What is LED-therapy and low-level laser therapy (LLLT)?

LED-therapy and low-level laser therapy have become very popular and are all over the media nowadays. What are these technologies and why do they seem to be miracle treatments for almost everything?


What is LED-therapy and low-level laser therapy (LLLT)?


LED-therapy and LLLT are two closely related light therapies, to such extend that the names are sometimes used interchangeable. But is it the same?

Both LED-therapy and LLLT use light energy (photons) to enhance biochemical reactions that occur naturally in the body. A very important feature for this is that the device used does not cause a heat reaction in the body. The moment a heat reaction occurs, the body immediately initiate an inflammatory response. This response overrides various beneficial biochemical process associated with LED-therapy and LLLT. Therefore, LED and LLLT devices in therapy are limited in energy output.  Because of this the devices needed for LED-therapy or LLLT can be less expensive and also less regulated than high-power lasers.


Both LED’s and low-level lasers contain diodes that can be made of the same materials, usually silicon with specific minerals added in specific amounts to produce different colors. In lasers, the diode is mounted in a well-shaped area that is lined with reflective materials that sends only one wavelength of light. The result is a narrow beam of light that is concentrated into a beam, referred to as “coherent” light. However, when using low power levels the light energy does not remain coherent and scatters when it hits the skin. This is why LED’s and low level laser devices have similar healing effects.


For the remainder of this article the acronym LLLT will refer to both LED-therapy and low-level laser therapy.


What effects does LLLT have on the body?


The effects of LLLT on the human body have been researched and documented in thousands of studies around the globe since the 1960’s. Although it is a very well researched field, there are still new discoveries almost daily. For this article we will only focus on some of the biochemical reactions relevant to the aesthetic industry.

Adenosine triphosphate (ATP) syntheses.

One of the best known core principles of LLLT is that it enhances adenosine triphosphate (ATP) production in the cell. This is because it excites the electrons in the electron chain of the mitochondria. The photons (light particles) are absorbed by the cytochrome C oxidase. This leads to electronically excited states, and consequently can lead to quickening of electron transfer reactions. More electron transport necessarily causes increased production of ATP.


Why is ATP so important?

ATP is the biochemical way of the body to store and use energy. The light induced increase in ATP synthesis and increased proton gradient lead to an increasing activity of the Na+/H+ and Ca2+/Na+ antiporters, and of all the ATP driven carriers for ions, such as Na+/K+ ATPase and Ca2+ pumps. Ca2+ regulates almost every process in the human body (muscle contraction, blood coagulation, signal transfer in nerves, gene expression, etc…).


Gene expression

The gene expression profiles of human fibroblasts irradiated by low-level light show that the irradiation can affect the expression of many genes that belong to different function categories. Irradiation of LLLT stimulates cell growth directly through regulation of the expression of genes related to cell proliferation and indirectly through regulation of the expression of genes related to cell migration and remodeling, DNA synthesis and repair, ion channel and membrane potential, and cell metabolism. Irradiation by light also enhances cell proliferation by suppression of cell apoptosis.


Anti-inflammatory effect

Immune cells responsible for the inflammatory process are strongly affected by LLLT. Mast cells playing a major role in inflammation undergo degranulation at specific wavelengths which results in the release of the pro-inflammatory cytokine TNF-α from the cells. LLLT enhances the proliferation, maturation and motility of fibroblasts and increases the production of basic fibroblast growth factor. Lymphocytes proliferate more rapidly and epithelial cells exhibit increased motility. The ability of macrophages to act as phagocytes is also enhanced under the application of LLLT.


This is all very nice to know, but what does it means to the aesthetic therapist?


The first thing about LLLT is that it is typically a gentle treatment that most people experience as relaxing and pleasant. It is also a treatment that can be combined with a wide range of other treatments and therapies.

LLLT is a slow therapy and trying to rush it will eradicate the very reason for its existence. To achieve biomodulation (stimulation of biochemical reactions) one must apply sufficient energy in a manner that prevents a photothermal (heat) reaction, but at the same time satisfy the minimum required energy to get a beneficial response. The only way you can achieve this is to use sufficiently low-level light and allow the necessary time to generate a chemical reaction.


LLLT is a maintenance therapy. What is meant with this is that for the best results it must be done regularly over an extended period. This is something that you ideally would include weekly in a facial as part of the client’s fixed personal care regime, rather than an extended treatment once every three months.

The power of LLLT lays in its ability to regenerate from within. This is in itself a slow and continues process.


Not very LED or laser will work. When you work with any form of light therapy, you have to choose the wavelength(s) that will stimulate your target. For example; 633 nm will have much more effect than 650 nm. However, to the human eye both wavelengths are red light. Take the time to educate yourself on the most effective wavelengths for the treatments you would like to provide.


What are the most frequent treatments with LLLT?


LLLT is regularly used in anti-ageing treatments. This can be as part of another treatment or it can be a dedicated treatment. For this you relay on a combination of the three biochemical reactions discussed above. Firstly, you supercharge the skin. Increased ATP production in the skin cells allow for improved biochemical reactions inside and around the cell. Lesser important tasks that reduce with age and lead to visible ageing can be started up again at cell level, leading to a younger looking skin.

Using the reactions as discussed under the gene expression, you increase cell generation. You also enhance collagen and elastin production.


Another application of LLLT we see very often nowadays is body sculpting. This is generally called laser lipo or laser fat loss. This treatment is commonly sold with a lot of big promises and often leads to disappointing results. The key with this treatment is that the light enables the fat to be released by the fat cells. However, this treatment is only successful when the released fat is burned. The treatment in itself will have very little result. However, the magic is that you can determine what fat must be burned.


LLLT treatment for acne is also very well known.  For successful acne treatment you have to find the source of the problem, else you only manage the effect it has on the skin. If the problem is hormonal, you will not stop it with LLLT. However, you will be able to eliminate a large portion of the negative effect on the skin.


This is only a small example of the most common uses of LLLT in the aesthetic industry. As mentioned earlier in the article, LLLT can be combined with a wide range of therapies.


Do not hesitate to share any questions or comments you have on LLLT with us and we will try to help you find an answer.