Photobiomodulation: The Clinical Applications of Low-Level Light Therapy

Background Low level light therapy is a recent aaddition to the pantheon of light-based therapeutic interventions. Termed “photobiomodulation”, the absorption of red/near infrared light energy induces enhancement of mitochondrial ATP production, cell signaling and growth factor synthesis and attenuates oxidative stress. Photobiomodulation is highly commercialized with devices marketed directly to the consumer. In the grey area between the commercial and therapeutic sectors, harnessing the clinical potential in reproducible and scientifically measurable ways remains challenging. Objectives This article presents a summary of the clinical evidence for photobiomodulation and discusses the regulatory framework for low level light therapy Methods A review of the clinical literature pertaining to the use of low level light therapy for skin rejuvenation (facial rhytids and dyschromias), acne vulgaris, wound healing, body contouring and androgenic alopecia was performed. Results A reasonable body of clinical trial evidence exists in support of the role of low energy red/near infrared light as a safe and effective method of skin rejuvenation, treatment of acne vulgaris, alopecia and, especially, body contouring. Methodological flaws, small patient cohorts and industry funding mean there is ample scope to improve the quality of evidence. It remains unclear if LED-based light sources induces physiologic effects of the nature and magnitude of laser-based systems which were used in most of the higher quality studies. Conclusions Low level light therapy is here to stay. However, its ubiquity and commercial success has outpaced the empirical approach on which solid clinical evidence is established. Thus, the challenge is to prove its therapeutic utility in retrospect. Well-designed, adequately powered, independent clinical trials will help us answer some of the unresolved questions and enable the potential of this therapy to be realized.