Location, Location, Location and Light Therapy for Acne

Young woman getting photo-therapy treatment with blue light

Different parts of the body need different amounts of light therapy.

There is a well-known saying about the value of real estate that the three most important things about a piece of property are location, location, and location. It turns out that the same thing can be said about the effectiveness of blue and red light therapy for acne.

Blue light therapy for acne has been around for about 20 years. It’s a very safe and moderate effective technique that uses a lamp that generates blue visible light. It does not have to generate wavelengths of light that could damage the skin or eyes. Blue light resonates with blue pigments in the outer cell membranes of acne bacteria. These pigments heat and burst the membrane, and the bacteria are unable to reproduce. They die and the skin has a chance to heal.

Red light therapy for acne has been around for a little less than 20 years. It’s also a very safe and very effective technique that uses visible light, this time in the red spectrum. Like blue light therapy, red light therapy does not depend on wavelengths that could damage the skin or eyes or overheat the skin. Red light reaches deeper into the skin and shrinks the oil-producing glands at the base of acne-prone pores. It does not eliminate the production of oil completely—this actually would not be a good thing, since sebum keeps the skin lubricated—but it does reduce the production of oil so that pores stay open.

Lamps that produce a combination of blue and red light are available for US $50 to $200. They can be worth many times their initial cost in savings on acne medication. But it turns out that different parts of the body need different amounts of exposure for best results.

Taking a Cue from Pre-Cancer Treatment

Blue light therapy is not just used for treating acne. It is also used for treating problems that can be triggered by using the wrong products for lightening the skin. Sometimes black and blue blotches appear on Asian skin after attempts to use hydroquinone as a skin lightening treatment.

Blue light therapy is also used to treat methicillin-resistant Staphylococcus aureus (MRSA) and to treat a kind of pre-cancerous condition of the skin called actinic keratosis. A dermatologist named Amy Forman Taub, who teaches medicine at Northwestern University in Chicago, has noted very large differences in results when using different amounts of blue light on different areas of skin.

Dr. Taub always uses a pre-treatment called 5-aminolevulinic acid before she treats pre-cancerous skin. This pre-treatment can be used for pre-treatment of acne, but this should be under medical supervision.
Different parts of the body need different amounts of light therapy.

  • Face lesions are pre-treated for 60 to 90 minutes and then exposed to blue light for 16 minutes, with the skin 2 to 4 inches (5 to 10 cm) away from the blue light lamp. Dr. Taub has her patients use zinc oxide sunscreen (the kind of sunblock life guards use that makes their noses white) for two weeks and to be sure to use moisturizers for at least a month. If another treatment is necessary later, she does longer pretreatment and much shorter exposure to blue light, just 1 minute.
  • Scalp lesions are pre-treated for 60 to 90 minutes and then exposed to blue light for 20 minutes, again with the skin 2 to 4 inches (5 to 10 cm) away from the lamp. If there needs to be a second treatment, Dr. Taub uses a full 20 minutes of blue light.
  • Lesions elsewhere on the body are pre-treated for 2 hours and then exposed to blue light for 20 minutes, with the skin 2 to 4 inches (5 to 10 cm) away from the lamp. The arms, legs, and chest respond better to pulsed blue light.

Do these recommendations translate into acne therapy?

There is no firm scientific evidence, but it’s probably the case that you need less time under a blue light lamp when you are treating face acne and more time under a blue light lamp when you are treating scalp or body acne. Holding the lamp close to the face (protecting your eyes with goggles to avoid glare) or scalp, but not so close that you feel actual burning, may make a big difference in the quality of  your results.

What about pre-treatments for blue light therapy therapy for acne?

It is a good idea to use any exfoliants before you use blue and/or red light therapy. They remove just a tiny amount of dead skin so that blue light can penetrate just a tiny distance deeper into your pores. If you have sensitive skin, you may want to stick with products that use polyethylene beads to remove dead skin. Exposed Skin Care makes a product with corundum crystals.

It also helps to exfoliate with either alpha- or beta-hydroxy acids (usually either glycolic acid or salicylic acid) before using blue or red light therapy. They lift the plug at the tip of clogged pores so that the light penetrates deeper into the pore and the sebaceous glands beneath. If you have dry skin you may get better results when you use exfoliants that contain glycolic acid. If you have oily skin, you may get better results when you use exfoliants that contain salicylic acid. Exfoliants that contain both glycolic and salicylic acid are OK unless you have very dry or very oily skin. An exfoliant probably has to sting just a little for it to do its job.

If you have dry skin, it’s best to use exfoliants on the side of your face. If you have oily skin, make sure you treat your forehead and nose.

It’s important, however, to rinse all products off your skin before your light therapy. Light has to penetrate them, too, and thoroughly cleansing your skin before starting your therapy makes it easier for light to penetrate your skin.

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