Can Red Light Therapy Reduce Signs of Aging

On today's episode of AP Class, we're breaking down the evidence behind a fan favorite, red light therapy. From LED masks to luxury wellness studios, red light therapy has completely taken over the beauty and longevity space. But as providers, we wanted to know, is there actually evidence behind this, or is this a trend wrapped in really good marketing? So today we're diving into a randomized split-face study that compared amber light and red light therapy to determine if these truly improved wrinkles and signs of aging. We'll break down the science, the study, and the clinical outcomes, plus what this means for patients who are trying to decide if purchasing these devices are worth the investment. 

Episode participants:
Radiance Wellness | https://www.instagram.com/radiance.well/
Megan Ucich | https://www.instagram.com/the.skin.practitioner/
Aayesha Patel | https://www.instagram.com/aaestheticsbyaayesha/
Sarah Pertschuk | https://www.instagram.com/beautyinjectorsarah/

Episode show notes / blog: Link

Disclaimers & disclosures: https://radiance-well.com/privacy-policy

Transcript

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So getting into the results, both red and amber LED light showed statistically significant changes and it reduced the wrinkle volume in the periocular area by 30%. And I freaking love that result because this shows us that it really works. You can add this red light therapy as your 11th step in your regimen. Shake it. Yes. you know, shake, vibration plate, red light. It's It's working. It's working. And so that's really significant for a non-invasive low energy treatment. Totally. Welcome to AP Class, your virtual journal club for all things aesthetic medicine. Created by injectors for injectors. This is where we take a clear evidence-first look at the research shaping modern aesthetics. Each episode, we'll unpack a study. What's solid? What's questionable? And how the evidence informs natural, refined results in real practice. Class is now in session. On today's episode, we're breaking down the evidence behind a fan favorite, red light therapy. From LED masks to luxury wellness studios, red light therapy has completely taken over the beauty and longevity space. But as providers, we wanted to know, is there actually evidence behind this, or is this a trend wrapped in really good marketing? So today we're diving into a randomized split-face study that compared amber light and red light therapy to determine if these truly improved wrinkles and signs of aging. We'll break down the science, the study, and the clinical outcomes, plus what this means for patients who are trying to decide if purchasing these devices are worth the investment. Class is now in session. Hello. Hi. Hi. Welcome back. This is our fifth episode. No, no. Fifth. I thought it was the fourth. Okay. Wait, wait, wait, wait, wait, wait, wait, wait. The first one we broke down a research study. The second one, Stanford study. BBL microneedling. Microneedling. The mid cheek. Oh my god. The mid cheek. Number five. Wow. Okay, we're flying. I love this for us. Yay. Um, what's new? Not that you know we don't see each other every day. Oh my god, that was so quirky. Um, yeah. Nothing's new with me. What about you, Sarah? Um, not a lot. I mean, we've been having really great time in clinic. type thing. Doing a lot of we did a BBL basically a seminar workshop yesterday which was really interesting. Learned a lot there. Yeah, we have an Allergan training next week. Lots of AP Class episodes. I know um LAMCA just happened in LA. Oh yeah, last weekend. We didn't go to that, but um we need to look into the conferences, figure out what we want to go to next. Yes. Um, it's on our to-do list. Yeah. One thing I wanted to shout out, I know you and I were talking about this, but Open Evidence. So, for any listeners that are providers that want access to more like research in an AI format, Open Evidence is freaking awesome. Yeah. Yeah. Highly recommend. So good. I mean, I probably shouldn't say this on online, but I recently had to take my recertification exam, and it's open book. It's open book, guys. And that thing saved me. It saved me. It's so good. It's so good. Yeah. And when my kids had norovirus two weeks ago, I was like, "Okay, here is my clinical scenario." Oh, wow. Two-and-a-half year-old, she weighs this much, like vomiting for six days. It's like, "Okay, what's her skin turgor? Take a look at her mucous membranes." I'm like, "Oh my god." Okay. Yes. I'm like back in practice. Well, I remember like a few weeks ago, you texted us, "Hey, how do I figure out the amoxicillin dose for ear infection?" And I literally looked it up online, tried to calculate it, and I couldn't get the answer. So, if Open Evidence gives you the answer to those things, that's great. Open Evidence is like UpToDate on steroids. Oh, that's amazing. Which like UpToDate, I