Skincare with Friends Episode 60: Home LED Devices- How to Choose the Best at Home Phototherapy Machine for Your Skin.

We put out a post asking for listener requests on our Facebook group and a lovely listener Ilona asked for “home beauty treatments like LED devices etc. scientific research much appreciated as always” so I thought I would look into LED light devices. I had a little hand held one from Amazon and lots of people wanted to know how I got on with it. To be honest I didn’t get any results from it, so I just stopped using it. But there is some decent evidence behind light therapy for skin, so it’s worth looking into.

There are a lot of home devices on the market and they vary wildly in price from £30 to £1895, so I wanted to know whether there is a vast difference between the cheap and expensive machines, seeing as they are only light bulbs after all. What I learned reading the studies is that LED light can work well for the skin but it has to be very specific otherwise you are just going to be wasting a lot of time- I have those specifics for you here.

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What is LED Light Therapy and How it Works

Photo therapy (also known as Low Level Laser Treatment or LED light treatment) is described as using light as any kind of treatment in a non traumatic way (unlike lasers which are traumatic). For light to be therapeutic there are specific features it must have, you can’t just sit near a light bulb and expect a skin miracle.

The light needs to have a

• High power output- measured in miliamps (mA) or amps (A)- from what I can gather 30mA is high
• Have a specific wavelength- the wavelength of the photon gives it it’s colour, more on wavelength further down
• Narrow divergence- so the light is directed towards the target, your face.

Absorption of visible light photons at appropriate levels induces a photochemical reaction, and a primary photochemical cascade occurs within the cell, usually instigated by the mitochondria (the adenosine triphosphate-producing power-houses of the cell). Photons (photons are particles representing a quantum of radiation and are without mass) of particular wavelengths target specific chromophores in the skin. Wavelength of a therapeutic source therefore has a double importance, namely to ensure absorption of the incident photons in the target chromophores, and to be able to do so at the depths at which these chromophores exist. The wavelength of the incident photons determines not only which part of the cell is the target, but also the primary photoaction. Wavelength is thus probably the single most important consideration in phototherapy, because without absorption, there can be no reaction.

(Calderhead, 2007)

So basically, very bright light at very specific wavelengths/colours causes cells to behave differently.

What Can LED Light Treatment Do?

When choosing your device, you really want to think about your treatment focus so you can pick the appropriate wavelength for your issue. Conditions that could benefit from LED mask treatment-

• Rejuvenation
• Wound healing
• Acne
• Post operative inflammation and scarring (eg after a chemical peel)
• Psoriasis
• Eczema
• Improves androgenic alopecia
• Helps prevent cold sores

The Negatives/Risks Involved in LED Therapy

• Light therapy might cause some temporary redness and dryness. You might be a bit pink and need a layer of moisturiser after a treatment.
• Blue light seems to have more worrisome issues than the other colours, but generally all the studies deem phototherapy to be a safe treatment. Blue light has been shown to affect the circadian rhythms, the brain needs low light in the evening to start producing sleep hormones and blue light is known to keep the natural hormonal progress towards sleep from happening.
• Also, high energy blue light can pass through the cornea and lens to the retina causing diseases such as eye damage.
• According to research, intense LED light can increase the production of free radicals and can induce delay of barrier recovery. The free radicals thing is a bit concerning when you’re trying to treat aging.

We can counteract these negative effects by using an antioxidant product before the treatment and using eye protection during at home LED treatment.

What to Look for in Your At Home LED Therapy Device

In clearing devices for sale, the FDA uses “power” as expressed in milliwatts per centimeter squared (mW/cm2) & “energy” as expressed in Joules per centimeter squared (J/cm2).  Essentially, this is measuring the amount of energy being emitted by a device, at the surface of the LED, over the area of one square centimeter and then over the course of a single second of treatment. It’s good to know the J/cm2 per treatment, the higher the better. Lots of brands don’t disclose this figure.

• Whether the device is wireless and rechargeable or plug in only– Do you have a plug socket near your sofa? will you want to use the device and move about? I don’t know about you, but I can’t sit still unless there is good tv on so I want something rechargeable ideally. 
• How well it fits to the contours of your faces– Distance to the skin is a factor in effectiveness the body’s ability to absorb the discreet wavelengths of energy decreases dramatically to the point that about 2 to 3 inches away from the skin the absorption is negligible. It should be curved and adapt to the contours of the face.
• The wavelength of light– For acne particularly a combination of wavelengths works best but the wavelengths have to be specific, you will want blue 415nm and red 633nm, more on this below.
• How many diodes are devoted to each wavelength– The more the better.
• Comfort– Take a minute to think about how the design will impact on the wear. Rigid devices might dig in around the nose particularly. Some devices you can only use when you’re lying down, which might not be ideal.
• Do you want to treat your neck?– Some devices come with an LED collar.
• What are you trying to treat?- If you are treating acne or something that may have a bacterial component like eczema, you will want blue light. Red light and infrared benefits most skin issues and have good evidence for them, so I would always want both featured.

