Photobiomodulation therapy (PBMT), known to consumers as “red light therapy” has been validated in the medical community for decades. In fact, red light therapy is now a billion-dollar (and growing) at-home health trend (GVR, 2023). Despite being FDA-recognized and backed by a robust body of research, there are many misconceptions about “red light therapy”. Importantly, being poorly educated on the science of PBM can leave consumers susceptible to misleading marketing, create barriers between patients and medical professionals when discussing PBMT.
To better understand current consumer knowledge of PBMT, we surveyed 31 unique volunteers with differing levels of previous exposure to PBMT. The majority of these volunteers were not customers of JustLight, had not previously engaged with our brand, and were not offered any compensation for completing this survey, to minimize bias. All volunteers provided informed consent. Volunteers anonymously completed a 13-question survey that asked about past experiences with various PBMT services and technologies, included ten True/False questions about PBMT, and asked for age range and sex. After completing the survey, participants were directed to a published blog post on our website discussing each point in depth.
Our results are summarized below:
Of the 31 volunteers we surveyed, 12 were Male, 17 were Female, and 2 responded ‘Other’/’Prefer not to say’. For age, 35.5% of our sample was between 18 – 24 years old, 29.0% was 25 – 34 years old, 3.2% was 35 – 44 years old, 6.4% was 45 – 54, and the remaining 25.8% was 55 – 64 years old. Of our sample, 66% knew of some form of PBMT already; 60% of these individuals were female.
Of the 10 True/False questions asked, the average score was 49.67% (SD = 28.9%). Here, we present the data on the top two questions that were answered correctly, and the top two answered incorrectly.
#1 Correctly Answered:
Not all light is equal.
When it comes to red light therapy, there are many important factors that matter, such as type of light, dose of light, etc. (True)
When posed with this question, 70.9% of our respondents answered correctly. This is hopeful given the wavelength and dose determine the efficacy of PBM, but it is still unclear which details of light dosing consumers truly understand. For example, most people likely realize that UV light specifically causes sunburn, but does that knowledge help consumers decide between two PBM devices?
Importantly, understanding a nuance exists, but not exactly what that nuance is, can cause further confusion. The results of this survey suggest there may be some confusion: over 70% of our sample answered this item correctly, but the overall score on the survey was only 49%. Thus, going forward, we will attempt to replicate and further elucidate these results with a new sample of volunteers.
#2 Correctly Answered:
When administering red light therapy, it is important to use protective eyewear or close your eyes to avoid staring directly into the LEDs. (True)
64.5% of our respondents correctly indicated that eye safety is an important part of PBMT. This is somewhat unsurprising given the intuitive tendency to not look directly into a light source. For PBM devices, the FDA recommends all manufacturers include a disclaimer about eye safety (FDA-2022-D-3116, 2023).
This is likely for two reasons:
- the brightness of the LEDs can cause temporary discomfort to the eyes
- prolonged exposure to red stimuli (i.e. red LEDs) causes a harmless visual aftereffect making your vision temporarily appear more blue or green (Thompson & Burr, 2009).
Interestingly, PBM actually can benefit eye health when used to heal damaged tissue in the eye, particularly in the retina (Eells et al., 2008; Geneva, 2016). But when it comes to non-ophthalmic concerns, consumers seem to understand eye protection is important during PBMT.
#1 Incorrectly Answered:
Red light therapy works through clothing. (False)
Interestingly, 96.7% of our sample did not know clothing diminishes the efficacy of PBMT. Infrared light is readily absorbed by fabrics, and red light can be reflected or absorbed depending on the color. Thus, clothing limits the light that is available to be absorbed by target cells and is not recommended during PBMT over the treatment area. Makeup and skincare products are also not recommended because pigments in cosmetic products, such as foundation and concealer, react with the light before it reaches target cells.
Not understanding the importance of using PBMT on clean, bare skin can lead to misuse and ineffective treatment at home. Thus, there is a need for better education on how to prepare for PBM treatments, and clear instructions on device packaging when relevant.
