Episode #19: Photobiomodulation

Photobiomodulation (LED or LLLT) utilizes light to trigger biological changes.  It primarily involves red (633 nm) and near infrared light (830 nm) for wound healing and tissue repair by promoting cellular growth and regeneration which accelerates the healing process. 

It also helps reduce inflammation and pain in muscular injuries.
Neuroprotective effects are also being studied to enhance cognitive effects and help protect from neural inflammation seen in a variety of disease states of the brain.

PBM is non-invasive, non-thermal and now at home devices are available.

Hope you enjoy!

Dr. Saluja and Kane

Thank you for your listenership!

Transcript

MIC2 0:11

Hi everyone. And thank you for joining us in another episode of just laser it and All Things Cosmetic. How are you doing today, Cain?

MIC1 0:18

I'm doing really well. I'm excited to talk a little bit about another topic. Alright,

MIC2 0:23

All right. well this topic today, well first of all we have to say, I hope everyone's staying warm. This was 14 degrees today, Cain,

MIC1 0:30

you woke up and it was really, really cold.

MIC2 0:33

to get out of bed. Well today we're going to talk about something that maybe will kind of sound like it's warming us up. We're going to talk about light And specifically, we're going to talk about photobiomodulation. That's a mouthful,

MIC1 0:46

it? Yeah, it is. It's Like, what is that?

MIC2 0:50

Okay, so you've heard of low level light therapy. You've heard of LED. Is this something that's familiar to you, Kane? Yeah.

MIC1 0:58

I mean, you know, that's something that we have in the office, that's something you see advertised on TV, all sorts of stuff. Yeah,

MIC2 1:03

Right. So LED is light emitting diodes. And so photo biomodulation is now the new consensus word for low level light therapy for LED. They've they've conglomerated it into photobiomodulation. Because what it's doing is, it's taking light, photo, and it's modulating the biological tissues of the body. So that's where it's got the name

MIC1 1:25

photovoltaic. So that's just the umbrella term for LED lights and light? Correct. Okay.

MIC2 1:30

That's, that's just the consensus now so let's talk about what it is, and I'm going to always start with the history So back in the early 1900s, 1903, Neal Svensson was awarded a Nobel Prize for using UV light to treat tuberculosis, and he also used red light therapy to treat smallpox. So he's actually given an award for this. This dates all the way back to the early 1900s.

MIC1 1:54

I had no idea that technology even existed back

MIC2 1:56

Isn't it interesting? And so then, if you fast forward to the 1960s, Andre Mester was looking at a ruby laser. So a ruby laser is a 694 nanometer wavelength laser that was used for tattoo removal, and for pigmentation, et cetera. But He utilized this and what he was trying to do was, his thought was if I use very low level light therapy, could I induce dysplasia or could I induce, cancers on the skin? And so he tried doing this as a model to study for skin cancers. And what he found was no, low level light therapy did not cause cancer. And in fact, on the mice that he was looking at, it actually regrew hair. It improves the hair growth. And then later on he found that this light could also improve wound healing. So we found that there was some healing properties to low level light therapy.

MIC1 2:50

So it started off as something that would be bad is actually turning out to be good.

MIC2 2:56

That's right. You never know what you're going to find sometimes. And so it kind of was dormant for about three decades. And then in 1998, credit was given to Professor Harry Whalen. And he basically took the LED and made a NASA grade LED. He did this in the, in the NASA Space Medicine Laboratory in Houston. And what he did was, he created an LED that was more powerful than the initial LEDs. And he, he made it so the light was less divergent. So if light diverges, it covers over a greater area and it minimizes intensity. He was able to get it more like a quasi laser. So it was more collimated in essence,

MIC1 3:39

So it was more of a focused beam.

MIC2 3:41

a more focused beam. So he could create more tissue changes.

MIC1 3:45

So this is, so now this is NASA technology.

MIC2 3:47

is NASA technology. Correct. It could really withstand a lot of different temperature issues, a lot of different environmental issues. So it really became a robust type of, of light delivery. And so that's kind of when led started taking off and you saw them in different practices. In fact, we have a salt facial that has 1700 different bulbs on it, so we have a very robust one. But then, in the past couple of, probably in the past decade, we started to see LEDs more for home use. And you see that often now. And you've seen some.

MIC1 4:21

Yeah, you see them on commercials all the time. Right.

MIC2 4:23

Right. And so

MIC1 4:24

starting to become quite a popular therapy.

MIC2 4:27

It is. And, but I just kind of want to go through a little bit about the different wavelengths of LED to understand the at home use, because I do think there's definitely some benefits there and now that the price of LED has come down quite a bit, it makes it really reasonable to have at

MIC1 4:44

of my questions, I guess, that I was having as you were discussing about the history is, is it really, can you have a robust enough at home use device? You know, it's, it's, you see a lot of stuff on TV and you're like, yeah, is that really, is that really powerful enough to even work?

