May 28, 2025

Are EMFs Harmful or Healing? Understanding Natural, Manmade & Therapeutic EMFs

EMFs Friend or Foe? EMFs are a hot topic of discussion these days, especially on social media. Many people are (rightfully) concerned about excessive EMF exposure, but most are confused about exactly what EMFs are, the differences between man-made and natural (sometimes called native) EMFs, how they affect our biology, and how EMFs (good and bad) are produced by the myriad devices we use each day. In this article, we will dig into all of this and more, with the goal of educating and empowering consumers to make safe, healthy choices about EMF exposure. What are EMFs? EMFs are produced by the movement of electrically charged particles and consist of two inseparable components: electric and magnetic fields. When these fields oscillate, they travel through space as electromagnetic radiation. While some EMFs remain close to their source (like static electric or magnetic fields), others radiate outward and can interact with biological systems. Understanding how they behave - and how the body responds - is key to using them wisely.     EMFs vary in characteristics, including: Frequency – how often the field oscillates per second (measured in Hz). Wavelength – the distance between wave peaks. Intensity – the strength of the electric or magnetic component. Waveform – the shape of the wave (sine, square, etc.). Coherence – how synchronized or orderly the waveforms are. Pulsing – whether the field is continuous or switches on and off rhythmically. Biological impact depends not only on these factors, but also on how close the field is to the body and whether exposure is short-term or continuous. These details matter more than whether an EMF is “natural” or “manmade.”   Natural vs. Manmade EMFs Natural EMFs are those the body evolved with over millennia. Sunlight, for instance, provides visible light as well as invisible ultraviolet (UV) and infrared (IR) rays. The Earth itself generates a powerful, steady magnetic field and a weak but essential electric field. Natural resonances like the Schumann frequencies pulse in extremely low frequencies (ELF), helping regulate brainwaves and circadian rhythms. These EMFs tend to be low in intensity, rhythmically patterned, and biologically coherent. They fluctuate in ways the body recognizes, often in harmony with other cycles, such as sunrise and sunset, weather systems, and seasons. They support functions like sleep, hormone balance, mitochondrial activity, and mood.   Manmade EMFs have become a dominant presence in our environment over the last century. These include: Power lines and household wiring – Power lines emit ELF electromagnetic fields that oscillate in sync with the electrical grid. Power line fields are continuous and pervasive, especially in urban and suburban areas, while devices like power cords, and chargers emit ELF fields if they are powered. TV and radio broadcasts - Traditional broadcast systems use a wide range of radio frequencies to transmit audio and video signals. Though distant from the body and less intense individually, they contribute to the overall EMF environment. Cell Towers, Smartphones, Wi-Fi, and Bluetooth - Cell towers and phones emit pulsed, modulated microwave signals for voice and data. Bluetooth is considered a low-power technology, but because devices like earbuds and wearables are in constant skin contact, biological exposure may be more significant than power levels suggest. Wi-Fi routers emit pulsed high frequency radiation to transmit date wirelessly throughout home and buildings. These EMF sources expose users to high frequency radiation almost continuously. Smart Meters - Smart meters emit sharp bursts of high frequency radiation, often hundreds of times a day, to transmit utility data wirelessly. Their signals fall in the sam range as Wi-Fi but are uniquely problematic due to proximity to living spaces and frequent pulsing. Appliances and electronics - Appliances and electronics often produce stray electric and magnetic fields, especially when plugged in. These EMFs differ not just in source, but in structure. They are often pulsed, modulated to carry date, emitted 24/7, and delivered at much higher intensities or in close contact with the body (such as ear buds or cell phones). They are biologically novel, meaning the body hasn’t had evolutionary time to adapt to them. EMFs emitted by these sources contribute to what is often called “electrosmog”, which can be described as an invisible haze of artificial electromagnetic radiation that now fills our homes, workplaces, and public spaces. As more wireless and electronic technologies are layered into daily life, the electrosmog EMF load continues to grow, creating a baseline level of exposure that is unprecedented in human history. To put this into context, it is estimated that exposure to EMFs around the 1Gz frequency band has increased by more than a quintillion times in just over a century. Therapeutic manmade EMFs, on the other hand, are intentionally designed to support health and healing. The two most used therapies are: Photobiomodulation Photobiomodulation is the use of specific wavelengths of non-ionizing light to influence biological function, particularly at the cellular level. The use of red and near-infrared light is commonly referred to as Red Light Therapy and is typically delivered through panels or flexible wraps. Research suggests that the most effective light intensities fall within a range that is comparable to safe levels of natural sunlight. By mimicking the wavelengths and gentle intensity of natural sunlight, these devices help recreate the EMFs of natural light in a targeted, therapeutic way. Pulsed Electromagnetic Field Therapy Pulsed Electromagnetic Field (PEMF) Therapy uses pulsing magnetic fields to stimulate biological processes in the body. While the Earth’s magnetic field is static and steady, PEMF therapy introduces rhythmic pulses to mimic natural patterns (such as biological electric rhythms), making the field dynamic and biologically engaging. By pulsing at frequencies that align with Earth-based rhythms, such as the Schumann Resonance (~7.83 Hz), PEMF therapy delivers magnetic fields designed to support cellular repair, circulation, and nervous system balance.   Not All EMFs Are Harmful It’s easy to label all EMFs as dangerous, especially in a culture increasingly aware of electrosmog. But not all EMFs are harmful, and some are profoundly beneficial.  