Photobiomodulation in Dermatology: Harnessing Light from Visible to Near Infrared

Main Article Content

Daniel Barolet, MD FRCPC

Abstract

Photobiomodulation (PBM), the therapeutic use of low intensity light, typically in the visible and infrared (IR) wavelengths, has been demonstrated to be efficacious in the treatment and prevention of numerous skin conditions. The PBM biological response begins with chromophores, photon accepting molecules which convert light into signals that can stimulate certain biological processes. Important chromophores initiating the PBM response are Cytochrome C Oxidase (CCO), with absorption peaks in the red and near IR wavelengths, opsins absorbing blue and green wavelengths and intracellular water acting at specific sites in the cell. PBM can activate cell signaling processes. The increase in electron transport, oxygen consumption, mitochondrial membrane potential, and ATP synthesis, particularly in hypoxic or stressed cells, can lead to the up-regulation of cell repair and survival pathways. In PBM, the light delivery parameters which maximize the therapeutic response are defined within specific ranges, with total fluence and irradiance being of particular importance. PBM emerges as a valuable complementary treatment modality in dermatology. In terms of tissue repair, wound healing is accelerated by PBM. Cutaneous wounds, erosive mucositis in oncology, leg ulcers, as well as burns and radiodermatitis all benefit from PBM treatment. Widely used to accelerate healing after aggressive aesthetic treatments, PBM reduces inflammation following treatments like skin resurfacing, vascular and benign pigmented lesions, or chemical peels. It has also been shown to be effective in treating dyspigmentation. In the case of hyperpigmentation, melanin synthesis is inhibited with IR light. Additionally, PBM has shown benefits in the treatment of acne, prevention and treatment of hypertrophic scars. It has shown promise in skin rejuvenation, the treatment of alopecia, cellulite, as well as other skin diseases. The discovery of new applications for PBM, already an effective form of treatment and prevention for many skin conditions, is continually expanding.

Keywords: Photobiomodulation, low-level laser therapy, LLLT, Laser, LED, Light emitting diode, chromophores, cytochrome c oxidase, clinical trials, treatment, complementary, skin, dermatology, cutaneous, phototherapy

Article Details

How to Cite
BAROLET, Daniel. Photobiomodulation in Dermatology: Harnessing Light from Visible to Near Infrared. Medical Research Archives, [S.l.], v. 6, n. 1, jan. 2018. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/1610>. Date accessed: 15 dec. 2024. doi: https://doi.org/10.18103/mra.v6i1.1610.
Section
Review Articles

