. And they're aware. So even this morning, as I'm in the sauna with my red light on, my children are filtering in there with me, which is great quality time with them. But they're also getting the benefits of red light and they know it. They know the basics. They know why. They're not just doing it to do it. They see me do it and they have some understanding as to the balance of it as well. We turn fires on in our home at night. We try to be out early in the morning. We try to be out at sunset outside walking, controlling our blood glucose levels via our insulin sensitivity. And this just fits so beautifully into that family time as well. So I hope that you get to take that information. You get to apply it to your life. If you have any questions on red light, on devices, I just encourage you to leave me questions in the comments. We will look at those. We will answer them. I will point you in the best directions that I can. And I wish you the best on your quest for your peak performance. If you have any questions or topics you would like me to explore further, please leave them in the comments. I read them all and they often help shape the future conversations here. If you would like to learn more about my surgical practice, you can visit clinic5c.com where you will find additional information on my approach to surgery, recovery, and performance focus care. I also want to be clear that the views shared on this podcast are my own and are not associated with or representative of my clinical teaching affiliation with the University of Washington School of Medicine. Nor should this be taken as individual medical advice. Thank you for spending your time with me. I appreciate you being here and I will see you on the next episode.