Here’s what research has shown across the spectrum for the different types of EMFs present in our environment: Natural EMFs: Sunlight and Circadian Rhythms -Sunlight acts as the body’s primary circadian pacemaker, helping synchronize the sleep-wake cycle, hormone secretion, and metabolic processes through direct input to the brain’s suprachiasmatic nucleus. UVB and Vitamin D Production - Ultraviolet B (UVB) radiation stimulates the production of vitamin D in the skin, which supports immune function, bone metabolism, and has been linked to improved mood and reduced risk of depression. Sunlight and Serotonin - Sunlight exposure may boost mood through mechanisms beyond vitamin D—specifically by increasing serotonin levels in the brain, a neurotransmitter associated with calmness, focus, and emotional stability. Schumann Resonances and Brain Activity -Schumann resonances—natural electromagnetic standing waves centered around 7.83 Hz—closely align with alpha brainwave activity and may play a role in regulating mental states, emotional balance, and sleep cycles. Earth’s Magnetic Field and Biological Regulation - The Earth’s static magnetic field, though constant and low in intensity, has been linked to biological processes such as orientation, circadian timing, and melatonin regulation. Some studies suggest it acts as a stabilizing background influence on the nervous system. Ionizing Radiation from Natural Sources - Not all natural EMFs are inherently beneficial. Overexposure to ultraviolet radiation from the sun can cause DNA damage, accelerate skin aging, and increase the risk of skin cancer. Other forms of natural ionizing radiation (like cosmic gamma rays and solar X-rays) can also damage cells and contribute to background radiation exposure.   Therapeutic Manmade EMFs: Photobiomodulation – Photobiomodulation (especially red/near infrared light therapy) has been shown to reduce pain and inflammation, support healthy circulation, and speed up healing in both skin and deeper tissues. It works by improving energy production inside cells and modulating oxidative stress, making it useful for everything from muscle recovery to wound care. Studies also suggest benefits for mood, brain function, athletic performance, and skin rejuvenation. PEMF (Pulsed Electromagnetic Field Therapy) - PEMF therapy has been shown to reduce inflammation, increase blood flow, promote tissue regeneration, and even support healing of bone and tendon. It has been found to be helpful in supporting athletic performance, speeding recovery from exercise, and preventing injuries.   Non-Therapeutic Manmade EMFs: Oxidative Stress - Exposure to non-ionizing EMFs, such as those from Wi-Fi and mobile devices, has been associated with increased oxidative stress. This oxidative stress can lead to cellular damage and has been implicated in various health concerns. Disruption of Calcium Signaling - EMFs can activate voltage-gated calcium channels, leading to elevated intracellular calcium levels. This disruption in calcium signaling can affect numerous cellular processes and has been linked to potential health risks. DNA Damage - Research indicates that exposure to non-ionizing EMFs can cause genetic damage, such as DNA strand breaks and chromatin conformation changes. Such genetic alterations may increase the risk of mutations and have been observed in various cell types. Circadian Rhythm Disruption – Although research has been mixed, EMF exposure may affect melatonin production and disrupt circadian rhythms. This interference with the body's natural sleep-wake cycle can have broader implications for overall health. Reduced Fertility - Studies have found that non-ionizing EMFs can negatively impact female reproductive health (including effects on oocytes, ovarian follicles, hormonal balance) and sperm count. These changes may lead to decreased fertility and other reproductive issues.   ______________________________________________________________________________________________ Many natural EMFs, like sunlight, are essential for human health. Therapeutic EMFs harness these beneficial frequencies and structure them in a way the body can use. On the other hand, non-therapeutic manmade EMFs - those not designed with biology in mind - have been linked to biological harm. _____________________________________________________________________________________ Manmade EMFs Done Right Not all EMF-based therapies are created equal. While devices used for Red Light Therapy and PEMF devices can offer profound health benefits, they can also unintentionally introduce harmful EMFs into the body—especially when the devices are poorly designed. High levels of magnetic field emissions, flicker, stray current, and wireless communication features like Bluetooth can all contribute to a hidden "EMF load" that undermines the very benefits these therapies are meant to deliver.   Therapy that heals, not harms At fringe, we believe that therapeutic EMF devices should support the body, not stress it. That’s why our Red Light Therapy products are engineered with EMF-conscious design principles that prioritize user safety. By minimizing unnecessary electromagnetic exposure and mimicking natural EMF patterns in both wavelength and delivery, our devices provide powerful therapeutic benefits without adding to the invisible burden of electrosmog.       Here's how we do it No Bluetooth or wireless connectivity – this eliminates constant RF emissions. External power supply on our panels – keeps electric & magnetic fields away from the body. Flicker-free light output – supports nervous system regulation & avoids sub-perceptual stress. Biomimetic wavelengths and irradiance – replicates natural red & near-infrared light from sunlight. Battery-powered wraps – eliminate wall current entirely for a low-EMF experience during use.   Safe & biologically aligned  Meanwhile, many "smart" therapeutic devices on the market prioritize app control and convenience over biological safety. These features often involve permanent Bluetooth or Wi-Fi connectivity, keeping RF radiation active near the body, even when the device is not in use. What’s marketed as “smart” is often out of sync with the body’s natural biology and may ultimately do more harm than good.  When it comes to manmade therapeutic EMFs, smart design means staying close to nature and using modern engineering to deliver powerful, biologically aligned therapies without introducing avoidable stressors.   At Fringe, that’s our commitment: Therapy that heals, not harms. Conclusion EMFs aren’t inherently friend or foe. They’re simply the products of nature and technology. Some are natural (like the rhythms of sunlight or the Earth’s magnetic field) while others  (like the constant digital noise from wireless networks and power grids) can disrupt biological balance. The question isn’t whether EMFs are good or bad, it’s whether they’re in harmony with the systems our bodies are built to understand. At Fringe, our devices are built to emit EMFs that heal, not harm. We design every product with intention to reduce invisible stress, align with nature, and deliver therapeutic energy in its most biologically compatible form. Our Red Light Therapy products are designed with smart, low-EMF engineering: no Bluetooth, no flicker, external power supplies, and biologically aligned wavelengths and intensity. We believe therapeutic EMFs should support healing without adding to the body’s invisible electrosmog burden, and we build every product with that principle in mind.

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April 1, 2025

Deconstructing Red Light Therapy Intensity: Why MORE Isn’t Always BETTER!

