How Red Light Therapy Works
The effects of RLT take place at the cellular level, and cellular activity is mostly at the molecular and even atomic level. For this reason, we will need to talk about biochemistry for a little while. Don’t be concerned if you don’t immediately grasp some of these submicroscopic interactions. Just by reading through the following, you should get a sense of how your body and metabolism work.
Stick with it—this background will be incredibly helpful as we move through this article.
One of the key players you will be meeting is nitric oxide, a chemical that is important to many biologic processes in the body. It is a neurotransmitter, which means it sends signals between neurons (nerves), and it controls how the brain works in different ways. Nitric oxide also helps to regulate blood flow and has potent anti-inflammatory properties. In the body, nitric oxide binds to cytochrome c oxidase (CCO), an enzyme found in mitochondria (tiny organelles that are the powerhouse of cells). These enzymes help convert energy from food sources into adenosine triphosphate, or ATP, a molecule that cells use for energy.
We will get back to nitric oxide in a few paragraphs, but first, let’s pause and get to know more about mitochondria and ATP.
Cellular Respiration
If you’ve wondered how the food you eat and the oxygen you breathe actually go to work for you, imagine this incredible metabolic process that is taking place right now in the trillions of cells in your body so your cells can have the energy they need to make proteins. This is called cellular respiration, and it is the foundation of life:
The carbohydrates you eat are broken down during digestion from starches and complex sugars into a simple molecule made of carbon, oxygen, and hydrogen; you know it as glucose.
The glucose passes into your blood, where capillaries bring it to your cells, and it is absorbed and then passes into the mitochondria. But first, enzymes (which are proteins that catalyse, or cause reactions) in the cytoplasm liquid in the cells break down the glucose into even simpler sugars called pyruvates, and also produce two ATP molecules which help fuel the ongoing metabolic process (patience; many more ATP molecules are coming!).
The pyruvates and other molecules, including NADH and coenzyme A, then pass into the mitochondria to take part in an amazing process known as the electron transport chain, which involves proteins and electrons passing in and out of the mitochondria’s inner membrane. (Mitochondria have a double membrane; an outer one to keep out the cytoplasm of the cell and other items, and an inner membrane, where much of the action takes place).
This protein-pumping process borrows energy from those first two ATP molecules to energise the electrons, which then connect with oxygen molecules (O2) in the Krebs Cycle that help the molecules turn into citric acid (yes, the same stuff in oranges), and finally we end up with 36 (or more) ATP molecules being produced. This represents more stored up energy, ready to be released as needed.
What is this potent energy storehouse? The ATP molecule is composed of adenosine (a nitrogenous base), ribose (a sugar molecule), and a string of three phosphate molecules (the “tri” of triphosphate), which are held together by high-energy hydrogen bonds.
It’s in these three bonded phosphate molecules where the energy our cells need is stored, and on cue, the ATP kicks off one of its three phosphate molecules, breaking and releasing a high-energy hydrogen bond to form ADP or adenosine diphosphate. That released energy is powering your muscles, your organs, your brain, and especially your heart. (Your heart muscle cells are about 45% composed of mitochondria, compared to 20% to 25% in your other muscles, and only 5% in skeletal tissues).
The reason for this detailed explanation is to help you understand just how important these mitochondria really are, and why red light’s influence can be so important. If the wavelengths of red light actually reach the mitochondria and influence their critical operations, that’s very important for us to recognise.
The Role of Nitric Oxide
This brings us back to nitric oxide (NO), also called nitrogen monoxide; it’s a colourless gas formed by the oxidation of nitrogen. “Nitric oxide performs important chemical signalling functions in humans and other animals” (Britannica, 2022). It is essential to the functioning of the mitochondria in our cells, functioning as both an energy producer and metabolic regulator.
Because of its importance in cellular metabolism, nitric oxide is thought to be a potential therapeutic target for treating disorders like diabetes and cardiovascular disease. Nitric oxide affects both crucial functions of mitochondria; the generation of energy and the control of cell death. It does this by modulating the production of reactive oxygen intermediates and of ATP.
