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Is red light technology the missing piece to controlling acne?

July 21, 2021 7 min read

Shine a little light on acne vulgaris

 

Pimples, zits, spots, pizza face – it goes by many names but acne is a condition that most people will experience at least once in their lives. For many teenagers it affects their self-esteem and causes emotional distress at a time when they are already struggling with the transition from child to adult. If they are lucky, by the time they are in their early 20's they have grown out of it but many don't. For some ‘lucky’ people acne sticks around for life. Who ever thought there would be a time that they would have to be dealing with pimples and wrinkles?!? [LINK WRINKLES TO AGEING/REJUV ARTICLE FOR SEO]


Acne, formally known as acne vulgaris, occurs when hair follicles become clogged with oil and dead skin cells [1]. This leads to blackheads and hard bumps under the skin which can progress to inflamed eruptions. These bumps and blackheads are known as comedones [1]. Acne can show up in many ways depending on its severity:

  • Whiteheads - closed clogged pores
  • Blackheads - open clogged pores
  • Papules - small red, tender bumps
  • Pustules – pimples which are papules with pus
  • Nodules - large, solid lumps under the skin that can be painful
  • Cysts - large, painful, pus-filled lumps under the skin

The follicle may bulge and form into a whitehead. The plug may be open to the surface and darken, causing a blackhead. A blackhead may look like dirt stuck in pores but, in fact, the pore is congested with bacteria and oil, which turns brown when it's exposed to the air [1]. Pimples are raised red spots with a white centre that develop when blocked hair follicles become inflamed or infected with bacteria. Blockages and inflammation deep inside hair follicles produce cyst-like lumps beneath the surface of the skin. Often people with acne will have different types of acne formation at the same time. They will also have times where it can be better or worse, depending on lots of lifestyle factors.


These different forms of acne can occur on the face, neck, chest, back and shoulders where the bulk of the sebaceous glands are found [1]. It often heals slowly and as one looks like it is healing, another will pop up to the surface. Occasionally acne can lead to scarring, which gives a pitted appearance, if the lesion was deep or was picked. After acne has cleared, the affected skin may be left with darker/hyperpigmented or lighter/hypopigmented marks [1]. 


What factors can lead to acne formation?


  • Excess oil (sebum) production [1]
  • Hair follicles that are clogged with oil and dead skin cells [1]
  • Bacteria - Propionibacterium acnes (P. acnes) [2]
  • Inflammation [1]

What triggers or makes acne worse?


  • Hormonal changes - Androgens are the hormones that increase in both males and females during puberty. They also vary in amounts during the menstrual cycle which explains why women can have acne at times during the month. The hormonal changes cause the sebaceous glands to enlarge and make more sebum [1]. 
  • Certain medications such as corticosteroids [1]
  • Diet – Certain foods including carbohydrate-rich foods, such as bread, cakes and biscuits may worsen acne [1]. Many people who experience acne benefit from a low sugar whole foods style of eating. 
  • Stress – For people who have acne, stress may make it worse and make it more difficult to treat [1].

What are the typical treatments?


Typical treatments are either topical formulation or medication, depending on the cause and severity. Examples of topical treatments are antibiotic creams, topical retinoids, benzoyl peroxide, alpha hydroxy acids (AHA), salicylic acid, or azaleic acid [2]. In severe or stubborn cases, oral antibiotics such as tetracycline and doxycycline, oral retinoids and hormonal medications may be used [2]. Despite the options that are available for treatment of acne, many patients don't respond well or experience some adverse effects [3]. These treatments can cause side effects such as skin sensitivity, redness and irritation or digestive discomfort if using medications. There are also cosmetic therapies and treatments available. These topical treatments have varying degrees of success and should be weighed up with the potential risks. One of these treatments is light therapy. 


A simple form of light therapy is exposure to sunlight. Sunlight can improve acne by up to 70% [4]. The sunlight decreases the androgenic hormones in the sebaceous gland. Unfortunately it is known that sunlight exposure contains UVA and UVB light rays which can cause damage to the skin [3]. Infrared and red light technology embraces the use of light therapy for acne without the damaging UVA and UVB rays.