What Wavelengths of Light To Choose for Home Phototherapy

The main therapeutic colours for phototherapy are blue, around 415 nm; red, around 633 nm, and near infrared, around 830 nm

The wavelength of light and their corresponding target chromophores-

• 400-450nm (blue)- porphyrins in bacteria cells 
• 630-670nm (red light)- fibroblasts (cells that make collagen) and keratocytes
• 830nm (infrared)- Immune cells like mast cells and macrophages, fibroblasts and keratocytes

Meaning that blue light has no effect on human skin but does target bacteria like p.acnes. Red light should have an effect on collagen production so be good for aging. Infrared could work for aging, wound healing and reducing inflammation. 

“It is apparent that for wound healing itself, or any process which depends on the wound healing process such as skin photorejuvenation, the ideal combination is the sequential application of 830 nm followed by 633 nm LED phototherapy, with a final 830 nm LED session to establish the remodeling process”. 

“Red light at 633 nm has a recognized antiinflammatory effect, is known to recruit large numbers of normal T-cells, and is moreover the optimum wavelength to activate fibroblasts to repair the matrix damaged by the P. acnes lesion. The combination of 415 nm and 633 nm LED phototherapy, applied sequentially, should therefore be the ideal”

(Calderhead, 2007)

You might read that green light can help with pigmentation, yellow light for healing and purple for something else, but there isn’t much evidence to support any of these claims. The main evidence is on blue, red and infra red.

• Eczema- Blue then red
• Acne- Blue then red
• Psoriasis- Blue the red
• Aging/rejuvenation- Infrared, red, then infrared

Some at Home LED Light Devices and Their Stats

It’s really difficult to find out specific technical data on commercial devices, I have done what I can. It is less common to find a device with Infra red output. For me, I’m looking for something comfortable, that contours to my face, is wireless, has infrared and gives me information on the energy output. And I don’t want to pay loads of money for it. I’m not sure whether I want one of those creepy Hannibal Lecter/creepy doll face masks, I don’t know if I could take the teasing I would get from family members.

Some of them come with neck collars, which is a good idea, you don’t want a super young face and a terribly ancient neck.

• Cellreturn LED Platinum- £1,600 ish, a helmet like design, wireless, simultaneous red 660nm and invisible infrared 850nm. 690 leds. Total energy 20 min  treatment 1.89J/cm2
• Dennis Gross Drx Spectralite- £430 rigid plastic, FDA approved, red and blue light, 100 red and 62 blue leds. Also Dennis Gross Body Wear Pro £430
• MZ Skin Light Therapy Golden Facial Treatment led device- £385 rigid plastic 150 diodes each ? red, blue, green , yellow and white
• Boost Led Mask– £395 flexible silicone, wireless, recharcheable, red and near infrared, 18 j/cm2, 56 red leds and 56 near infra red, they do a neck/chest bib for £395
• Déesse Pro Mask- £1,680, 770 led diodes, FDA approved, rigid plastic face mask, 154 of each colour- blue, green, red and near infra red. No neck thing
• Also Déesse Pro Express- £395 FDA approved, flexible silicone, red and near infrared, 49 LEDs each
• NuFace Trinity with With Wrinkle Attachment- £418.50 Handheld device with interchangeable heads. Difficult to find out any technical specifics, 36 bulbs,  red, amber and infrared
• CurrentBody Skin– £295 (plus neck and décolletage mask for £435)- flexible, portable face mask with power pack, red and near infrared, ?? how many bulbs and power not disclosed on their site
• Amazon masks. Cheaper face shaped masks for £30 have 24 diodes  
• Also from Amazon, this one by SENSSE is £130 and has 90 leds Red light 622nm, Blue light 463nm, Yellow light 592nm, Purple light 425nm. Flexible silicone design, wireless rechargeable

The Boost mask would be my pick. The design looks comfortable and portable, also their website is frank and unpatronising and gives figures rather than using flowery phrases. As it says on the Boost website, red and near infrared has the best evidence behind it, so that is the treatment I’m most interested in.

I might have to get a device to try, all the positive evidence I read has tempted me in. Some of the products we mention on the Skincare with Friends podcast LED skincare device episode-

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References

Ablon G. Phototherapy with Light Emitting Diodes: Treating a Broad Range of Medical and Aesthetic Conditions in Dermatology. J Clin Aesthet Dermatol. 2018;11(2):21-27.

Bonanns et al 2007 “Blue light friend or foe” Journal of Photochemistry and Photobiology B: Biology Volume 212, November 2020, 112026

Barolet & Hamblin 2016 “Infrared and skin: Friend or foe” Journal of Photochemistry and Photobiology B: Biology Volume 155, February 2016, Pages 78-85

Calderhead, R. G. (2007). The photobiological basics behind light-emitting diode (LED) phototherapy. Laser Therapy, 16(2), 97-108.