#2 Incorrectly Answered:
Full-body red light therapy offers the same benefits as targeted, local red light therapy. (False)
32.2% of our sample indicated that the benefits of targeted and full-body PBM are the same; however, there is no data directly comparing the efficacy of these protocols, and studies on full-body PBM are still in their preliminary stages (Zagatto et al., 2020; Fitzmaurice et al., 2022) or unreplicated (Navarro-Ledesma et al., 2022). Historically, clinical studies on PBM have used localized, targeted PBM limited to a relatively small treatment area. These studies have revealed that optimal dosing parameters are not the same between different areas and tissue types (i.e. skin, muscle, bone, etc.) (Zein et al., 2018). Based on the PBM dosing hypotheses to date (Flores Luna et al., 2020; Nie et al., 2023), dosing parameters in a full-body solution would still need to be specific to the treatment area and target tissue. An obstacle facing consumers of PBM today, however, is the inconvenience of treating multiple areas with localized PBM because multiple separate treatments are required. The marketed solution to this problem is “full body red light therapy”, akin to a tanning bed of mirror-length light panel, but these have not been robustly tested in clinical studies, like targeted PBM. Thus, consumers deserve to be aware of the lack of evidence surrounding full-body PBM, especially before investing in expensive, full-body devices, which are typically in the $10,000s.
Main take-aways:
Overall, consumers have a lot to learn about PBM to ensure appropriate at-home use. Most consumers we surveyed understood that safety is important and that there are nuances of choosing the “right” type and dose of light. However, it remains unclear if these consumers understand what makes a reliable PBM device. Researchers, doctors, and companies should focus more on the education surrounding PBM to improve users’ experience with PBMT.
References
Code of Federal Regulations, Title 10, Part 851 (10 CFR 851), Worker Safety and Health Program – Department of Energy, §851.23 – Safety and Health Standards.
Dompe, C., Moncrieff, L., Matys, J., Grzech-Leśniak, K., Kocherova, I., Bryja, A., … & Dyszkiewicz-Konwińska, M. (2020). Photobiomodulation—underlying mechanism and clinical applications. Journal of clinical medicine, 9(6), 1724.
Flores Luna, G. L., de Andrade, A. L. M., Brassolatti, P., Bossini, P. S., Anibal, F. D. F., Parizotto, N. A., & Leal, Â. M. D. O. (2020). Biphasic dose/response of photobiomodulation therapy on culture of human fibroblasts. Photobiomodulation, Photomedicine, and Laser Surgery, 38(7), 413-418.
Eells, J. T., Gopalakrishnan, S., & Valter, K. (2016). Near-infrared photobiomodulation in retinal injury and disease. In Retinal Degenerative Diseases: Mechanisms and Experimental Therapy
Fitzmaurice, B., Heneghan, N. R., Rayen, A., & Soundy, A. (2022). Whole-body photobiomodulation therapy for chronic pain: a protocol for a feasibility trial. BMJ open, 12(6), e060058.
GVR-4-68040-030-9. Light Therapy Market Size, Share & Trends Analysis Report By Product (Lightbox, Floor & Desk Lamp), By Application, By Light Type (Blue Light, Red Light), By End-use, By Region, And Segment Forecasts, 2023 – 2030.
Geneva, I. I. (2016). Photobiomodulation for the treatment of retinal diseases: a review. International journal of ophthalmology, 9(1), 145.
Nie, F., Hao, S., Ji, Y., Zhang, Y., Sun, H., Will, M., … & Ding, Y. (2023). Biphasic dose response in the anti-inflammation experiment of PBM. Lasers in Medical Science, 38(1), 66.
Navarro-Ledesma, S., Carroll, J., Burton, P., & Ana, G. M. (2023). Short-term effects of whole-body photobiomodulation on pain, quality of life and psychological factors in a population suffering from fibromyalgia: A triple-blinded randomised clinical trial. Pain and Therapy, 12(1), 225-239.
Randa Zein, Wayne Selting, Michael R. Hamblin, “Review of light parameters and photobiomodulation efficacy: dive into complexity,” J. Biomed. Opt. 23(12), 120901 (2018), doi: 10.1117/1.JBO.23.12.120901.(pp. 437-441). Springer International Publishing.
Rentz, L. E., Bryner, R. W., Ramadan, J., Rezai, A., & Galster, S. M. (2022). Full-body photobiomodulation therapy is associated with reduced sleep durations and augmented cardiorespiratory indicators of recovery. Sports, 10(8), 119.
Thompson, P., & Burr, D. (2009). Visual aftereffects. Current biology : CB, 19(1), R11–R14. https://doi.org/10.1016/j.cub.2008.10.014
Zagatto, A. M., Dutra, Y. M., Lira, F. S., Antunes, B. M., Faustini, J. B., Malta, E. D. S., … & Ferraresi, C. (2020). Full body photobiomodulation therapy to induce faster muscle recovery in water polo athletes: preliminary results. Photobiomodulation, Photomedicine, and Laser Surgery, 38(12), 766-772.