MIC2 5:05

you bring up there because L. E. D. certainly you have to have an intensity that's enough to create this photo biomodulation, but you can't have too much. energy. So, if you have too much energy, it can actually turn things off and give you a negative effect instead of a positive effect. So, there's kind of that sweet spot of where it should be. And, we'll talk about the mechanism of action. But I wanna first just kind of go over the different colors that you might see. So, Probably the three primary colors that you're gonna see, or wavelengths, you're gonna see blue light, you've heard about blue light, which is in the 400 to 470 nanometers. This is more important for working on the porphyrins that are endogenous to pee acnes, and for the, for the acne lesions. So when you think about acne, clear skin, you think about blue light.

MIC1 5:54

blue light. And the color is strictly just a wavelength.

MIC2 5:59

It's a wavelength of light, and it's where it's absorbed. And it's what it's interacting with. So shorter wavelengths, like blue light, they're not going to penetrate as deep. So they're going to act, they're going to have more of their action on the surface of the skin. And blue light is absorbed more by these, these porphyrins. Red light, for example, can be absorbed by different things that we're going to talk about, as well as near infrared light. And so green light is something that's utilized as well, not as, not as frequently. That's 470 to 550 nanometers, and then certainly red light is something that you see a lot, which that's 630 to 700 nanometers. Red light is good for inflammation, so anytime, even post procedurally red light can help minimize the inflammation of the skin. It's good for rosacea patients as well. This is what we place patients under for immediately post procedure, like if they have a CO2 laser, we'll put them under the, the LED to help with that.

MIC1 6:51

red light just, it kind of helps, helps with inflammation, but kind of calms, calms the skin down, is, would that be a? Correct,

MIC2 6:58

correct. Correct. But probably one of The most important wavelengths is the near infrared light, and that is one of my favorite wavelengths for that is the 830 nanometer wavelength. And so near infrared is anywhere from 700 to to. about 1100 nanometer wavelength. And the reason is that one of the primary places where both red light and near infrared light is absorbed into is in the mitochondria. And there's a specific region on that mitochondria, cytochrome c oxidase, where near infrared light is absorbed, and it basically can knock off a little nitric oxide that that rests and blocks this whole oxidative phosphorylation, where we get our energy from. It blocks the ability of oxygen to be utilized, and so when, when light is absorbed, It photo disassociates that and allows for the proper processes of the mitochondria to work, so you can get that whole pathway to occur at a better rate.

MIC1 8:03

for me. No! Let's, let's talk about this.

MIC2 8:05

think about this. I, I'm going to give you something, this is really interesting. So when you talk about mitochondria, let's go back one step. So mitochondria really are, are interesting little organelles And so when we have, humans have eukaryotic cells, right? Think of you, human, is you, eukaryotic cell. Bacteria are prokaryotic cells. And the idea was that back at the time of the great oxygenation event, which occurred 2. 4 billion years ago, when the level of oxygen of the Earth changed, and it changed because of a specific bacteria, cyanobacteria, the, the organisms were basically anaerobic organisms. They didn't use oxygen, and so all of a sudden, at this great oxygenation event, the bacteria that had a better survival were the ones that can, that could use oxygen. And so, eukaryotic cells engulfed these prokaryote cells, which later became mitochondria in our in our cell. So, for example, DNA that you know about is found in our nucleus of our cell, and it's a double helical structure. In mitochondria, it's a circular structure, so mitochondria has separate DNA, and that's the same type of structure that's in bacteria. So, when this occurred, that's when our mitochondria, became our powerhouse of our, of our cell that used oxygen and could, could really help with cellular metabolism.

MIC1 9:35

Okay. So just so you know, that did not simplify

MIC2 9:38

Oh, oh, okay.

MIC1 9:39

but, but look at the end of the day, it's, it's the mitochondria is a component of our cell and the history and evolution of it is, is

MIC2 9:47

It's fascinating.

MIC1 9:49

But just help me, help me understand like what does red light or infrared, I think is what the other light, what is it doing to work? I mean, what's, what impact is it having on a mitochondrial level?

