At-Home LED Devices for the Treatment of Acne Vulgaris

Abstract

This systematic review and meta-analysis examines 6 studies to determine the safety and efficacy of different types of at-home light-emitting diode devices in reducing acne lesions.

Although over-the-counter and prescription medications are commonly used to treat acne, there is growing interest in at-home light-emitting diode (LED) devices emitting red and/or blue light, which is thought to target the Cutibacterium acnes bacteria and reduce inflammation. This systematic review and meta-analysis sought to synthesize the available data regarding the safety and efficacy of at-home LED devices in the treatment of acne.

Methods

Details about eligibility, sources and search strategy, criteria, study selection, risk of bias, and statistical analyses is available in eMethods in Supplement 1. This study followed the PRISMA reporting guideline. We included any randomized clinical trial that assessed the efficacy of a portable or at-home red and/or blue LED device and had an outcome of either absolute or percent change in lesion count or improvement in the Investigator Global Assessment (IGA). Risk of bias was assessed using the Cochrane risk-of-bias tool (version 2.0). Data were synthesized using a random-effects model.

Results

After removal of duplicates, the search identified 440 references, 6 of which met the inclusion criteria.^1,2,3,4,5,6 Blue light devices operated at wavelengths ranging from 414 to 445 nm, and red light devices operated at wavelengths ranging from 630 to 670 nm (Table). Study duration ranged from 2 days to 12 weeks. The studies included a total of 216 participants ranging in age from 12 to 50 years with mild to moderate acne. Four of the 6 studies were considered to have low risk of bias (Figure).

Table. Summary of Studies.

Source	Device specifics				Patient population				Study arm		Adverse effects, occurrence in treatment groups, No. (%)
	Type of LED	Wavelength, nm	Fluence, J/cm2	Device	Participants, No.a	Mean age, ya	Fitzpatrick skin type	Acne severity	Control group	Treatment regimen
Papageorgiou et al,2 2000	Blue + red	415 (Blue); 660 (red)	4.3 (blue); 2.67 (red)	NA	55	24.8	NA	Mild to moderate	White light	15 min/d for 12 wk	Acne flare, 2 (7%); dryness/itch, 1 (3%); facial rash, 2 (7%); headache, 1 (3%)
Na and Suh,4 2007	Red	635-670	5.4b	Softlaser SL30	28	23.6	NA	Mild to moderate	No lightc	15 min twice daily for 8 wk	Burning sensation, 1 (3%)
Gold et al,5 2011	Blue	414	NA	Tanda Zap	30	30	I-IV	Mild to moderate	Sham devicec	2 min twice daily for 2 d	None noted
Ash et al,6 2015	Blue	414	17.6	NA	41	NA	NA	Mild to moderate	No light	Every other day for 8 wk	None noted
Kwon et al,1 2013	Blue + red	420 (Blue); 660 (red)	0.91 (Blue); 1.22 (red)	OCimple Light Therapy System MP 200	35	NA	III-V	Mild to moderate	Sham device	5 min twice daily for 4 wk	Mild dryness, 2 (11%); mild erythema and desquamation, 1 (6%)
Nestor et al,3 2016	Blue + red	445 (Blue); 630 (red)	NA	La Lumiere illuMask	27	NA	I-VI	Mild to moderate	Benzoyl peroxide	15 min daily for 12 wk	None noted

Abbreviations: LED, light-emitting diode; NA, not available.

^a Participants in LED and control groups, not accounting for other treatments arms.

^b Reported as a cumulative fluence of 604.8.

^c Split-face design.

Figure. Lesion and Investigator Global Assessment (IGA) Improvement With Light-Emitting Diode (LED) Treatment.

Compared with control, the LED devices resulted in greater percent change in inflammatory lesions (45.3%; 95% CI, 25.1%-65.5%; I² = 43.2%; n = 5 studies), noninflammatory lesions (47.7%; 95% CI, 18.0%-77.4%; I² = 83.22%; n = 4 studies), and IGA (45.7%; 95% CI, 29.1%-62.4%; I² = 54.85%; n = 4 studies) (Figure). Red, blue, and combination wavelength devices were found to be efficacious. In the included studies, improvement was typically noted after 4 to 12 weeks of use. Egger test and funnel plots did not support evidence of publication bias.

No severe adverse reactions were reported in any of the studies. The few patients who did experience adverse effects reported mild dryness, erythema, or discomfort or pain during light therapy (Table).

Discussion

This systematic review supports the safety and efficacy of at-home or portable red and/or blue LED devices for the treatment of acne vulgaris. Significant reductions in both inflammatory and noninflammatory lesions, as well as greater IGA improvement, were observed among individuals treated with red and/or blue LED devices compared with control participants. The adverse effect profiles were favorable, with minimal irritation or discomfort. Our findings indicate that at-home LED devices likely are a viable treatment option for patients with mild to moderate acne who are seeking nonpharmacologic management approaches. While few studies have compared LED devices with topical acne therapies, Nestor et al³ found greater rates of IGA improvement and Papageorgiou et al² found greater reductions in inflammatory lesions with LED devices compared with benzoyl peroxide.

With respect to wavelength, it seems that both red and blue LED devices are efficacious, with increased efficacy reported when used in combination. When Papageorgiou et al² compared blue light with red and blue light in combination, they found that the combination of red and blue light resulted in greater improvement in lesions and acne clearance.

This study has limitations. Moderate to high heterogeneity between the studies (such as differences in light source, fluence, and treatment duration) made comparisons difficult. The results of this study might not be generalizable to other devices currently on the market. Although Egger test did not detect publication bias, publication bias may have been present, given the limited regulation of the at-home LED device market.

At-home LED devices, particularly those that combine red and blue light, are efficacious for acne and can likely complement other over-the-counter and prescription treatments. Additional studies comparing the relative efficacy of different wavelengths, fluences, and treatment protocols are necessary to identify the optimal treatment approach for acne vulgaris with light.

Supplement 1.

eMethods

Supplement 2.

Data Sharing Statement