Light Therapy – Blue and/or Red Light

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Red and/or Blue Light May Reduce Acne to Some Degree, but Should Be Combined with Other Treatments

• What Is It?
• In-Office Devices (At the Doctor’s Office)
• At-Home Devices
• Bottom Line

What Is It?

Light therapy refers to non-laser sources of light that help to some degree in preventing papules and pustules, the everyday “pimples” that many people get that are inflamed and red. Smaller lesions, such as non-inflamed whiteheads and blackheads, as well as larger, severe acne lesions like nodules and cysts, respond more poorly.

When light is shone on the skin, it penetrates through various skin layers where it may help:

• Kill some bacteria: Acne is in part a bacterial disease
• Reduce skin oil (sebum) production: Less skin oil normally means less acne
• Calm inflammation: Acne is at its core an inflammatory disease

Benefits of light therapy include low side effects and potentially longer-term results. Drawbacks include incomplete, temporary, and often poor results, and difficulty in application–it can take 10-60 minutes a day to treat the skin with light. 

Since light therapy will not clear acne completely, it should be combined with other therapies, with the exception of isotretinoin (Accutane), which must be used alone.¹

Light therapy can be administered in a doctor’s office or at home. Let’s have a look.

In-Office Devices (At the Doctor’s Office)

Strength of light devices: When administered in a doctor’s office, more intense light is used, and physicians normally use light devices that can more effectively shine light on a larger area of the skin.

How often: 1 – 2 treatments per week for 3 – 4 weeks are usually required.

Cost: Each treatment costs around $40-$50.

Warning: Your doctor will make sure you are wearing protective eye coverings because the light emitted may harm the retina.

Doctors can also perform a procedure called photodynamic therapy, which involves topically applying a photosensitizer to the skin and “incubating” the skin before light is shone. This tends to produce better results, but also comes with more side effects. You can read more about photodynamic therapy here.

At-Home Devices

Strength of light devices: Tabletop light therapy devices employ weaker light than devices used at physicians’ offices. 

How often: At-home devices typically require 10-15 minutes of treatment every day, with the user sitting very close to the device or wearing a specially-made mask that emits light. Handheld devices, which some experts claim help light penetrate more deeply into the skin, require a person to hold the device directly on several areas of his/her face and requires a total of 30 minutes to 1 hour of treatment time per day. 

Cost: At-home devices are available for purchase over-the-counter and usually cost between $200 and $350.

Warning: Since red light can harm the retina, depending on the device, you may need to wear goggles when administering light therapy. It is important to check the manufacturer’s instructions to determine if eye protection is required.

What Type of Light Is Used for Acne Therapy?

Different colors of light that are visible to the human eye correspond to different wavelengths. Human eyes can detect light in the range from 400 to 700 nm. The low range of this spectrum (400 nm) corresponds to violet light, whereas the high end of the spectrum (700 nm) corresponds to red light.

The wavelength of light determines how deeply light can penetrate the skin, with violet and blue light penetrating only into shallow layers of the skin and red light penetrating into the deepest layers of the skin. Red, blue, or a combination of red and blue light can be used to treat acne. Typically, a combination is used. 

Blue Light

Blue light has historically been the most commonly used light for the treatment of acne, although doctors now tend to prefer a combination of blue + red light.

Blue light covers the spectrum from 407 to 420 nm. When blue light reaches the oil glands in the skin, it can excite compounds produced by acne bacteria called porphyrins.^3-5 When excited by light, these porphyrins kill the bacteria.⁶ Researchers are not sure whether blue light works in other ways as well.

Some promising studies have reported that physician-administered blue light therapy results in 60 – 73% reduction in acne, with effects lasting in the weeks following treatment.^7-9 However, the population size from these studies is too small to conclude just how effective blue light therapy really is and whether it is effective in the long term.

Red Light

While blue light works by killing acne bacteria, red light penetrates more deeply into the skin and reduces the production of inflammatory molecules that contribute to the formation of acne.¹¹

Because red light penetrates into deeper layers of the skin than blue light, it can reach skin oil glands, and shrink them, ultimately reducing the amount of skin oil produced by these glands.

Researchers have only performed one small study on 30 people to investigate the effectiveness of physician-administered red light therapy as a stand-alone treatment. The study reported that red light therapy reduced non-inflammatory acne (whiteheads and blackheads) by 59% and inflammatory acne (papules and pustules) by 66%. The authors stated, “Although it does not eradicate the acne lesions completely, it clearly diminishes the number of acne lesions. Patients may require adjunctive treatment to achieve acne-free skin. The effect of treatment is not sustained long term because many patients showed an increase in acne lesions after discontinuation of the use of red light.”¹²

Blue + Red Light

Most doctors use a combination of red and blue light in order to maximize the benefits of both therapies. Based on two relatively small studies thus far that tested a combination of red and blue physician-administered light, results show a reduction in inflammatory lesions by 76-83%.^13,14 Although using a combination of blue and red light provided a slight advantage over using blue light only, the difference between the two treatments was not significant.

More studies using a larger number of participants are needed to conclusively determine the effectiveness of the commonly used red + blue light combination therapy.

Effectiveness of At-home Light Therapy Devices

The studies described above assessed the effectiveness of physician-administered light therapy in doctors’ offices. However, blue, red, and blue + red light devices are also available for at-home use.

The advantage of these devices is convenience, as they can be used at any time without the need to see a doctor. However, at-home devices use a lower intensity of light and are therefore less effective than devices used in doctors’ offices. At-home devices are also often smaller than the devices used at doctors’ offices, and normally expose a smaller area of the skin to the light.

Because these research findings are very recent, the American Academy of Dermatology guidelines have not yet changed to reflect this new information. Their most recent recommendations, published in 2011, still advise approaching light therapy for acne with caution.

While the latest research findings suggest we can afford to take a more positive attitude to at-home light therapy devices, the Academy’s point is still valid that light devices on the market differ, and most of them have never been tested in any rigorous scientific studies.

Bottom Line

While blue, red, and blue + red light devices may temporarily reduce acne, they do not completely clear the skin. Therefore, it is best to use light therapy alongside other proven treatments. It is not known whether light therapy devices are effective in the long term. Physician-administered in-office light therapy appears to be more effective than weaker at-home devices.

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