think we all have used as clinicians. Yeah. But it's really it's super expensive. So anyone who wants Open Evidence, I think you have to be a provider because you have to put in an NPI number. Um but it's free. That's incredible. And it pulls all of the latest research. So yeah, that's amazing. We love that. Anyways, let's get into it. Okay, episode number five. For those of you that don't know me, I am Megan Ucich, family nurse practitioner. I'm Aayesha Patel, physician associate. and I'm Sarah Pertschuk, physician associate. We are the providers at Radiance Wellness and we are here bringing you AP class. So on today's episode, we're diving into a study on photobiomodulation. The title of the study is called photobiomodulation reduces preocular wrinkle volume by 30% a randomized control trial. So that's a big word. It may sound foreign, but it's actually something that is found in many households. It is a type of light therapy and in particular most people know that as red light therapy. Photobiomodulation is just the big fancy scientific term for that. Um but we all know the claims that red light therapy or any type of of light therapy is great for the skin. We see it everywhere. But this study in particular was taking a look at two different types. So red light versus amber or yellow light. comparing those to see are there any changes in the skin and in signs of aging. Yeah. And we all know that there's like a huge hype right now on LED lights. Like there's face masks masks and like whole body contraptions. And we get patients in all the time and they're like, "So, should I get this? Like, is it worth it? What is it going to do?" And to be honest, like I didn't know what the correct scientific answer was there. Um, we know that we use them in practice with our treatments, facials, providers are using them, patients are using them at home, but we didn't know what the scientific answer of what's going on there. Um, well, I at least didn't. So, it was nice to kind of get into the study and learn the actual quantified outcomes of what LED therapy can do. Mhm. Yeah. It really reminds me of that reel on Instagram and Tik Tok right now of that girl. She's on her shake plate. She's got her red light mask on, her Stanley cup, the red wand, the red hair wand, and you know the weights on her wrist, every contraption that's out there. And I really want to know is this something that we are recommending to add one more thing into people's nighttime regimens. Yeah. That 11th step into your skin. Exactly. Do we need this one? Yeah. So the interesting part about this study was it compared the two wavelengths directly. So we know generally that red light is for anti-aging and amber light is for rejuvenation. And this study was great because it determined if there was a statistical significance between the difference between the red light and the amber light when all other variables are controlled which we haven't really seen. I think just to back up real quick because when we were reading the study and I was doing a little bit of research on it too, I wanted to know like okay well what is it about red light therapy? Like what is it actually doing to the skin? So bear with me here, but red light is absorbed by mitochondrial cytochrome C oxidase, which sounds really complicated, but it's not. It's within the cells of our skin in the powerhouse. We're joking around. Mitochondria, the powerhouse of the cell. Yes, that's like the one thing that everyone can remember from science. If you don't remember that from microbiology, are you even a mid-level provider? I don't know. Um but so that basically triggers this cascade of cellular effects. It increases ATP. All right? So that's the energy currency of the cell. We know that it increases collagen synthesis. It decreases collagen breakdown. It stimulates fibroblast. We know that stimulating fibroblast increases collagen. And then it modulates reactive oxygen species and inflammation. So think of your reactive oxygen species as like your anaerobic bacteria or acne. Um inflammation in the skin. So those are all of the things that we know it's benefiting and we see that people know that when they do red light masks they they tend to see um improvements in acne or inflammation. Yeah. So this is great because it translates directly into how we can talk to our patients and what we can recommend that they buy if they if we do recommend that they get one of these red light masks or boards. Yeah. Yeah. I was ready to throw down like three grand on a on a panel. So, I definitely this study was really helpful. Like, okay, it's worth it. I don't think Greg, you guys, don't give it away. Don't tell Greg. Don't tell Greg. Oh gosh, it's not three grand. It's like 300. Okay, so before we jump into it, let's just quickly go over hierarchy of evidence. So, where does this land in all of our research? So, this is a level-two study. So, if we think