References

1. Anders JJ, Lanzafame RJ, Arany PR. Low-Level Light/Laser Therapy Versus Photobiomodulation Therapy. Photomedicine and Laser Surgery. 2015;33(4):183-4.
2. Barolet D. Light-emitting diodes (LEDs) in dermatology. Seminars in cutaneous medicine and surgery. 2008;27(4):227-38.
3. Hamblin MR, Pires de Sousa MV, Arany PR, Carroll JD, Patthoff D, editors. Low level laser (light) therapy and photobiomodulation: the path forward. SPIE BiOS; 2015.
4. Wang Y, Huang YY, Wang Y, Lyu P, Hamblin MR. Photobiomodulation (blue and green light) encourages osteoblastic-differentiation of human adipose-derived stem cells: role of intracellular calcium and light-gated ion channels. Sci Rep. 2016;6:33719.
5. Wang L, Jacques SL, Zheng L. MCML--Monte Carlo modeling of light transport in multi-layered tissues. Comput Methods Programs Biomed. 1995;47(2):131-46.
6. Passarella S, Karu T. Absorption of monochromatic and narrow band radiation in the visible and near IR by both mitochondrial and non-mitochondrial photoacceptors results in photobiomodulation. J Photochem Photobiol B. 2014;140:344-58.
7. Avci P, Gupta A, Sadasivam M, Vecchio D, Pam Z, Pam N, et al. Low-level laser (light) therapy (LLLT) in skin: stimulating, healing, restoring. Seminars in cutaneous medicine and surgery. 2013;32(1):41-52.
8. Poletini MO, Moraes MN, Ramos BC, Jeronimo R, Castrucci AM. TRP channels: a missing bond in the entrainment mechanism of peripheral clocks throughout evolution. Temperature (Austin). 2015;2(4):522-34.
9. Barolet D, Christiaens F, Hamblin MR. Infrared and skin: Friend or foe. J Photochem Photobiol B. 2016;155:78-85.
10. de Freitas LF, Hamblin MR. Proposed Mechanisms of Photobiomodulation or Low-Level Light Therapy. IEEE journal of selected topics in quantum electronics : a publication of the IEEE Lasers and Electro-optics Society. 2016;22(3).
11. Damodaran S. Water at Biological Phase Boundaries: Its Role in Interfacial Activation of Enzymes and Metabolic Pathways. Subcell Biochem. 2015;71:233-61.
12. Pollack GH, Figueroa X, Zhao Q. Molecules, water, and radiant energy: new clues for the origin of life. Int J Mol Sci. 2009;10(4):1419-29.
13. Hamblin MR. Mechanisms and applications of the anti-inflammatory effects of photobiomodulation. AIMS biophysics. 2017;4(3):337-61.
14. Passarella S, Karu T. Absorption of monochromatic and narrow band radiation in the visible and near IR by both mitochondrial and non-mitochondrial photoacceptors results in photobiomodulation. J Photochem Photobiol B. 2014;140C:344-58.
15. Frigo L, Favero GM, Lima HJ, Maria DA, Bjordal JM, Joensen J, et al. Low-level laser irradiation (InGaAlP-660 nm) increases fibroblast cell proliferation and reduces cell death in a dose-dependent manner. Photomed Laser Surg. 2010;28 Suppl 1:S151-6.
16. Huang YY, Sharma SK, Carroll J, Hamblin MR. Biphasic dose response in low level light therapy - an update. Dose Response. 2011;9(4):602-18.
17. Sommer AP, Pinheiro AL, Mester AR, Franke RP, Whelan HT. Biostimulatory windows in low-intensity laser activation: lasers, scanners, and NASA's light-emitting diode array system. Journal of clinical laser medicine & surgery. 2001;19(1):29-33.
18. Chaves ME, Araujo AR, Piancastelli AC, Pinotti M. Effects of low-power light therapy on wound healing: LASER x LED. Anais brasileiros de dermatologia. 2014;89(4):616-23.
19. Barolet D, Roberge CJ, Auger FA, Boucher A, Germain L. Regulation of skin collagen metabolism in vitro using a pulsed 660 nm LED light source: clinical correlation with a single-blinded study. The Journal of investigative dermatology. 2009;129(12):2751-9.
20. Barolet D, Duplay P, Jacomy H, Auclair M. Importance of pulsing illumination parameters in low-level-light therapy. J Biomed Opt. 2010;15(4):048005.
21. Barolet D. Pulsed versus continuous wave low-level light therapy on osteoarticular signs and symptoms in limited scleroderma (CREST syndrome): a case report. J Biomed Opt. 2014;19(11):118001.
22. Jacques SL. Optical properties of biological tissues: a review. Phys Med Biol. 2013;58(11):R37-61.