The ClinicRed technology contains both infrared and red light to make the most of the benefits of both light spectrums [LINK ARTICLE ABOUT HOW THE LIGHT SPECTRUM VARY FOR SEO]. Usually the combination provides the best benefit. When it comes to acne though, research shows that the red light spectrum is the one which is the most effective, usually around the 630nm mark [2]. In a study which compared infrared and red light technology separately, it was shown that the areas treated with red light had a significant decrease in acne whereas the areas treated with infrared technology individually did not have as good results [2]. These results were found through a 10 week course of treatment. It is thought that red light works by reducing inflammation and that infrared works deeper than what is required for acne. It was found that both the red and infrared lights were in a safe therapeutic range without any complications [2]. Red light technology is available on its own but it means that what it can be used for is restricted, for example, it won't be beneficial for muscle or joint pain. By using ClinicRed devices there is the benefit for acne and the skin surface with the red light technology but also the flexibility of using it for other purposes due to the infrared light technology. Having the combination of light spectrums allows for more broad uses while still being effective for acne.


Another light spectrum which is used and studied is blue light. Blue light has been shown to be effective for killingP.acnes but the red spectrum penetrates more deeply into tissue for enhanced results [2]. This means that red light can affect the sebum secretion of sebaceous glands and skin cell behaviour in a way that blue light can not. It also reduces inflammation more than blue light does while also minimising the acne-causing bacteria [2].

 

Using red light technology does not mean other treatments such as topical remedies can't be used. In fact, studies show that using the red light spectrum with topical treatments can actually help them to work better. Aminolevulinic acid (ALA) was combined with red light technology. This combination led to more than a 90% clearance of acne within one month [4]. When using the red light on its own there was still a 44% clearance within this time [4]. They found that any side effects from the red light technology were resolved within two hours whereas the ALA side effects took 5-7 days to resolve [4]. ALA plus red light showed clinically and statistically significant clearance of inflammatory acne after multiple treatments which lasted for at least 10 weeks after treatment [4]. This study showed little improvement using ALA alone in this time frame. These results have been replicated in a few studies showing that combining red light technology with this form of medical treatment offered the most superior results [4]. In general, light-based treatments are safe and are not associated with any long-term complications [4]. Many of the immediate post-treatment events which did occur, such as mild pain, redness, or minimal swelling, resolved spontaneously and required no treatment [4].


It appears that severe acne shows a slightly better response than mild acne to red light technology [5]. Non-inflamed comedones do not respond as well as inflammatory lesions. The reason for this is that non-inflammatory acne lesions have less light-absorbing chromophores [5]. This is good news for those who have very inflamed acne since it is usually the most stubborn to treat. This type of acne needs a multi-dimensional approach which red light technology can be a part of. 


As mentioned, healed acne often leads to pigmentation issues and scarring [1]. Infrared and red light technology can also help to prevent and improve these marks. These light spectrums improve healing time and process which helps to prevent these types of healing marks from forming [3]. When there is pigmentation or scarring, light therapy can help to break it down to improve the appearance and texture by around 65% after a month of treatment [3].


Red light technology may be the edge that can break the cycle of acne production in a safe and effective way. By using it on its own or in conjunction with standard treatment, people may see the results they have been longing for. Acne is thought of as an aesthetically unappealing condition only but the emotional symptoms of having acne can really affect mental health so having effective treatments available in an easy and affordable way may be a lifesaver, or at least a face-saver!



References:


[1] Mayo Clinic Staff, Acne, Mayo Clinic, September 2020, https://www.mayoclinic.org/diseases-conditions/acne/symptoms-causes/syc-20368047


[2] Aziz-Jalali MH, Tabaie SM, Djavid GE., Comparison of Red and Infrared Low-level Laser Therapy in the Treatment of Acne Vulgaris, Indian Journal of Dermatology, March 2012,  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3352636/


[3] Avci P, Gupta A, Sadasivam M, et al, Low-level laser (light) therapy (LLLT) in skin: stimulating, healing, restoring, Seminars in Cutaneous Medicine and Surgery publication, March, 2013, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4126803/


[4] Pei S, Inamadar AC, Adya KA, Tsoukas MM., Light-based therapies in acne treatment, Indian Journal of Dermatology, May 2015, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4439741/


[5] Ablon G. Phototherapy with Light Emitting Diodes: Treating a Broad Range of Medical and Aesthetic Conditions in Dermatology, Journal of Clinical Aesthetics Dermatology, February 2018, https://www.researchgate.net/publication/323238893_Phototherapy_with_Light_Emitting_Diodes_Treating_a_Broad_Range_of_Medical_and_Aesthetic_Conditions_in_Dermatology




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