Red Light Therapy Intensity: Why Higher Power Isn’t Always Better for Results “High intensity, medical grade Red Light Therapy”. This is a statement that is often made about Red Light Therapy devices, implying that to see real therapeutic benefits, that a device must be really powerful. But is this actually true? What does the scientific evidence say about high intensity Red Light Therapy devices?  Let’s dig into the research. But first, we need to define what light “intensity” is. Light intensity (also known as power density) describes the amount of light being delivered by a device. Also sometimes called irradiance, it’s usually measured in units called mW/cm2. Intensity is related to power, which is the rate at which energy is delivered, measured in Watts (W). If we look at that energy per square cm of exposure site, we get W/cm2, or mW/cm2 – our intensity. So, intensity is the amount of energy from a device at any given moment, and if we consider that as a function of time of exposure, we get the energy density (measured in J/cm2), which is the total energy delivered over time. This combination of intensity with exposure time is also referred to as the “dose” of light delivered by the treatment.   Let’s dig into the assumption that higher powered devices are required to derive benefit by exploring five lines of evidence.   1. Where did the idea that high intensity Red Light Therapy is required for therapeutic benefit come from? This idea comes from the fact that for decades, virtually all research and applications of photobiomodulation were done with lasers, which are high intensity devices. Research into Red Light Therapy began in the 1960’s, and lasers dominated the field until around the early 2000’s, when LED’s (light emitting diodes) began to be studied. The scientific literature is comprised of around 85% studies using lasers as light sources, with the rest using LED’s. Companies making higher powered devices are often trying to get close to the power of lasers, citing laser research that shows benefits. However, hundreds of studies have now shown that LED Red Light Therapy yields many benefits, such as reducing pain and inflammation. And, LED’s have four important advantages over lasers: (1) they’re safer, (2) they’re cheaper, (3) they can be easily used at home, and (4) LED’s can cover a greater area of the body allowing more tissue to receive light. Given this, an important question for researchers in the field to address was whether the benefits of Red Light Therapy were specific to something about laser light, or whether those benefits could be replicated using LED’s. In 2018, an analysis that reviewed the comparative evidence of lasers versus LED’s concluded that “most of these comparisons provisionally suggest that lasers could indeed be replaced with LED’s without significant worsening of the results.” This is despite major differences in power outputs, which demonstrates that high intensity lasers are not required for therapeutic benefits. 2. Does the research on Red Light Therapy demonstrate that a certain intensity range is needed to observe therapeutic benefits? There is an excellent comprehensive database online of published photobiomodulation research studies that describes the details of thousands of Red Light Therapy studies. We can look at this database to compare the intensity (power) of studies relative to their results, and to see if there are clear trends, such as a requirement for high intensity/power to yield benefits. Most studies using LED’s have an intensity between 10 and 100mW/cm2 and are most commonly between 10 and 50mW/cm2. For lasers, the intensity is much higher, based on the different characteristics of the light produced. Positive results spanning a wide range of outcomes are observed, and there are no clear trends related to light intensity. Some studies use extremely low intensity LED lights, some use higher intensity LED lights, and some use high intensity lasers. Although studies of certain light intensities are sometimes used to support specific products, when you look at the totality of the research, the main conclusion that can be drawn is that exposure to red and/or near infrared light across a wide range of light characteristics, including intensity, yields biological benefits.   3. Can devices with different intensities be used to deliver the same “dose” of light? Theoretically, the time variable can be manipulated when using devices with different intensities to deliver the same “dose” of light. Mathematical calculations show that higher intensity devices used for shorter periods of time can deliver a comparable dose of light to lower intensity devices used for longer periods of time. However, some research has demonstrated that our bodies don’t seem to absorb photons the same way when they are delivered at a high intensity, suggesting that “dose” may not simply be a mathematical calculation of intensity and time. For example, a recent comprehensive review of studies of red light therapy for the brain found that “NIR light with low-power density (15–30 mW/cm2) is a more effective intervention than that with high-power density (40–90 mW/cm2)." 4. If low, moderate, and high intensity devices have been shown to deliver therapeutic benefits, are there reasons for preferring low or moderate intensity rather than high? Yes, there are reasons to prefer low to moderate intensity devices as compared to high. For example, high intensity light can increase oxidative stress, which is harmful to biological health. When wounds are treated with low/moderate intensity red light therapy, markers of oxidative stress initially increase and then decrease dramatically as healing progresses. However, when wounds are treated with high intensity red light therapy, oxidative stress remains high. Similarly, levels of antioxidant enzyme activity (which reduces oxidative stress) increase with low/moderate intensity red light therapy but not with high intensity light. This suggests that low/moderate intensity Red Light Therapy reduces oxidative stress, while high intensity Red Light Therapy may cause it to increase. High intensity light also carries a risk of heating tissues and causing thermal damage.    5. Are there biological reasons to expect that there could be an upper limit to Red Light Therapy intensity when it comes to therapeutic benefits? Yes! Researchers have carefully studied the biological effects of Red Light Therapy and have clearly concluded that “dose” matters. If the dose is too low, there is no benefit; similarly, if it is too high, there is also no benefit – and there is the potential for harm. This is called a biphasic dose response, also known as the Arndt Shulz law. Picture this as an inverted U curve. If the dose is too low or too high, there will be minimal response, but there is a relatively wide range of doses in the middle range that are beneficial. As described by Dr. Michael Hamblin, “It has been consistently found that when the dose of is increased a maximum response is reached at some value, and if the dose in increased beyond that maximal value, the response diminishes, disappears and it is even possible that negative or inhibitory effects are produced at very high fluences.” Because “dose” is a function of intensity and time, using high intensity devices for too long can easily yield a dose of light that will not be beneficial, and may even be harmful.  These five lines of evidence clearly illustrate that the assumption that high intensity devices are needed to achieve benefit is not accurate. It is the dose that creates the benefit – and dose is a function of intensity and time. While it may be appealing to use a higher intensity light to get the treatment done faster, this carries risks including thermal damage due to heating tissues, as well as a risk of causing oxidative stress.  The tendency when using a high intensity device – which would require a treatment time of only a few minutes (or even less) – is to overdo it. For at-home devices, low to moderate intensities leave more wiggle room in terms of both safety and benefits.  Fringe Red Light Therapy Intensity Fringe Red Light Therapy products were designed to deliver light at an intensity of 20-40mW/cm2, which is the approximate intensity of the sun. This has been described as the “sweet spot” between higher intensities, which can have harmful effects, and lower intensities, which will have no effect at all. Although there are no clear distinctions between low, moderate, and high intensity devices, the intensity of Fringe Red Light Therapy devices would most appropriately be termed as low/moderate and stands in contrast to many devices on the market, which are 100mW/cm2 or even higher. At this intensity, our products can safely be used for treatment periods between 10 and 30 minutes, and our products are programmed with built-in timers to deliver a safe and effective dose of light.  We verify the intensity of our products using third party testing, which is important because independent research has found that many commercial home-based Red Light Therapy products do not deliver light as advertised.  Take Home Points The idea that high intensity Red Light Therapy devices are needed for therapeutic benefits originated from decades of research using high intensity lasers; however, subsequent research has demonstrated that lower intensity LED powered devices can yield comparable results.   An analysis of the totality of published Red Light Therapy research (using both lasers and LED’s) shows that benefits can be seen when using devices that span a very wide range of intensity, from low to high. This is consistent with research that shows the effective “dose” of Red Light Therapy follows a U-shaped curve, with benefits spanning a wide range but which has a lower and upper limit. The “dose” of light is determined by its intensity and the treatment time, although research has shown that delivering light quickly using a high intensity device may not be as effective as delivering it more slowly using a lower intensity device, suggesting that the “dose” is not the only factor that determines benefits. High intensity light can increase oxidative stress and the risk of thermal damage, so care must be taken when using high powered devices to limit treatment times, which can be difficult to do when using at-home devices. The Verdict? Research evidence does not support the claim that high intensity Red Light Therapy devices are required for therapeutic benefits. Using low to moderate intensity devices yields results that are comparable to using high intensity devices, with some research even demonstrating greater efficacy. Low to moderate intensity devices also have the advantage of greater safety and can be safely used at home as part of a regular wellness regime. Choose a device that suits your needs and preferred treatment conditions, and which delivers both red and near infrared light at an appropriate intensity. Combine red light therapy with an anti-inflammatory diet and supplements, regular exercise, stress management, and good sleep hygiene for best results.