23. Whelan HT, Smits RL, Jr., Buchman EV, Whelan NT, Turner SG, Margolis DA, et al. Effect of NASA light-emitting diode irradiation on wound healing. Journal of clinical laser medicine & surgery. 2001;19(6):305-14.
24. de Loura Santana C, Silva Dde F, Deana AM, Prates RA, Souza AP, Gomes MT, et al. Tissue responses to postoperative laser therapy in diabetic rats submitted to excisional wounds. PLoS One. 2015;10(4):e0122042.
25. Franca CM, Anders JJ, Lanzafame RJ. Photobiomodulation in Wound Healing: What Are We Not Considering? Photomed Laser Surg. 2016;34(2):51-2.
26. Alster TS, Wanitphakdeedecha R. Improvement of postfractional laser erythema with light-emitting diode photomodulation. Dermatol Surg. 2009;35(5):813-5.
27. Khoury JG, Goldman MP. Use of light-emitting diode photomodulation to reduce erythema and discomfort after intense pulsed light treatment of photodamage. Journal of cosmetic dermatology. 2008;7(1):30-4.
28. Trelles MA, Allones I. Red light-emitting diode (LED) therapy accelerates wound healing post-blepharoplasty and periocular laser ablative resurfacing. J Cosmet Laser Ther. 2006;8(1):39-42.
29. Chaves ME, Araujo AR, Santos SF, Pinotti M, Oliveira LS. LED phototherapy improves healing of nipple trauma: a pilot study. Photomed Laser Surg. 2012;30(3):172-8.
30. Calderhead RG, Kim WS, Ohshiro T, Trelles MA, Vasily DB. Adjunctive 830 nm light-emitting diode therapy can improve the results following aesthetic procedures. Laser therapy. 2015;24(4):277-89.
31. Barolet D. Accelerating Ablative Fractional Resurfacing Wound Healing Recovery by Photobiomodulation. Current Dermatology Reports. 2016;5(3):232-8.
32. Pandeshwar P, Roa MD, Das R, Shastry SP, Kaul R, Srinivasreddy MB. Photobiomodulation in oral medicine: a review. Journal of investigative and clinical dentistry. 2016;7(2):114-26.
33. Gautam AP, Fernandes DJ, Vidyasagar MS, Maiya AG, Vadhiraja BM. Low level laser therapy for concurrent chemoradiotherapy induced oral mucositis in head and neck cancer patients - a triple blinded randomized controlled trial. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. 2012;104(3):349-54.
34. Basso FG, Pansani TN, Turrioni AP, Bagnato VS, Hebling J, de Souza Costa CA. In vitro wound healing improvement by low-level laser therapy application in cultured gingival fibroblasts. International journal of dentistry. 2012;2012:719452.
35. Pourreau-Schneider N, Ahmed A, Soudry M, Jacquemier J, Kopp F, Franquin JC, et al. Helium-neon laser treatment transforms fibroblasts into myofibroblasts. Am J Pathol. 1990;137(1):171-8.
36. Salvador DRN, Soave DF, Sacono NT, de Castro EF, Silva GBL, LP ES, et al. Effect of photobiomodulation therapy on reducing the chemo-induced oral mucositis severity and on salivary levels of CXCL8/interleukin 8, nitrite, and myeloperoxidase in patients undergoing hematopoietic stem cell transplantation: a randomized clinical trial. Lasers Med Sci. 2017;32(8):1801-10.
37. Kumar SP, Prasad K, Shenoy K, D'Souza M, Kumar VK. High-level Evidence Exists for Low-level Laser Therapy on Chemoradiotherapy-induced Oral Mucositis in Cancer Survivors. Indian journal of palliative care. 2013;19(3):195-6.
38. Lalla RV, Bowen J, Barasch A, Elting L, Epstein J, Keefe DM, et al. MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer. 2014;120(10):1453-61.
39. Beckmann KH, Meyer-Hamme G, Schr, #xf6, der S. Low Level Laser Therapy for the Treatment of Diabetic Foot Ulcers: A Critical Survey. Evidence-Based Complementary and Alternative Medicine. 2014;2014:9.
40. Wang H-T, Yuan J-Q, Zhang B, Dong M-L, Mao C, Hu D-H. Phototherapy for treating foot ulcers in people with diabetes. Cochrane Database of Systematic Reviews. 2015(11).
41. Costa MM, Silva SB, Quinto ALP, Pasquinelli PFS, de Queiroz dos Santos V, de Cássia Santos G, et al. Phototherapy 660 nm for the prevention of radiodermatitis in breast cancer patients receiving radiation therapy: study protocol for a randomized controlled trial. Trials. 2014;15:330.
42. Censabella S, Claes S, Robijns J, Bulens P, Mebis J. Photobiomodulation for the management of radiation dermatitis: the DERMIS trial, a pilot study of MLS® laser therapy in breast cancer patients. Supportive Care in Cancer. 2016;24(9):3925-33.