about that pyramid at the top, we have our level one, systematic reviews, randomized control trials. Um, level two is our our lower quality RCTs. This is going to land there and we'll explain why, but so usually there's some limitations in the methodology to make it a level two or it's happening just in like one center, a single study. Um, and then level three cohort studies, case control, level four case studies, case reports, level five expert opinion. So we're up there. This was a pretty solid study. This was a good one. Um the population that they picked. So it included women aged 40 to 65 years old that had moderate um signs of photoagging. So that's visible wrinkles, skin laxity, pretty relative to the patients that we see in practice. They had 137 participants. Only 83 completed the trial and we'll get into that later. But none the none the none the so is that even a word? None the so no that's not a word. Oh yeah, but I like it. Roll with it. Let's hear it. Whatever that means. Um, nevertheless, nevertheless, nevertheless. Nonetheless, so nevertheless. I don't know where that goes. Nevertheless, it was still a controlled group. So they excluded anyone that had uncontrolled thyroid disorders, skin pathologies, recent aesthetic treatments, anyone that's pregnant or breastfeeding, um anyone that's using retinoic acid or photosynthesizing medications, or anyone with significant facial asymmetries. One thing to keep in mind, yeah, they didn't have anyone using retinoic acid, but a lot of our patients do use it or they should be using it. And it isn't a true contraindication. So, you can still use your retinoids and still use your LED masks at home at the same time, but one thing is to keep in mind, you don't want to use something so thick or olusive that's going to block that absorption of that LED light. So, you're not going to put on something super thick and creamy, right, before putting on your LED mask, right? Yeah. That had me, of course, going down a rabbit hole like, what can you put on your skin before your LED mask? And you really can use pretty much everything. And and like you mentioned, these were just to control for variables in the study because if someone's on a retinol, then maybe they have an improvement in something, right? Yeah. So, um, and it and I think just for people to understand that retinoic acid and Sarah, you were mentioning this too, like it doesn't the LED red light doesn't absorb or doesn't give off that UVB radiation, which is what is photosensitizing. Yeah. So using a retinol, using photosensitizing medications has no effect on red light and what it does to the skin. Yeah. Cool. So they also limited the study to Fitzpatrick scale level two through four. And the I always want to say Grogu from Mandalorian, but it's Glogau. The Glogau photo. Yeah. the the Glogau Scale two through four as well. So for the Fitzpatrick scale, we're not seeing how the red light works on anybody that's really dark or anybody that's really fair. And for the Glogau Scale, we're not seeing anybody at a one. So those are people that don't have a lot of wrinkles in general, but we are seeing two through four. And four is the top of the Glogau Scale. they do have more photoaging and wrinkles at rest. So yeah, so that scale basically is one through four. One is like your 20 to 30 year olds. They don't really have a lot of signs of aging, right? Your scale two or type two is your 30 to 40 year olds and those are your patients with um wrinkles kind of getting there. Not yet like with movement. With movement I think type three. Yeah, type two is wrinkles in movement. Type three is wrinkles at rest. So that's your 50 through 60 year olds. And then type four is just your severe wrinkled changes in skin color. Yep. Yep. Yeah. Um so going into a little bit of the intervention, this is one of the biggest strengths in this study. It's a splitfaced randomized control trial. And we talked about this in our last episode with microneedling. That's really a gold standard in dermatology and when you're when you're looking at skin to be able to use one face and split it because our skin is going to be different and will react differently. So to be able to split face your own does that make sense? Face your own face. Split face your own face. Split your own face in half and test it on both sides is really the best way to kind of control for other variables as well. The other thing they did is all of these patients had to wear goggles. So that they couldn't see, okay, what side is red, what side is amber when they were having treatment, too. Yeah. So, this study design is like our favorite in aesthetics because you can't it's hard to compare patient outcomes between two different patients and it is in one patient. You're eliminating that genetic factor, their lifestyle, their skin care habits. It's just one person, same skin. Um, in this study, they're using um identical energy. So