How LED phototherapy offers practitioners a safe and effective alternative to prescription acne treatments

LED phototherapy is a safe and effective treatment for adult and teenage acne, working with topical treatments to negate the need for antibiotics or isotretinoin, says Consultant Dermatologist Dr. Justine Hextall.

Studies show that 44.5% of people who receive a new acne diagnosis receive long-term oral antibiotics[i], while 24.9% of acne consultations result in an oral antibiotic prescription and 23.6% in topical antibiotics[ii]. The median number of continuous courses of antibiotic therapy per person is four, with a median cumulative duration of 255 days[iii].

LED phototherapy offers a non-invasive, medical treatment alternative, using light-emitting diodes (LEDs) to stimulate cellular activity and promote skin rejuvenation. It is safe, versatile and has minimal side effects, while addressing a number of intractable dermatological skin conditions, from acne and rosacea to psoriasis and hyperpigmentation. It is also known as an aesthetic treatment capable of improving the appearance of the skin by reducing fine lines and wrinkles.

Adult acne

When it comes to the most common causes of acne, Dr. Hextall cites various factors which can trigger adult acne, including Polycystic Ovary Syndrome (PCOS) or other underlying hormonal conditions and fluctuations, such as those caused by perimenopause and menopause. “Oestrogen is a very important part of the skin barrier function as an antioxidant. When we start to lose oestrogen that can lead to blemish-prone skin, acne and rosacea, for which HRT alongside topical treatments can be helpful, however LED phototherapy can be a really effective adjunct to help skin repair and reduce inflammation.”

Similar to acne, rosacea and/or perioral dermatitis can also occur in adults, sometimes simultaneously, often triggered by combinations of skin barrier dysfunction and stress: “So, making a diagnosis is very, very important because you don’t want to be prescribing actives when you need to treat rosacea or dermatitis specifically, along with barrier repair,” explains Dr. Hextall.

Teenage acne

Teenage acne tends to present as a t-zone of oiliness but does not cause the same sensitivity as in adults. “In teenage years there is a big surge in androgens, which increases oil production in the skin and sticky skin cells, which block pores. If, on top of that you’re stripping the skin barrier with harsh OTC skincare products, you are stressed, lacking sleep or have a poor diet, this can all be pro-inflammatory.  Acne is much more common in industrialised nations, where you have an acne prevalence in teenagers of about 85%, whereas in less developed countries, of which there are very few left in the world, you have a prevalence of about 5%.”

Seeing the light

Dr. Hextall’s uses Dermalux Tri-Wave MD for a number of reasons; it is capable of treating large skin areas (so addressing the body, as well as the face) and delivering up to 240 j/cm² in a single treatment session using three of the most clinically evidenced light wavelengths for LED Phototherapy – Blue 415nm, Red 633nm and Near Infrared 830nm. Each light targets specific skin concerns, which used in parallel can significantly cut treatment times.

  • Blue light (wavelength 415nm) has effective antimicrobial properties and reduces the formation of biofilms[iv].
  • Near-infrared light (NIR) (wavelength 830nm) encourages the proliferation and migration of fibroblasts and keratinocytes in wound healing[v] and reduces inflammation.
  • Red light (wavelength 633nm) stimulates collagen production, reduces inflammation, promotes overall skin health and reduced scarring[vi].

Dr. Hextall explains that these three specific light wavelengths used singularly and in combination at different stages of the treatment are particularly effective in treating acne because they tackle bacteria and inflammation, while also reducing scarring. “In treating acne, blue light helps to destroy the porphyrins produced by bacteria, which cause the redness and swelling of acne. Red and Near Infrared light tackle the inflammation,” she explains.

In treating both adult and teen patients, Dr. Hextall prescribes once or twice weekly LED phototherapy sessions with her Dermalux Tri-Wave MD device, which usually achieves improvements within two to four weeks. “Most treatment is cumulative. Once we have seen the skin recovering, I switch to a maintenance regime of perhaps once every couple of weeks or once a month, depending on the patient and the severity of their condition,” she says, further explaining: “We know that acne is not linear, so we might see an active acne episode with lots of inflammation. It switches off with treatment, but the question is, what do we see as being ‘switched off’? Is it 80% or 100%. That’s why I suggest that the whole point of maintenance is that you’re quietly targeting the acne, at the same time reducing inflammation and reducing post acne marks.”

Dr. Hextall’s holistic approach to acne treatment for both adults and teens takes their individual factors into account. “If I can add LED phototherapy to target acne and inflammation I can treat without resorting to anti-biotics or isotretinoin. We don’t know the long term effects for teenagers who might be put on antibiotics for a year to treat their acne, plus there’s a lot of emerging science around the importance of the gut microbiome, so using Dermalux in my treatment armoury has to be a good thing.”

Learn more about Dermalux registering for the Dermalux Academy: https://dermaluxled.com/education/

[i] A study analysing UK primary care data from 2004 to 2019 found that among 217,410 individuals with a new acne diagnosis, 44.5% (96,703 people) received long-term oral antibiotics (defined as prescriptions lasting 28 days or more). These individuals were prescribed a total of 248,560 such prescriptions over a median follow-up of 5.3 years. ​PMC+4UCL Discovery+4PubMed+4

[ii] ​The Pharmaceutical Journal

[iii] ​Oxford Academic+2UCL Discovery+2PubMed+2

[iv] The antimicrobial effects of blue light: An emerging tool for infection control: Authors: Gupta A, Avci P, Sadasivam M, et al. Journal: Lasers in Surgery and Medicine Year: 2013 Volume: 45 Issue: 2 Pages: 95-106 DOI: 10.1002/lsm.22134

[v] Infrared radiation affects the proliferation and migration of fibroblasts and keratinocytes in wound healing: Authors: Barolet D, Boucher A Journal: Journal of Cosmetic and Laser Therapy Volume: 11 Issue: 2 Pages: 96-103 Year: 2009

[vi] Light emitting diode-red light for reduction of post-surgical scarring: Results from a dose-ranging, split-face, randomized controlled trial,  Alana Kurtti, Julie K. Nguyen, Jeremy Weedon, Andrew Mamalis, Yi Lai, Natasha Masub, Amaris Geisler, Daniel M. Siegel, Jared R. Jagdeo  First published: 31 March 2021 https://doi.org/10.1002/jbio.202100073