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December 20, 2024

Light Therapy & Menopause

Menopause Menopause is the natural transition that occurs when a woman stops menstruating, which usually happens between the ages of 40 and 58. The term “transition” refers to a change from one state to another, which is a very apt descriptor for what happens during menopause. Hormonally speaking, menopause marks a shift to an entirely new hormonal milieu, which not surprisingly, can be quite challenging.  Hormonal Changes During Menopause The hormonal changes that accompany menopause are dramatic. From perimenopause (the stage leading up to menopause) to post-menopause (the stage following menopause), levels of estrogen and progesterone drop to a fraction of their previous levels. This sharp decline is not linear, instead showing fluctuations that can create a whirlwind of physical and psychological symptoms. Levels of testosterone also decrease during this transition.   The effects of menopause The effects of menopause on the brain and body are similarly dramatic. Although these vary widely between individuals, there are many common symptoms, including hot flashes, loss of libido, vaginal dryness, sleep issues, weight gain, dry skin, hair thinning, digestive changes, sexual dysfunction, urinary symptoms (including incontinence) and mood disturbances. Some menopausal symptoms are local, occurring mainly in the pelvic region, while others (such as hot flashes) are felt throughout the body. Similarly, some symptoms are transient while others cause persistent and long-term physical changes.  The experience of menopausal symptoms is extremely common. Overall, it is estimated that 75-80% of women suffer from symptoms related to menopause, of which 20-30% are considered severe. Approximately 75% of women worldwide experience hot flashes, while 40-60% suffer from sleep issues. As many as 83% of women report experiencing vaginal dryness, often with associated pain during intercourse. Research has found that 9 in 10 women weren’t educated about menopause, and since talking about these symptoms has long been viewed as “taboo”, women often suffer menopause symptoms in silence, leaving them unable to access tools that might help to alleviate them.  Improving access to supportive tools during menopause is a critical public health issue. This includes natural and alternative therapies, as well as novel tools such as light therapy. Light - including red, near infrared, and blue light – may help to alleviate several of the challenging symptoms of menopause, including sleep and mood issues, vaginal dryness and atrophy, hair loss, overactive bladder, sexual dysfunction, cognitive and digestive changes, and skin problems. Read on to learn how light therapy can be used to support women’s health during this important transitional period. Light therapy Before we can explore how light therapy can be used to support women’s health during menopause, we first need to answer the question: what is light therapy? The answer is really quite simple. Light therapy (also known as photobiomodulation) is the application of light with specific wavelengths to the body for the purposes of influencing biology. In theory, light therapy can use any wavelength of light, but the most commonly used are red, near infrared, and blue. The use of red and near infrared light is commonly referred to as “red light therapy”. All three wavelengths of light may be useful in supporting women during menopause, although red and near infrared light have the greatest utility.   Research has shown that light therapy has many effects on a cellular level. Briefly, with red and/or near infrared light, the most notable observed effects include an increased production of cellular energy, reduced inflammation, decreased oxidative stress, decreased pain, increased blood flow, enhanced collagen and supportive tissue production, and improved microbiome health (gut and vagina). Blue light is mainly used to destroy pathogenic microorganisms like yeast and bacteria.  Light Therapy & Menopause Given that there is such a wide range of menopausal symptoms (note that for simplicity, symptoms related to peri-, meno- and post-menopause are being considered here as “menopausal” symptoms), it is likely that the various physiological effects of light therapy will be more or less relevant for certain ones.  For example, some of the changes seen during menopause – such as vaginal atrophy, dryness, and urinary incontinence - are due in part to a decrease in blood flow and loss of connective tissue in the pelvis. While specific research into using light therapy to treat these symptoms is still sparce, researchers have proposed that based on existing scientific evidence, red light therapy may alleviate these symptoms by stimulating the production of collagen and elastin, supporting bladder function, and enhancing blood flow.    Many symptoms of menopause are also experienced in other states, and we can look to those conditions for clues regarding how to use light therapy to alleviate the same symptoms during menopause. This includes anxiety and depression, hair loss, sleep disturbances, acne, digestive issues, and infections. While research specific to these symptoms in menopausal women is lacking, there is clear evidence that light therapy (with red, near infrared, and/or blue light) can be helpful in other conditions, and we can extrapolate from there to the menopausal state. Based on the known physiological effects of light therapy, and the evidence of benefits in a range of clinical conditions, we propose that the use of red, near infrared, and/or blue light may help to alleviate several of the most common symptoms experienced by women during this life transition, including: Mood: Mood changes are a common experience during menopause, with many women reporting increases in anxiety and depression. Light therapy (with red and near infrared light) has been shown to reduce depressive symptoms in both humans and animals, likely due to improvements in mitochondrial function, increased brain blood flow, and decreased neuroinflammation. A 2009 clinical trial found a reduction in symptoms of depression and anxiety in as little as a single session. The effects of light therapy on mental health are so compelling that a recent systematic review concluded that it is “strongly recommended” as a treatment for moderate depressive disorder and is “recommended” for the treatment of anxiety disorder. Studies of red light therapy and depression often apply light therapy directly to the skull, while some use an intranasal approach. Cognition: Cognitive changes, such as memory loss, are also commonly experienced by women during menopause. Researchers have shown in a series of controlled clinical studies that near infrared light therapy improves cognition in young and middle-aged healthy adults when applied to the prefrontal cortex of the brain. Cognitive improvements were accompanied by changes in brain function, including increased brain blood flow. In 2019, a meta-analysis of all the research looking at the effects of light therapy (including near infrared light, or near infrared and red light in combination) found that the overall effect on cognition was positive, leading the authors to conclude that light therapy is a “cognitive-enhancing intervention in healthy individuals”.                                    Hair Loss: Menopausal women frequently report hair loss and thinning. The ability of light therapy to induce hair growth was observed in studies conducted more than 50 years ago. Early clinical trials used primarily red light, and the effectiveness of these studies led to the development of several red light therapy devices for hair loss. Subsequent studies have shown that near infrared light also stimulates hair growth, with red and near infrared light improving hair growth in androgenetic alopecia, which is the most common type of hair loss that affects both men and women. Light impacts hair growth through effects on mitochondria, which lead to increases in the length of time the hair follicle spends in the growth phase.                                                                                             