Deeper dive. Now we’re going deeper into the biochemistry behind all of these critical functions; be patient and give it a read-through, because later on, it will help you to understand how red light therapy operates at the cellular level. You’ll be reading about enzymes; you will recall that these are protein molecules that cause chemical reactions between other proteins.
To begin, let’s introduce an enzyme called cytochrome c oxidase, or Complex IV, which is a “Large transmembrane protein complex found in bacteria, archaea, and mitochondria of eukaryotes,” explains Wikipedia (2022). (Eukaryotes are cells that contain a nucleus with DNA, which is fundamental to animal life):
Complex IV is the “Last enzyme in the respiratory electron transport chain of cells located in the membrane.” This means that the enzyme receives one electron from each of four other cytochrome c molecules and “Transfers them to one oxygen molecule (O2) and four protons” (a single proton is a hydrogen atom). This leads to the formation of the familiar molecule, H2O, which is water; there are two hydrogen atoms and one oxygen atom in each water molecule.
Scientists have long debated over the exact way that nitric oxide attaches to cytochrome c oxidase. Nitric oxide may directly bind to the ‘haem group’ in red blood cells, which is the non-protein component of oxygen-carrying haemoglobin, located in the middle of the iron-containing active site of the protein, according to one line of evidence.
Others, however, have proposed that in order for nitric oxide to bind to anything, an intermediary molecule must first bind to the haem group. This intermediate may be another chemical that is involved in cellular metabolism, like an amino acid. Research on this issue is ongoing.
Despite its importance, nitric oxide can damage cells if levels are too high or if it cannot be properly metabolised. This appears to be the case when cytochrome c oxidase is in contact with excessive nitric oxide. Because it disrupts numerous cellular processes, such as DNA replication and mitochondrial respiration, nitric oxide can kill cells when produced in excess for long periods of time. Low levels of cytochrome c oxidase activity have been associated with several diseases, such as heart disease and chronic fatigue syndrome.
This brings us to how this affects, and is affected by, phototherapy: Red and near-infrared light are thought to be primarily absorbed by cytochrome c oxidase in the body, increasing the bioactivity of nitric oxide. This appears to return this enzyme’s levels to normal, upregulating its activity while simultaneously enhancing energy production, cellular health, and general health. The advantages of RLT for other conditions and diseases connected to low cytochrome c oxidase activity require further studies, as research into this promising modality progresses.
You have now completed your primer on the metabolic processes and quick education in biochemistry! Phew! Summing up, you should now know that phototherapy potentially provides restorative benefits at the cellular and intracellular levels. This brings us to the properties and characteristics of the light that is used in phototherapy.
Frequencies and Wavelengths of Light
These two terms—frequency and wavelength—will be showing up often in this and other chapters, so a good grounding on what they mean and why they’re important is in order.
Light is part of a wide spectrum of electromagnetic radiation (EMR), which is one of the four known universal forces or energies in what’s known in quantum mechanics as the Standard Model. The other three are the force of gravity; the weak force that mediates atomic decay; and the strong force which holds the nucleus of atoms together. Two other forces—dark matter and dark energy—are believed to influence galactic movement but have not yet been positively identified.
Light is but one form of electromagnetism. It is a fundamental force in nature that encompasses both electricity and magnetism. As the name implies, this force is responsible for the interaction between electric charges and magnetic fields. The unified theory of electromagnetism was established in the latter half of the 19th century by the renowned physicist James Clerk Maxwell. Maxwell’s work was built upon the earlier discoveries of several prominent scientists, including Michael Faraday, who made a significant contribution to our understanding of electromagnetism.
The speed of light is 186,282 miles (299,792 km) per second, which means light from the moon (250,000 miles away) takes about 1.3 seconds to get here, and light from the sun (93,000,000 miles from us) takes about 8.2 minutes to arrive. Even at this impressive speed, light from the most distant galaxies that the Hubble and James Webb space telescopes are detecting has been travelling for billions of years to reach their lenses. Nothing can travel faster than light, as Albert Einstein’s 1905 Theory of Special Relativity posited, and which has been verified extensively.