both LEDs identical energy, same duration, same number of sessions, just different wavelengths. So the amber LED was at 590 nanome and red LED was 660 nanome, but their light dose parameters were the same. So 3.8 jewels or fluence and 6.4 mills of irradiance, and it was at a 10-minute session. Mhm. So to get into like the fluence and the irradiance, the metaphor I like to use is watering a plant. So irradiance is how fast that water is coming out of a hose or how hard that light is touching the skin. Um and then your fluence is how much water that plant is actually absorbing. So your water out of the hose can be super intense and super hard and you can have it for a shorter period of time and you can still have the same amount of water if your hose was coming out slowly for a longer period of time. So it's kind of you would originally think like okay get in there go hard faster. Yeah. More results more is better. Yeah. But it's like with microneedling where people's initial thought was,"Oh, it needs to be like bloody red, go hard, go deep." And actually, you can really tip the skin by doing too much or tip the water bucket. Tip the water bucket. There you go. Okay. So, I did really like the way that this study was laid out. They did 10 sessions of the red light therapy or the amber light therapy. Well, actually both since it's split face. And they did it over four weeks and they had people come in two to three times a week and do it for about 10 minutes, which is totally reasonable and super applicable to real life. I love that. Yeah, me too. Yeah. They actually found that if they did it every day that it didn't work as well as if they did it two to three times a week. And if they made it stronger, it also didn't work as well as making it a little bit lower. So, like you were saying with the plant, if you have your hose spraying really strong water, that can damage the plant. Exactly. And if you just kind of have it sprinkling the plant over time, you can I don't know, it collects more water and grows. It grows. This feels so much more attainable. Like when I read that, I was like, "Yes, because everything in my brain is like it has to be every day or nothing." You guys know like I barely take my supplements on a regular day like drinking water. But so to be able to do this two to three times a week for 10 minutes, I'm like, damn, that's I can do that. That's manageable. And I think for patients too to know this doesn't have to be every day. It doesn't need to be an hour of your time. It's 10 minutes, right? Yeah. So really applicable. And then as far as the outcomes go, the primary endpoint in this study was wrinkle volume in the periocular area. Mh. The way they found it was they measured it with imaging. So it wasn't up to the doctor's assessment or the patient's perception. Yeah. Or questionnaire. It was measurable and quantifiable because of that imaging. The Visioscan. The Visioscan which is well known and very detailed. Yeah. So that was really that really made this a more significant study in my mind because some of the other studies we've done like the microneedling one which was also split-face was more on patient perception and the doctor's eye. Yeah. And there's a place for both, right? Qualitative and quantitative measurements. But for sure in science and in medicine we need to see more of those quantitative measurements and have those objective findings. Um and so the secondary outcomes were some of those things that we kind of talk about with patients hydration, elasticity and quality of life. So quality of life is going to be of course a survey study that or a survey finding. Um so not just do the wrinkles improve but does the skin behave any differently? Are we seeing changes in hydration or elasticity? And then more importantly, what does this mean for patients? Because sometimes even our clinical outcomes, although they may seem big or small to us, to a patient really that's what matters. Like are they feeling a difference in their quality of life based on what we're doing? At the end of the day, that's the most important part. So getting into the results, both red and amber LED light showed statistically significant changes and it reduced the wrinkle volume in the periocular area by 30%. And I freaking love that result because this shows us that it really works. You can add this red light therapy as your 11th step in your regimen. Shake it. Yes. you know, shake, vibration plate, red light. It's It's working. It's working. And so that's really significant for a non-invasive, low energy treatment. Totally. I wasn't expecting such a huge percentage. Um, but if you look closer, the difference between the red and the amber wasn't that big. So, they both did a great job. Um, red light had a 31.6% reduction in wrinkles and amber had 29.9%. So very close. So statistically the red light did perform better, but clinically they were both very small