43. Robijns J, Censabella S, Bulens P, Maes A, Mebis J. The use of low-level light therapy in supportive care for patients with breast cancer: review of the literature. Lasers in Medical Science. 2017;32(1):229-42.
44. Agrawal T, Gupta GK, Rai V, Carroll JD, Hamblin MR. Pre-conditioning with low-level laser (light) therapy: light before the storm. Dose Response. 2014;12(4):619-49.
45. Barolet D, Boucher A. LED photoprevention: reduced MED response following multiple LED exposures. Lasers Surg Med. 2008;40(2):106-12.
46. Menezes S, Coulomb B, Lebreton C, Dubertret L. Non-coherent near infrared radiation protects normal human dermal fibroblasts from solar ultraviolet toxicity. The Journal of investigative dermatology. 1998;111(4):629-33.
47. Frank S, Menezes S, Lebreton-De Coster C, Oster M, Dubertret L, Coulomb B. Infrared radiation induces the p53 signaling pathway: role in infrared prevention of ultraviolet B toxicity. Experimental dermatology. 2006;15(2):130-7.
48. Barolet D. In vivo mechanisms of photoprevention in a pig model. Lasers in Surgery and Medicine. 2015;47(S26):42.
49. Wu CS, Hu SC, Lan CC, Chen GS, Chuo WH, Yu HS. Low-energy helium-neon laser therapy induces repigmentation and improves the abnormalities of cutaneous microcirculation in segmental-type vitiligo lesions. The Kaohsiung journal of medical sciences. 2008;24(4):180-9.
50. AlGhamdi KM, Kumar A, A AA-G, Al-Rikabi AC, Mubarek M, Ashour AE. Ultra-structural effects of different low-level lasers on normal cultured human melanocytes: an in vitro comparative study. Lasers Med Sci. 2016;31(9):1819-25.
51. Kim JM, Kim NH, Tian YS, Lee AY. Light-emitting diodes at 830 and 850 nm inhibit melanin synthesis in vitro. Acta Derm Venereol. 2012;92(6):675-80.
52. Kang HY, Suzuki I, Lee DJ, Ha J, Reiniche P, Aubert J, et al. Transcriptional Profiling Shows Altered Expression of Wnt Pathway– and Lipid Metabolism–Related Genes as Well as Melanogenesis-Related Genes in Melasma. Journal of Investigative Dermatology. 2011;131(8):1692-700.
53. Martignago CC, Oliveira RF, Pires-Oliveira DA, Oliveira PD, Pacheco Soares C, Monzani PS, et al. Effect of low-level laser therapy on the gene expression of collagen and vascular endothelial growth factor in a culture of fibroblast cells in mice. Lasers Med Sci. 2015;30(1):203-8.
54. Mizutani K, Musya Y, Wakae K, Kobayashi T, Tobe M, Taira K, et al. A clinical study on serum prostaglandin E2 with low-level laser therapy. Photomed Laser Surg. 2004;22(6):537-9.
55. Barolet D, Cormack G. LLLT for Melasma. Lasers in Surgery and Medicine. 2015;47(S26):1-78.
56. Barolet D, Moreau JL, Auclair M, Barolet F, St-Arnault S, I. L. Reduction of CO2 Laser-Induced PIH by Prophylactic LLLT. Lasers in Surgery and Medicine. 2009;41(S21):p. 65.
57. Barolet D, Boucher A. Prophylactic low-level light therapy for the treatment of hypertrophic scars and keloids: a case series. Lasers Surg Med. 2010;42(6):597-601.
58. Mamalis A, Koo E, Garcha M, Murphy WJ, Isseroff RR, Jagdeo J. High fluence light emitting diode-generated red light modulates characteristics associated with skin fibrosis. J Biophotonics. 2016;9(11-12):1167-79.
59. Wu S, Zhou F, Wei Y, Chen WR, Chen Q, Xing D. Cancer phototherapy via selective photoinactivation of respiratory chain oxidase to trigger a fatal superoxide anion burst. Antioxidants & redox signaling. 2014;20(5):733-46.
60. Weiss RA, McDaniel DH, Geronemus RG, Weiss MA. Clinical trial of a novel non-thermal LED array for reversal of photoaging: clinical, histologic, and surface profilometric results. Lasers Surg Med. 2005;36(2):85-91.
61. Lee SY, Park KH, Choi JW, Kwon JK, Lee DR, Shin MS, et al. A prospective, randomized, placebo-controlled, double-blinded, and split-face clinical study on LED phototherapy for skin rejuvenation: clinical, profilometric, histologic, ultrastructural, and biochemical evaluations and comparison of three different treatment settings. J Photochem Photobiol B. 2007;88(1):51-67.
62. Boulos PR, Kelley JM, Falcao MF, Tremblay JF, Davis RB, Hatton MP, et al. In the eye of the beholder--skin rejuvenation using a light-emitting diode photomodulation device. Dermatol Surg. 2009;35(2):229-39.