Overactive Bladder: Overactive bladder, involving a frequent urge to urinate, is a urinary symptom experienced during menopause. Overactive bladder often results in urinary incontinence. Although research related to light therapy and overactive bladder is limited, one study found that application of red light to the abdomen three times per day for 12 weeks resulted in a reduction of urinary incontinence as compared to a control group, suggesting a potential benefit in this condition.    Skin Changes: During menopause, many women report skin changes, including acne, dryness, altered pigmentation and wrinkles. Light therapy has been widely used in spas and dermatology clinics for its effects on skin health, in addition to at-home use. Red and near infrared light is helpful in the treatment of wrinkles,  psoriasis, acne, hyperpigmentation, and rosacea, while blue light is helpful in the treatment of acne. Studies show results such as smoother skin; wrinkle reduction and improved skin elasticity; and normalization of skin pigmentation. The effect of red light therapy on wrinkles can be quite dramatic, with one study showing a 30% decrease in eye wrinkle volume. Gut: Gut dysbiosis, involving changes in the gut microbiome, are common around the time of menopause. Estrogen is known to affect the gut microbiome and similarly, some of the microbes in the gut microbiome (called the estrobalome) are able to influence levels of estrogen in the body. Keeping the microbiome healthy during menopause is essential, and light therapy (with red and near infrared light) may provide some support. Animal research has shown that when red or near infrared light was applied to the abdomen of mice, the composition of the microbiome shifted to include more of a bacterial strain that is associated with better health. In humans, red and near infrared light applied to the abdomen of Parkinson’s disease patients modulated the composition of the gut microbiome, with a shift towards more “healthy” bacteria, and in a case report of a patient with breast cancer, application of near infrared light to the abdomen was associated with increased diversity of gut microbes, which is considered to be a healthy change Vaginal Dysbiosis: Similar to the gut, the vagina has a microbiome, and menopause can cause dysbiosis in this region as well. Hormone-induced dysbiosis can increase the vaginal pH and change the composition of the microbes, which is associated with bladder dysfunction and bladder pain syndrome. Light therapy, particularly with red and near infrared light, is proposed as being a positive modulator of the vaginal microbiome. There are several proposed mechanisms, including modulation of nitric oxide. Nitric oxide is important for the lactobacillus species that dominate in the vagina that are known to decrease during menopause.                                                                                                                                    Sleep: As already mentioned, sleep disturbances are experienced by 40-60% of menopausal women. Light is a primary regulator of the body’s circadian rhythm, so it is not surprising that light therapy has effects on sleep. Application of red and near infrared light during wakefulness improves sleep quality in people with cognitive decline, Guillain-Barré Syndrome, fibromyalgia and stroke. When red light therapy is applied during sleep, there is an increased clearance of waste products from the brain and improved flow of cerebrospinal fluid, which are required for optimal brain health. Blue light triggers wakefulness, suppressing melatonin, so direct exposure of the eyes to blue light should be limited to daytime hours. Vaginal Infections: Vaginal infections with yeast and bacteria are more common during menopause due to the changes in estrogen, vaginal pH, and vaginal dryness that occur. In addition to their positive effects on the microbes in the gut and vagina, red and near infrared light have also been shown to have effects on pathogenic (harmful) microorganisms in the female pelvis. Red light has been shown to be helpful in treating vaginal candida, as has blue light. Specifically, blue light at 415nm (the same wavelength as in the Fringe Pelvic Wand) had the most potent anti-candida effects. Blue light has also been shown to be helpful in the treatment of vulvovaginitis. Vaginal Atrophy: Vaginal Atrophy, Dryness & Sexual Dysfunction: The loss of estrogen during menopause causes many changes to the integrity of tissues in the vagina. This results in tissue atrophy and dryness, which can cause great discomfort, especially during sex. The main structural connective tissues are collagen and elastin, which provide strength and flexibility to the vagina. These changes occur for a variety of reasons, including a decrease in blood flow which results from the loss of estrogen. Application of red and near infrared light is known to increase blood flow by increasing levels of nitric oxide. It has also been shown to increase the synthesis of collagen and other supportive connective tissue including elastin. Suggesting that red and near infrared light may help with tissue support and rejuvenation during menopause.  Light Therapy Products for Menopause While early research on light therapy used primarily lasers, more recent research has found that LED’s can also be used, which also have the advantage of applying light to a larger area of the body as well as an improved safety profile. The use of LED in red/near infrared/blue light therapy devices has also greatly reduced the cost of treatment, making it something that can be done in the comfort of one’s own home. A wide range of products are available, each of which is uniquely suited to address specific needs. The four most useful light therapy products to address the symptoms of menopause are: Red light therapy panel Panels usually deliver red and near infrared light, ideally with the option to use separately or in combination. Panels can be used to treat most body parts, including the face, chest and back. They’re great for supporting sleep and mood, when light should be entering through the eyes. They can also support digestion when directed towards the skin of the abdomen, as well as the skin on the face. The Fringe Red Light Therapy Panel delivers both wavelengths of light at the same “sweet spot” intensity as the sun. shop our panel Red light therapy wraps Red Light Therapy Wraps deliver light directly to the skin and can be applied to specific body parts, such as the head and abdomen. They should also deliver both red and near infrared light. Wraps have the advantage of being cordless and very convenient to use. The Fringe Red Light Therapy Head Wrap delivers light to the head (including red and two wavelengths of near infrared light) and is ideally suited to support mood, cognition, and hair loss. The Fringe Red Light Therapy Wrap has a rectangular shape and can be applied to the abdomen to support bladder function and digestion. shop our wraps           Light therapy face mask Like wraps, face masks deliver light directly to the skin but are specifically contoured to the face. Due to the antimicrobial effects of blue light, it should be included in face masks for the treatment of acne along with red and near infrared light. The Fringe Red Light Therapy Face Mask delivers all three wavelengths of light to support skin health, including acne, wrinkles, pigmentation, and more. shop the mask               Light therapy pelvic wand Light therapy pelvic wands are inserted directly into the vagina, delivering light directly to the vaginal tissues that are affected by menopausal hormonal changes. The Fringe Light Therapy Wand delivers red, near infrared, and/or blue light to support blood flow and tissue rejuvenation, which may help alleviate vaginal dryness, atrophy, and sexual dysfunction. shop the wand       To recap Menopause is a time of dramatic hormonal changes, which create uncomfortable symptoms for many women. Light therapy is a safe and effective tool that may be used to alleviate a wide range of menopausal symptoms in the comfort of one’s own home. Red and near infrared light provide support for symptoms including sleep and mood issues, cognitive changes, hair loss, gut and vaginal dysbiosis, skin problems, and vaginal tissue changes, while blue light may provide antimicrobial activity for menopausal acne and vaginal infections. Many different light therapy products are available - including panels, wraps, face masks, and pelvic wands – that provide light therapy support for different symptoms. Choose products that use LED lights to deliver red, infrared red, and blue light (where appropriate) at approximately the same intensity of the sun for best results.  For more information about Fringe light products, go to: https://fringeheals.com/shop-all-products/