Light is a wave, isn’t it? Physicists long believed that light travels as a wave, as we would expect. But light can also travel as a particle, which they have named the “photon.” Experiments shining a light on a board with parallel slits prove that light.
Today’s quantum physicists, while still perplexed, are comfortable with light being a particle when travelling through the vacuum of space. But also, as a light being a wave when passing through the atmosphere, which provides a tangible medium for wavelike activity. Since we’re here on Earth, and not en route to Neptune, we’ll keep our focus on light waves going forward. “Light waves have two defining characteristics: wavelength and frequency. Frequency is defined as the number of oscillations of a wave per unit of time, measured in Hertz (Hz); wavelength is defined as the distance between the two most near points in phase with each other. Hence, two adjacent peaks or troughs on a wave are separated
Red Light Research
Inspired by the positive results achieved by NASA, numerous studies have been conducted; some recently, to clinically prove (or disprove) the effectiveness of RLT in treating a variety of conditions.
RLT has been adopted enthusiastically by the alternative health community. Its adherents recognise the natural functions of this form of therapy and its gentle stimulation of the body to activate its own self-healing action. This is instead of depending on drugs and medications, or surgical interventions, with their inherent risks.
NASA’s WARP technology applied RLT wavelengths of 670 nm, which is in the visible part of the spectrum, but researchers are now testing the benefits of the entire red light range, from 630 nm to 700 nm, just into the edge of infrared light:
So far, benefits of healing and repair of wounds, pain relief, and anti-inflammatory activities have been observed as a result of applying these extended red light wavelengths. Work is continuing to test these and other wavelengths.
Here are results from additional phototherapy research, which shows positive results for RLT and Low-Level Light Therapy in different medical applications:
Dental
A study was conducted to evaluate the effectiveness of LED red light in the treatment of temporomandibular dysfunction syndrome (TDS), a common dental disease. The study was conducted among 50 students (40 females; 10 males) with TDS. Results: “The changes in the pain value and number of the tender muscles in both groups were highly significant,” though insignificantly lower in the placebo group, leading that the Red LED therapy a solution very useful in improving patients’ symptoms In addition, this study showed the importance of the psychological part of treatment of those patients.”
Skincare
A controlled trial was conducted among 113 subjects and 23 control volunteers to “Determine the efficacy of red and near-infrared light treatment in patient satisfaction, reduction of fine lines, wrinkles, skin roughness, and intradermal collagen density increase” (NIH, 2014).
Results: Wound Healing Given the reported ability of light-emitting diodes (LEDs) to send light deep into body tissues of the body, at wavelengths in a higher range (600-1000 nm), a meta-analysis of 68 studies on laser light and LED light was conducted to measure the effects on cutaneous wound healing, pain reduction, and tissue repair.
Results: The study concludes that “phototherapy, either by LASER or LED, is an effective therapeutic modality to promote healing of skin wounds.” Rheumatoid Arthritis Light therapy has been used as a short-term treatment to relieve arthritis pain and morning stiffness; it is “Now an FDA approved treatment: physicians use it to help patients suffering from chronic joint pain” (Red Light Clinic, 2022). Red light therapy is credited with collagen production stimulation, cellular rejuvenation, increased blood flow, and cartilage rebuilding, making it a “Favourable healing and preventative tool against the root causes of osteoarthritis, rheumatoid arthritis (RA), and various other inflammatory joint issues.” For verification, five studies were conducted among 130 randomly selected participants.
Results: LLLT (Low-Level Light Therapy) measurably reduced pain at a 95% confidence level, compared to placebo. It reduced morning stiffness duration by 27.5 minutes; and increased tip-to-palm flexibility by 1.3 cm.
Depression
Based on numerous studies, “Continual exposure to red light therapy has proven beneficial for individuals suffering from depression or fatigue,” Red Light Clinic reports. These positive effects are based on the ability of red light wavelengths to actually penetrate facial skin, triggering subcutaneous neurons to increase the production of mood-elevating neurotransmitters.