in difference where patients or even us providers wouldn't be able to notice. So I think the key point is that they both work great. Um and it's something that's worth adding and very effective. And I think that's helpful too because amber light is not as available to people. A lot of people, even myself honestly, I was like amber light or yellow light. Red light is obviously more common. And so to be able to show also like red light is just as effective if not more in certain instances. Yeah. So then the other um kind of surprising finding I think we were all thinking, oh yeah, for sure we'll see a change in hydration. There wasn't. If anything, there was a little bit of a decrease in hydration, which take that with a grain of salt, right? Like that doesn't necessarily mean it's not working. It's just within this study they didn't see um a change in hydration. There are actually other studies. There was one more recently purchased. There was one uh more recently um published that looked at near infrared light and hydration status and did find clinically statistically significant changes in hydration for the better. So, and that also is helpful because most devices at home have red light and infrared light kind of built into it. So, that's good to know. You may be, of course, we're not diving into those studies here, but there are ones that will show changes in hydration, too. Weren't you telling me that there's a new Pilates studio that has improved? That would be so much more motivating to like go to class. I'm like, "All right, I can out and shout out to Red Lagree down the street." We need to do a group session there. It's all about habit stacking. You know, you got to do them together. That's how you get them done. Is that how you view taking your supplements as well? I don't have anything to have to stack. Drinking water. That might be a good idea, right? You know, do as I say, not as I do. So the other thing that was measured was elasticity and unfortunately and sadly for me and maybe other people elasticity did not seem to improve. So that was kind of a bummer but it is good for us to be able to discuss with our patients who are coming in wanting a lift or a tightening look. Red light is not going to get you those results but maybe with other treatments as well we can get there over time. Okay. Um and then as you mentioned earlier, both groups did have improvement in quality of quality of life, which I think is really valuable. You know, modest improvements in wrinkles is really encouraging to know that patients feel better about their appearance even with just just a small change. And that's like a big part of aesthetics. Like, yeah, objective changes do matter and that's important. But I think patient perception is also just as important. Yeah. And feeling more confident and helping them with their self-esteem. I mean, that's one of the biggest reasons why I think we all do this. Yeah. Absolutely. For sure. Yeah. So, let's quickly get into limitations. Yeah. So, there's one of the biggest limitations was that about 40% of the participants dropped out of the study. Yeah. Yeah. Bummer. I'm like, where did you go? Why? I guess it just they didn't see, you know, significant reasons to stay, but they also didn't get to the end of the study, so how are they going to know? I'm not sure what happened there, but um that can definitely introduce bias um and affect how reliable the results are, which we found in other areas of this study as well. And they also only measured it for about 4 weeks after the study. And as we know, collagen remodeling starts at about 21 days. So they probably did weren't able to measure, you know, all of the potential changes of the skin over time. So there was probably measurable changes that were taking place at the where they stopped measuring and continuing on. So that would be nice to know in the future how long how durable are these results? How long are they lasting? How long should we be continuing red light therapy? I mean we always say everything is forever, but I mean it would be nice to know some longer measurements. Yeah. Yeah. My guess with the dropout rate, you know, if I'm traveling somewhere to put a light on my face for 10 minutes, I can't take my supplements and drink water. I'm probably not getting there. who I mean we don't know the details of like how they found these participants but if they weren't like within the building right I can imagine getting someone to commute 30 minutes to do this for 10 minutes I don't know if it was a laser like free Botox I'm driving an hour let's go um but you know and that's hard too because there are meaningful benefits from doing this but because it's so small and it takes time sometimes I wonder the people that dropped out, went back and looked at the results of these. I'm like, you did. Darn. Yeah. Another thing I was also wondering was if any of these people are driving, another