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February 7, 2024

Red Light Therapy for Gut Health

The Human Gut The human gut, also known as the gastrointestinal tract (GI tract), consists of the esophagus, stomach, small intestine, and large intestine. In simple terms, it is a tube or passageway for food that passes from the mouth to the anus. Each part of the gut has its own job to do, which is usually described as the digestion and absorption of food, and the excretion of digestive waste products.  In recent years, however, a critical new role has emerged for the human gut, specifically the large intestine. As the last part of the GI tract, the large intestine receives food after most of the nutrients are absorbed and functions to reabsorb water and some remaining minerals. While this final step in the processing of food is essential, equally (if not more) important is the role of the large intestine as host to the gut microbiome, which is being described as a “major determinant of health.”  The Gut Microbiome The human body contains over 150 times more genes from resident microorganisms (such as bacteria, viruses, and fungi) than from its own human cells. With a total weight of just over 2kg, microbial cells outnumber human cells by around 10 to 1. Most of these organisms went unrecognized until the last two decades. However, we now know that the body is literally teeming with invisible inhabitants, which comprise what is referred to as the human microbiome. The combined human and microbiome genome is referred to as the “holobiome”.  The term “resident” is an apt descriptor when it comes to the microbiome. These organisms live inside the body, from birth to death. They also reside on the surface of the skin. And while the germ theory of disease has conditioned us to believe that most microorganisms are pathological, in fact the human microbiome is one of the most important biological predictors of health. The opposite is also true: alteration in the microbiome is an important predictor of disease. The microbiome communicates with the body, and the body communicates with the microbiome. This crosstalk is essential for human health.  The human microbiome can be broken down into several divisions, based on location. The microbiome that lines the mouth is the oral microbiome; the microbiome that lines the skin is the cutaneous microbiome; the microbiome that lines the vagina is the vaginal microbiome; and the microbiome that lines the digestive tract is the gut microbiome. The gut microbiome is the most well researched biome. The role of the gut microbiome is complex and spans a wide range of diverse functions. Gut microbes are involved in the metabolism of carbohydrates, lipids, and proteins, and help to extract nutrients from food. In the gut, they produce useful molecules such as short chain fatty acids and vitamin K. Gut microbes also manufacture neurotransmitters such as serotonin, and through the gut brain axis, regulate many aspects of cognitive function. The microbiome is also involved in the metabolism of ingested drugs and toxins.  The gut microbiome starts its development in utero and continues throughout the fetal period, with further colonization during delivery. Most gut microbes are acquired post partem, with breast milk as an important source in early life. A diet containing predominantly plants and whole foods is considered optimal to support the gut microbiome, with fiber being of utmost importance. Processed food, food that is high in sugar, and low fiber diets are bad for gut health. It has been recommended that dietary guidelines be revised to support a healthy gut microbiome. In addition to diet, there are several other factors that influence the health of the gut microbiome. According to the Canadian Digestive Health Association, non-dietary ways to strengthen the microbiome including: avoiding antibiotics, regularly sleeping for at least 8 hours per night, getting regular exercise, and engaging in stress reducing activities. Evidence is also accumulating that gut microbiome health can be supported by therapy with red and near infrared light.  Light Therapy Light therapy (also known as photobiomodulation) is the application of light with specific wavelengths to the body for the purposes of influencing biology. The most common form of light therapy uses red light (RL), which is visible as the color red, and/or near infrared light (NIRL), which is not visible but can be felt as heat. The RL used in light therapy usually ranges from 600 to 700 nanometres (nm), with the unit nm referring to distance the light wave travels in one cycle. The NIRL used in light therapy usually ranges from 800 to 900nm. RL and NIRL are naturally produced by the sun, which gives off solar radiation. The term radiation describes energy that is transmitted in the form of waves or particles. The spectrum of light in our environment consists of both light we can see (visible light) and light that our eyes can’t perceive (invisible light). This is called the electromagnetic spectrum. The visible light spectrum is quite narrow, consisting of wavelengths that range from 400 to 700nm and span from violet to red in color. RL is part of this visible light spectrum, while NIRL is not. Red and near infrared light therapy is the application of artificially generated light in the red and near infrared spectral bands. The term “red light therapy” usually describes the use of both RL and NIRL, although only the red light produced by the device is visible to the naked eye. IRL can still be perceived by the body as heat when it contacts skin. How Does Red Light Therapy Affect Gut Health? Red light can affect gut health both through effects on the microbes in the microbiome, as well as on the gut cells of the human host. It’s hard to tease out precisely what is happening in this complex microenvironment, but one thing is clear: light therapy administered to the gut has a positive biological effect. Research has indeed shown that light can modify the microbiome. For example, when RL or NIRL was applied to the abdomen of mice, the composition of the microbiome shifted to include more of a bacterial strain that is associated with better health. Bacteria have also been found to respond to the direct application of RL. Light therapy also impacts human cells. Light is absorbed in cells by molecules called chromophores, many of which are found inside the mitochondria. Mitochondria are the powerhouses of the cell, which make the energy currency of the cell known as ATP. Mitochondria are also involved in regulating the production of molecules called reactive oxygen species (ROS), which play a role in normal cellular function but can be harmful in high amounts. This is known as oxidative stress. Through its effects on mitochondria, light therapy can increase cellular energy production and modulate oxidative stress. Intestinal oxidative stress is associated with disease. Through effects on cellular metabolism and ROS production, as well as through reduction of other molecules such as reactive nitrogen species and prostaglandins, light therapy can decrease inflammation. Both RL and NIRL have anti-inflammatory effects, and unlike anti-inflammatory medications (such as NSAID’s), do not cause side effects. Inflammation is a hallmark of many gut disorders, such as Crohn’s Disease and Ulcerative Colitis.  By improving the health of the gut (both the microbiome and human gut cells), a wide range of positive effects are observed, including: Improving communication between microbiome and the rest of the body.  Improving digestion of food and production of energy and nutrients. Decreasing inflammation and production of reactive oxygen species. Increasing production of short chain fatty acids involved in immune function. Improving the health of the gut lining. Gut Dysbiosis When the gut microbiome is dysregulated, there is an adverse effect on its human host. This is called gut dysbiosis. Poor dietary choices, sedentary lifestyle, increased stress, and use of antibiotics (and other pharmaceuticals) can cause the gut microbiome to become unhealthy. This causes a loss of integrity of the gut lining, also known as leaky gut. In turn, the gut becomes permeable to things like microbes and food fragments, which activate the immune system and trigger an inflammatory response. Chronic inflammation ensues, and a vicious cycle is established in which the gut becomes increasingly compromised, which worsens the inflammation. Dysbiosis also impairs metabolism.  