Results. Patients who were fatigued, mildly depressed, or are susceptible to seasonal affective disorder have reported being happier, more energised, and more positive after being exposed to one-hour and two-hour light therapy. Given the potential of light therapy to provide a non-drug, rapidly acting treatment for a serious disorder like depression, further studies are being recommended.
Unveiling the Benefits of Red Light Therapy
“Science is simply common sense at its best.” — Thomas Huxley
One thing is for sure—RLT has attracted considerable attention in recent years for its potential therapeutic benefits. As you turn the pages of this chapter, we will examine the various purported benefits it has to offer. But before we embark on this exploration, it is important to clarify the use of the term “purported”. By no means do I intend to imply that these benefits are unproven, or mere claims. Instead, the term “purported” is used to acknowledge that our understanding of red light therapy is continually evolving, and new scientific research is constantly emerging to shed light on its efficacy.
To be clear, in this article, the approach is grounded in science. We will provide a balanced view of the benefits of red light therapy by examining the current body of scientific evidence, including peer-reviewed studies and clinical trials. This rigorous approach will allow us to present a comprehensive and unbiassed analysis of the therapy’s potential advantages and effectiveness. As we explore the various benefits together, I invite you to approach the topic with an open mind and a critical eye. By considering the scientific evidence, you will be better equipped to understand the true potential of red light therapy and make informed decisions about its application in your own life or practice.
RLT has gained traction due to its non-invasive nature, lack of side effects, and promising results in a multitude of health areas. From skin rejuvenation and wound healing to muscle recovery and cognitive enhancement, red light therapy is poised to revolutionise the landscape of modern healthcare. In this chapter, we will methodically explore the different domains where red light therapy has shown potential benefits. We will discuss the underlying mechanisms at play, review scientific evidence supporting its effectiveness, and provide insights into practical applications of this remarkable technology.
Join me on this enlightening journey as we shine a light on the myriad benefits of red light therapy, opening up a world of possibilities for improved health, wellness, and quality of life.
Being Able to Make an Informed Decision
One of the most important objectives of this article is to identify and elaborate upon the validated and confirmed benefits of using red light therapy and other forms of phototherapy. It will also indicate the claims of benefits that have not yet been proven.
The Scientific Method
To begin, it’s important to understand the discipline known as the Scientific Method, which establishes the parameters of how to separate fact from what is unproven. You may recall earlier mention that a claim or hypothesis that is not proven and verified is not necessarily untrue or unprovable; in time, it might be validated, but for now, it cannot be accepted as truth or fact.
But what qualifies as proven? At one extreme, a randomised, double-blind, placebo-controlled large-scale study produces findings that are up to 99% significant in their accuracy and can be projected to a larger population. The recent Covid-19 vaccine clinical trials conducted by Pfizer, Moderna, Johnson & Johnson, AstraZeneca, and other major laboratories, used matched samples of 10,000 participants (one sample group received the real vaccine; the other sample group received an inactive placebo). This is an example of research findings that can be trusted.
Matched samples (or matched pairs) mean all the participants were chosen at random, and the sample groups were matched in age, gender, geographic location, physical condition, and other factors.
Double-blind means neither the participant nor the researcher recording the results knows whether the participant received the drug or the placebo.
Anecdotal. At the other extreme of what is proven or statistically validated is what is known as anecdotal claims; something that is repeated in publications, and between people by word of mouth, and is treated as fact, even though it has not been clinically or scientifically tested.
Observational. Another type of questionable claim is when it’s based on limited or observational evidence. For example, when 10 or 20 people experience a benefit; the results may justify conducting more studies to learn more, but should not be accepted until the validation is completed.
Non-human studies. Another type of limited evidence is when positive laboratory results of a new drug trial are based on tests with mice or other non-human subjects. Given previous histories of animal studies leading to life-saving medications, lab animal tests, when positive, can give a green light to proceed to human trials, but until those human studies are completed under the scientific security and disciplines, we’ve been discussing, the findings are encouraging, but definitely not yet validated.