limitation could be the left side of their face might have more photoaging and wrinkling. And so depending on what side they got the amber light or the red light on, that could be a difference. So I'm curious a little bit more about that. You just got to keep people in a bubble. I know. Or drive around like me with a shade down their window. There you go. Yeah. So, one other limitation that I thought was interesting, the elasticity data was incomplete. So, they said that for some reason they like lost the data or something happened. I don't know. So much potential. So much potential. So, you know, we didn't find any significant findings in the elasticity data, but that's also because we didn't have the whole story with all of that. So, I think we can't really draw a strong conclusion about elasticity just like we can about collagen remodeling because we don't have all of the information available to us. Um, and then one other thing is kind of what we talked about in the beginning, the population is a little bit narrow. So, only women, specific age range, limited skin types. Um, so to just to be careful not to overeneneralize that, you know, because of this study, everybody is going to see the same effect, right? Yeah. So I think the takeaway is that we can confidently tell patients that there was a there's statistically significant changes from this red light. Yeah. Yeah. Um I think the conversation now with our patients is that yes red light LED does work but it's best positioned as an adjunctive treatment and not your primary modality and anti-aging. So we can confidently offer it as like a broader treatment plan pairing it with our microneedling or facials, but it's not going to be your only thing to anti-aging. It's best when we pair it with our other treatments in office and you can optimize those results by doing your own homework at home. The one caveat to that being if you do have patients that are not candidates for injectable treatments or lasers, maybe they have impaired wound healing or severe systemic inflammation. This is something that's safe and effective for them to do. So I think that's helpful for people that are like, I can't do any of these things. Well, you you can do this. Yeah. And see changes. I thought too that you know is this study applicable to devices that you can purchase. So they studied 330 to 360 was the wavelength. No, 600's. So 630 or 660. So yeah, they use 660 nanometers and of course I did a peruse of like what's on the market in terms of red light therapy because I know we did a post on this too with Sam like not all red lights are created equal and part of that is you need to understand the wavelengths. So most commonly the wavelengths for red light are 630 to 660. So if a consumer is going out there are looking to buy one, if you're looking to throw throw down three grand on a panel, make sure your red light hits for sure 660 nanometers. But then the other things like the irradiance and the fluence are going to have an effect too. And to know that the most concentrated amount of that red light is coming from the center and a little bit less on the periphery. How close does it hit the face? All of those things are important. stand right up against it. Right up there. Yeah. So, I think a call out for patients to know, yes, red light works. Yes, you will see meaningful changes in wrinkle reduction. No, it doesn't really matter if it's amber or yellow light versus red light. They're both meaningful. Um, it's great for people with inflammation. It's great for people that can't do other types of aesthetic treatments. It for sure is an adjunct therapy. We use it in office as such as well. Yeah. And you can add it to the 11th step in your regimen while vibration plate. Let's go. Yep. And that also you don't have to do it every day. Yes. Two to three times a week. 10 minutes. 10 minutes. That's nothing. So along with your vitamins, you're going to add on your LED light to your commitment chart. Maybe I'm going to just do it here in office. Perfect. Then we can all benefit. I don't think that our patients would be phased if we walked in with a red light mask. They would be like, I respect that. That makes sense 100%. Yeah. Yeah. All right. Well, thank you guys all so much for joining us for our fifth episode of AP Class. We dove into photobiomodulation red light therapy. Um, and hopefully this was helpful for our listeners, whether you are a patient or provider. and know that you can go buy that machine. Go buy that red light mask. Use it. Drop that $3,000. Do it. It's worth it. All right, we will see you guys next time. Thanks so much. Bye. You've been listening to AP Class, your virtual journal club for all things aesthetic medicine. If you found today's episode helpful, like and subscribe, share it with a colleague, and join us next time as we break down more evidence that helps elevate your practice. Until then, class dismissed.