Gut dysbiosis has been associated with an enormous range of human disease, including metabolic syndrome, neurological disorders, immune system disorders, autism, psychiatric disorders, obesity, systemic inflammation/autoimmunity, type 2 diabetes, chronic pain, multiple sclerosis, inflammatory bowel disease, and eye diseases. A 2021 article in The Guardian described that “The great opportunity – but also the great difficulty – of gut microbiome science is that poor gut health is associated with such a vast range of conditions.” This means that there is enormous potential to reduce human disease by improving the health of the gut microbiome, although it is important to acknowledge that our understanding of these relationships is still limited.  Clinical Applications of Light Therapy to the Gut The use of light to improve health dates back thousands of years. Sunlight has been used in medicine since at least the time of the Ancient Greeks, to treat conditions such as tuberculosis, skin disorders, and bacterial and fungal infections. However, the practice fell out of favor during the 20th century as modern societies embraced the medical pharmaceutical model of therapeutics. Over the last decade, there has been an increasing interest in harnessing the power of light as a therapeutic, and a wide range of applications are being explored. Several studies have investigated what happens when RL and/or NIRL light is applied to the abdomen. Interestingly, the bulk of this research has been done using abdominally applied light to treat brain disorders, rather than for GI tract diseases. This is because of the important relationship between the gut microbiome and the brain, through a pathway known as the gut-brain axis (GBA), which involves bidirectional communication between the gut (including the microbiome) and the brain. The GBA plays an important role in brain, gut, and immune health. Alterations in the gut microbiome may be associated with disease through the GBA. RL and NIRL applied to the abdomen (as well as the neck, head and nose) of Parkinson’s disease (PD) patients has been shown to modulate the composition of the gut microbiome, with a shift towards more “healthy” bacteria. Light applied to the abdomen and neck for 12 weeks also decreased symptoms such as impaired mobility in PD patients, with improvements lasting for up to a year. PD is a degenerative brain disease that causes motor symptoms (such as balance and gait problems) and non-motor symptoms (such as depression, sleep disorders, and cognitive impairment). It affects around one million people in the US, and over 10 million people globally.  Application of RL and NIRL to the abdomen (as well as the head) has also been used in the treatment of Alzheimer’s Disease (AD). In a 2022 clinical trial of patients with mild to moderate AD, those receiving light therapy showed improved cognitive function relative to the control group. Alzheimer’s Disease (AD), a form of dementia, is a neurodegenerative disease that comprises 70% of dementia cases. AD affects 1 in 10 US adults over the age of 65, or 5.7 million Americans.  It has been suggested that light therapy applied to the abdomen may be useful in reducing depression. The composition of the gut microbiome has been linked to depression, with depressive patients showing higher levels of certain bacteria that are involved in the synthesis of neurotransmitters such as serotonin and GABA. These neurotransmitters are involved in the regulation of mood. Gut microbiome composition has been strongly associated with mental well-being.   Given the associations between brain diseases and the GBA, it has been suggested that targeting the microbiome holds great potential in the treatment of neurodevelopmental and neurodevelopmental diseases. In addition to AD and PD, these include diseases such as multiple sclerosis, autism spectrum disorder, attention-deficit hyperactivity disorder, migraine, post-operative cognitive dysfunction, and long COVID. According to researchers from Australia, many studies are currently underway “with the aim of restoring the microbiome and potentially altering the course of these brain conditions.”  Light therapy may also be helpful in modifying the microbiome in diseases that primarily affect other body systems. For example, in a case report of a patient with breast cancer, application of NIRL to the abdomen was associated with increased diversity of gut microbes, which is considered to be a healthy change. The authors suggest that light therapy may be a way to improve gut health in patients with chronic disease. Most patients with chronic disease use medications which may adversely affect gut health (especially the microbiome). There is also great potential to use light therapy to treat gut disorders. For example, animal research has found that application of RL to the abdomen of rats with experimentally induced colitis (a form of inflammatory bowel disease) improved many markers of gut health, including reducing inflammation. There is interest in studying the use of light therapy to improve gut health in human subjects as well. Notably, a study using NIRL applied to the abdomen (as well as the front of both thighs) is currently underway to assess whether treatment reduces pain, fatigue, and depression in patients with inflammatory bowel disease. Effects on the gut microbiome will also be measured.  Using Light Therapy for Gut Health There are many light therapy devices on the market today that could be used at home to target gut health. With so many options available, how can you know which device is best for you? Here are five issues to consider. Style Preference: To treat the gut with light therapy, light should be applied to the abdominal area. Two types of devices are most appropriate for abdominal applications: (i) a light panel, or (ii) a light wrap. Your personal level of comfort with a device is important. Imagine yourself using it – Do you want to stand in front of the device, or would you prefer the flexibility of being able to lie down while wearing it? Do you want a device that is wireless, or can you commit to being close to an electrical outlet so that you can plug it in? Think about your personal preferences and choose accordingly. Laser vs LED: Light therapy is administered using either laser or LED lights. While early light therapy research was done using lasers, LED lights have become much more popular over the last decade. The research described in this article includes both types of light sources. In 2018, Dr. Michael Hamblin – the world’s leading light therapy expert – concluded that LED lights using comparable parameters to lasers performed “equally well”, which is very important because LED powered light therapy devices can be made at a fraction of the cost of laser devices. For at home use, look for a device that uses LED lights as safe and affordable option. Light Color/Wavelength – As described in this article, both RL and NIRL have been used in studies of light therapy to treat gut disorders. Positive results have been observed when these wavelengths were used either together or individually. So, look for products that use RL and NIRL either alone or in combination. Light Intensity – Light intensity refers to the amount of light being delivered by a device. It is also referred to as irradiance. The required intensity when using light therapy to impact gut disorders is unclear. There is variability in light intensity between studies, and no studies have directly compared different intensities. Since light is being delivered to the skin of the abdomen, it may be prudent to follow the advice given for light therapy to the skin, and mimic the intensity of the sun, which is around 24 mW/cm2. This is described as the “sweet spot” between higher intensities, which can have harmful effects, and lower intensities, which will have no effect at all. Placing a high intensity device directly on the skin could be harmful. Choose a sun-mimicking product and