Bias or influence is another cause of claims that aren’t trustable. Market researchers who understand statistics and what makes up the reliability of study findings are frustrated when focus groups are used to make important decisions. Ten people in a room discussing a new product do not represent a national population (or any population), and worse, the opinions participants express during the focus groups are heavily biassed by what others have said, and by what the group moderator may have implied while leading the discussion. We can sum up this review of the need to question the benefits of red light therapy, and all claimed medical results, by adopting a “healthy scepticism” until you know for sure that scientific methods have been followed, and the results have been validated. With all this understood, we can now get serious about looking into RLT’s effects and effectiveness. “Red light therapy (RLT) is a treatment that may help skin, muscle tissue, and other parts of your body heal,” declares WebMD (2019). Just as in an earlier quote from Cleveland Clinic, this description contains an important conditional phrase. It’s a big leap from “may help” to “will help.” We have some sorting out to do that will separate the proven from the unproven. Let’s take it one benefit at a time, keeping in mind that one RLT treatment that is confirmed to be effective in treating one symptom or problem does not mean it will also be effective in solving or relieving a different problem or disorder; conversely, it’s worth repeating that a treatment or therapy’s failure to perform as promised should not negate its potential to be effective in other areas.
How to evaluate the following information about RLT benefits:
In addition to the studies that are cited to validate the effectiveness of the benefits, some of the findings and successes with RLT are recommended by medical professionals, including board-certified dermatologists for skin and hair treatment. These are trustworthy authorities, whose recommendations are based on their review of clinical trials and other studies, and often combined with their own professional experiences in treating patients.
Benefits to the Skin
This will be the largest category of RLT applications for us to cover because there are many skin-related problems that are effectively treatable by RLT. The skin deserves our fullest attention because it is the body’s first line of defence against potential invading pathogens. It provides an almost impenetrable shield, and an acidic barrier that deters bacteria and viruses.
But despite these protections, our skin has many vulnerabilities. These range from diseases and injuries, to disturbances in a person’s appearance, which can deeply affect their self-esteem: The skin is actually an organ; the largest in our bodies and is subject to a host of injuries and insults, from rashes, acne, hyperpigmentation, rosacea, bug bites and inflammation, to bacterial and fungal infections, and skin cancer. Skin may carry scars from burns, cuts, and other wounds, residual marks from previous infections and other trauma, and may display stretch marks resulting from skin expansions and contractions caused by pregnancy or weight changes. And to the consternation of people as they age, skin tends to develop fine lines and wrinkles. It can also can become tissue thin; the slightest scratch can cause a deep gash. Ageing of the skin is a natural process and causes no discomfort, at least physically, but mentally it can be a frustrating signal of ageing, displayed for all to see on the face and hands. In addition to cellular causes, sun damage is a primary cause of premature wrinkles, along with many other skin problems. Unlike all of the interior parts of our body, the skin is what we, and others see, and react to. The $164 billion global skincare industry (Statista 2022) has grown steadily to meet the increasing demand for skin treatments with creams, gels, lotions, and medications taken both topically and orally; the question now is whether red light therapy can provide superior benefits and become a dermatologically accepted skin care alternative.
Treating Acne
Acne, a common yet often misunderstood skin condition, can have profound effects on both physical and emotional well-being. Affecting millions of people worldwide, acne is characterised by the appearance of pimples, blackheads, whiteheads, and even cysts, which can lead to scarring and discolouration if not properly treated. Beyond the visible symptoms, the psychological impact of acne should not be underestimated. Individuals suffering from this condition may experience social anxiety, low self-esteem, and even depression, which can significantly impair their daily functioning and quality of life. As such, it is crucial to recognise the serious nature of acne and strive to find effective solutions that address both the physical manifestations and the emotional challenges it presents.
Sun Damage
Whether it’s from casual sun exposure over the years, or efforts to obtain a tan, our skin suffers damage from the sun. The results include spots and dark areas, premature wrinkles, the onset of squamous cell and basal cell carcinomas, and the more dangerous metastatic melanomas.