63. Hession MT, Markova A, Graber EM. A review of hand-held, home-use cosmetic laser and light devices. Dermatol Surg. 2015;41(3):307-20.
64. Borelli C, Merk K, Schaller M, Jacob K, Vogeser M, Weindl G, et al. In vivo porphyrin production by P. acnes in untreated acne patients and its modulation by acne treatment. Acta Derm Venereol. 2006;86(4):316-9.
65. Ashkenazi H, Malik Z, Harth Y, Nitzan Y. Eradication of Propionibacterium acnes by its endogenic porphyrins after illumination with high intensity blue light. FEMS Immunol Med Microbiol. 2003;35(1):17-24.
66. Kawada A, Aragane Y, Kameyama H, Sangen Y, Tezuka T. Acne phototherapy with a high-intensity, enhanced, narrow-band, blue light source: an open study and in vitro investigation. J Dermatol Sci. 2002;30(2):129-35.
67. Hamilton FL, Car J, Lyons C, Car M, Layton A, Majeed A. Laser and other light therapies for the treatment of acne vulgaris: systematic review. Br J Dermatol. 2009;160(6):1273-85.
68. Zarei M, Wikramanayake TC, Falto-Aizpurua L, Schachner LA, Jimenez JJ. Low level laser therapy and hair regrowth: an evidence-based review. Lasers Med Sci. 2016;31(2):363-71.
69. Kim JE, Woo YJ, Sohn KM, Jeong KH, Kang H. Wnt/β-catenin and ERK pathway activation: A possible mechanism of photobiomodulation therapy with light-emitting diodes that regulate the proliferation of human outer root sheath cells. Lasers in Surgery and Medicine. 2017:n/a-n/a.
70. Carrasco E, Calvo MI, Blazquez-Castro A, Vecchio D, Zamarron A, de Almeida IJ, et al. Photoactivation of ROS Production in Situ Transiently Activates Cell Proliferation in Mouse Skin and in the hair Follicle Stem Cell Niche Promoting Hair Growth and Wound Healing. The Journal of investigative dermatology. 2015.
71. Adil A, Godwin M. The effectiveness of treatments for androgenetic alopecia: A systematic review and meta-analysis. Journal of the American Academy of Dermatology. 2017;77(1):136-41.e5.
72. Neira R, Arroyave J, Ramirez H, Ortiz CL, Solarte E, Sequeda F, et al. Fat liquefaction: effect of low-level laser energy on adipose tissue. Plast Reconstr Surg. 2002;110(3):912-22; discussion 23-5.
73. Brown SA, Rohrich RJ, Kenkel J, Young VL, Hoopman J, Coimbra M. Effect of low-level laser therapy on abdominal adipocytes before lipoplasty procedures. Plast Reconstr Surg. 2004;113(6):1796-804; discussion 805-6.
74. Avci P, Nyame TT, Gupta GK, Sadasivam M, Hamblin MR. Low-Level Laser Therapy for Fat Layer Reduction: A Comprehensive Review. Lasers in surgery and medicine. 2013;45(6):349-57.
75. Pfaff S, Liebmann J, Born M, Merk HF, von Felbert V. Prospective Randomized Long-Term Study on the Efficacy and Safety of UV-Free Blue Light for Treating Mild Psoriasis Vulgaris. Dermatology. 2015;231(1):24-34.
76. Guedes G, Belotto R, Campos G, Geraldo Y, Silva D. Reflection Spectrum Comparison in vivo of Vulvar Lichen Sclerosus when treated with Corticosteroid Therapy, Photobiomodulation, or Photodynamic Therapy. Lasers Surg Med. 2017;49(S28):34.
77. Barolet DL, D. LLLT Beneficial effects for symptomatic calcinosis in CREST symdrome. Lasers in Surgery and Medicine. 2009;41(S21):75.
78. Zmijewski MA, Slominski AT. Neuroendocrinology of the skin: An overview and selective analysis. Dermato-endocrinology. 2011;3(1):3-10.
79. Oplander C, Deck A, Volkmar CM, Kirsch M, Liebmann J, Born M, et al. Mechanism and biological relevance of blue-light (420-453 nm)-induced nonenzymatic nitric oxide generation from photolabile nitric oxide derivates in human skin in vitro and in vivo. Free radical biology & medicine. 2013;65:1363-77.
80. Weller R. Nitric oxide--a newly discovered chemical transmitter in human skin. Br J Dermatol. 1997;137(5):665-72.
81. Barolet D, Cormack G. Photobiomodulation of NO bioactivity and release in the skin Lasers Surg Med. 2017;49(S28):54.
82. Hashmi JT, Huang Y-Y, Osmani BZ, Sharma SK, Naeser MA, Hamblin MR. Role of Low-Level Laser Therapy in Neurorehabilitation. PM & R : the journal of injury, function, and rehabilitation. 2010;2(12 Suppl 2):S292-S305.
83. Michel F, Barolet D. A new visual analog scale to measure distinctive well-being effects of LED Photobiomodulation. SPIE Proceedings. 2016;9695(96950N-96950N-11).