MIC2 10:06

Thank you. Sure. So there's, cytochrome C oxidase, which is a key component of the mitochondria to function. It absorbs it the red light and the near infrared light. It specifically absorbs at 630 or so nanometers, which is in the red light area. And then there's another coefficient of absorption on the curve at about. 830 nanometers as well. So it absorbs preferentially at those places. And when it absorbs the light, that's when it could knock off that nitric oxide component, place down an oxygen component, which is what we want to see with the whole electron transport chain. So it basically makes your mitochondria function. And the functioning of the mitochondria is important because that, you need that energy in order to have all the cellular metabolism. It helps with, Also with cell signaling to turn on certain growth factors. And so it does a lot of important things. And one of the things is it can produce, produce collagen. It can turn on different cells in order to get the functioning

MIC1 11:10

the functioning appropriate. Okay, so red light and infrared light. It can go down to a mitochondrial level, which is a component of our cells, and the impact that it has on that will let it function more efficiently, more robustly, more appropriately, and that, at the end of the day, helps our healing, helps stimulate growth, and collagen, so that's what's really going on, is it actually,

MIC2 11:37

it, helps blood flow, and so those are the type of things, So you can see improvements with scarring. So the type of light that's associated the wavelength with more with, hair regrowth is this near infrared, is that 830. So, in my opinion, there's all sorts of different wavelengths of light that exists with over the counter LEDs. Primarily, blue, green, red, and near infrared for the purposes of rejuvenation of hair growth and healing. I like to have the red light and the near infrared light. Those are the two wavelengths that I'm looking for when I'm looking for an LED.

MIC1 12:13

And so this isn't just a snake oil type thing. This is actually, there's actually science that, that can demonstrate that it's reacting down to the mitochondrial cellular level. And that's what's stimulating the growth. That's what's stimulating the healing. That's what's working on the anti inflammation.

MIC2 12:28

Correct. There is a doctor, Dr. Michael Hamblin. And if you get a chance to read his, his work, I mean, he has done, he's dedicated his life to photobiomodulation and he shows so many different attributes of it and not just on the skin. Now, granted, mitochondria and fibroblasts and keratinocytes and, and, and bone cells is less than mitochondria in muscular tissue or brain tissue and whatnot. But it's amazing to see all the benefits of light therapy and what it can do. So, I'm glad that there are some good devices that are at home devices, which are under 500. It's important to know that there's a biphasic response with LED, meaning that, with PBM, photobiomodulation, meaning that you don't want to sit under your device, you know, there's masks, there's handheld devices, for hours in a day, because you can actually cause a decrease in the benefits that you see with it. So, typically they'll come with a time, they might say, with this energy, it's 10 minutes with this one. It's 20 minutes You want to do it like maybe once every other day is plenty to do

MIC1 13:39

so let me just kind of backtrack a little bit. So you have blue light and that's more for superficial, that's going to,

MIC2 13:46

more for acne

MIC1 13:47

acne, things that you can see on the skin. Then you have red light and infrared that actually penetrates a little bit deeper, has an impact on

MIC2 13:57

both are cellular, both of the organelles of the cells, but in the deeper tissue, you're correct to say that, like more of the vasculature, et cetera, more of the healing

MIC1 14:05

that helps with healing, that helps stimulate elastin, collagen, growth factors, etc. And the science is sound, I mean it actually does work. And there are at home therapies that you could purchase that you think would be robust enough to actually show a benefit.

MIC2 14:22

I do. And I mean, we have to modulate what type of benefit. It's more in sustaining the skin and to minimize aging. You know, for example, don't, don't do your LED and expect to wake up the next morning looking 20 years younger. That's not what it's going to do. But I do think there are some healing effects, certainly, that, I mean, I, you know that I use them at nighttime. So, it just helps, I think, with with my skin quality.

MIC1 14:46

Yeah, anything that's happening down on a cellular level, it's, it's going to take time and it may be so subtle that you don't even really notice it unless you look at before and after photos from a year ago or something.

MIC2 14:57

Correct. And I mean, they're even looking at it at other tissues, neurological tissue, etc. So it's, it's really interesting. I love to read about PBM because there's so much going on. And it's, it's non thermal, it's non ablative. I mean, you might feel a very minor amount of warmth with it, but it's not the heat that you, that you feel with a laser. So it's really easy to do per se as well.

MIC1 15:19

Okay. And for people like me, when you think you have a good thing, you tend to want to do a lot of it. This isn't probably one of those things you want to do a lot of because you actually can have diminishing returns if you do too

MIC2 15:30

Not a long duration, but you do want to use it at least every other night, I think, for, for good

MIC1 15:36

benefits. And they're usually set to a 30 minute timer or something

MIC2 15:38

20 minutes, 10 minutes on some, that's exactly right. So that's PBM in a

MIC1 15:44

a nutshell. Photobiomodulation. Say that fast.

MIC2 15:46

It's hard to say three times fast. All right, everyone, I hope you all have a wonderful evening tonight and thank you so much for

MIC1 15:53

science behind

MIC2 15:56

Okay, good.

MIC1 15:57

it. So, I'm glad we did it.

MIC2 15:59

Thank you.

MIC1 15:59

Alright, bye.