don’t overdo it when it comes to treatment frequency and duration. Education – While light therapy education will not change the specific functionality of a device, it does have the potential to profoundly impact how someone uses the technology. When a company provides evidence-based education that teaches consumers why, how, and when to use a product, devices can be used to better support healing. Look for products with accompanying education and instructions for use, whether in printed and/or digital formats. You can also look for companies that provide support by phone or email to current or prospective customers. Conclusion Hippocrates is credited with stating that “All disease begins in the gut”. While today’s science does not yet support that level of conviction, we do know that gut health is intimately associated with the overall health of the human body. We also know that “what happens in the gut doesn’t stay in the gut”, but rather influences other organs and systems through complex communication networks. The gut microbiome is inextricable from our own human gut, and both are important for optimal health. When using light therapy for gut health, it’s important to also engage in other gut-friendly activities. These include eating a gut healthy diet, staying hydrated, exercising regularly, and limiting stress. It’s advisable to work with a health care provider with expertise in this area and who can provide appropriate support. Many questions remain about how light therapy can be used to support gut health, but preliminary pre-clinical and clinical evidence supports the use of RL and NIRL both to induce healthy shifts in the gut microbiome and to decrease inflammation. Since RL and NIRL also have other effects, such as increasing energy and decreasing ROS production, many other benefits are likely to be observed. This is certain to be an area of active research interest, especially given the amazing safety profile of light therapy and the increasing availability of at-home devices. For more information about Fringe light products, go to: https://fringeheals.com/shop-all-products/

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January 20, 2024

Red Light Anti-Aging Therapy

Beauty 911: Red Light Anti-Aging Therapy The anti-aging industry is big business. Like REALLY big business. The global anti-aging market, which includes facial anti-aging skin care products, was worth around 63 billion USD in 2021, and is projected to grow by close to 7% to reach 93 billion USD by 2027. Other anti-aging therapies are also increasingly lucrative, with the Botox market valued at 7.23 billion and the dermal filler market valued at 5.01 billion in 2022. Older women (50 years and older) are considered a “gold mine” for the beauty industry, as they  seek ways to retain a youthful appearance. But it’s not just older women that are using anti-aging products. Advertisers now target women in their 20’s, with claims like “…it’s never too early to start looking after your skin”. Women aged 30-39 made up 18% of Botox procedures and 11% of dermal filler procedures in 2020, with women aged 40-59 making up the majority (57% and 49% respectively). These practices are so common that they are now described as being “a really good and essential thing” that is “ongoing” throughout life.  The anti-aging business is being driven by our societal interest in youthful appearance, and whether this is helpful or harmful is certainly up for debate. Regardless of where you stand on this issue, the truth is that the widespread use of anti-aging therapies is now a well-established fact of modern life. Along with this normalization, there has been a general acceptance of the inherent value of these interventions, as evidenced by consumer spending. What has been lost, however, is the consideration of associated risks, both short and long term.  Anti-aging therapies span a wide range of risk. Products such as lotions and creams are very different than injectable treatments or therapies that ablate the skin. It is the latter that carry risks that should be considered along with the potential benefit of improved appearance. While many of these are medical procedures that require specific training to be legally administered, practitioners have a wide range of expertise that influences the risk of adverse outcomes. And unfortunately, there are an increasing number of unqualified technicians taking advantage of unsuspecting consumers. “Botox Parties” are a real thing, where people gather in an informal setting and get Botox as a group, which can reduce the cost of going to a medical center or spa.  In this article, I will describe the risks of some of the most used anti-aging therapies (including Botox, dermal fillers, chemical and laser peels, and microdermabrasion and dermabrasion) so that consumers can be educated and informed about the real, but rare, potential risks. Botox Botox, more formally known as Botulinum Toxin, is an FDA approved medication used cosmetically to reduce the appearance of wrinkles. It can also be used in higher concentrations to treat medical conditions including migraines, bladder issues, and excessive sweating. Botox is a neurotoxin produced by the bacterium Clostridium botulinum that causes muscle paralysis by blocking the signals from nerves to muscles. There are other botulinum toxin FDA approved medications that work in the same way, including Xeomin, Dysport, Daxxify, Jeuveau, and Myobloc. By blocking the signals from nerves to muscles in the face, the muscles relax, leading to a lessening of wrinkles in certain areas such as the forehead, outer eyes, nasolabial folds, and between the eyebrows. Basically, the muscles are being temporarily inactivated, with the contraction being blocked for as long as the toxin is active. It usually lasts for 3 to 6 months. Rather than complete paralysis of the facial muscles, it is now recommended to use a “neuromodulatory” approach, where the activity of the muscles is reduced but not fully inactive. Botox has a high rate of effectiveness and patient satisfaction. A comprehensive review of 65 randomized clinical trials, with nearly 15,000 subjects, found that Botox decreases wrinkles within four weeks following treatment. It has also been found that up to 90% of people getting Botox are satisfied with treatment outcomes, which improves how they perceive their appearance and their psychological well-being.  Despite these clear benefits, there are some recognized risks to the use of Botox, ranging from minor to severe. Concerningly, although only a small number of adverse events are formally reported to medical regulators, recent research shows that up to 16% of Botox users have “complications”, which suggests that problems are underreported and underrecognized. The following is a list of potential adverse outcomes that should be considered by Botox users: Injection Site Injury – Since a needle is puncturing the skin, there is trauma that can result in injuries including bruising, tenderness, pain, and swelling. These are minor concerns that usually resolve quickly.  Infection – Infection can occur at the injection site due to contamination, which can cause a local reaction or a more serious abscess. Antibiotic treatment may be needed for resolution.  Allergic/Hypersensitivity Reactions – Allergic reactions can be either localized (staying within region of the injection site) or generalized (spreading throughout the body). The latter are much more serious and require medical intervention. Local reactions can usually be managed with antihistamines. Some reactions may be due to silicone oil, which is used as a lubricant to line most syringes. Decreased Sweat Gland Activity – The botulinum toxin can decrease the sweat gland activity in the affected area, which causes localized areas of dry skin. This is a minor side effect that can be treated with moisturizers. Nerve Damage – If the injection causes trauma to nerves in the area it can cause changes in sensation such as tingling or abnormal sensations. This usually resolves on its own as the nerve heals. Vision Problems – Botox injections around the eye area can cause problems including blurred vision, dry eyes, irritation of the cornea, and strabismus (which is when the eyes don’t line up properly). These are rare complications usually caused by improper injection techniques, and which may require treatment from an ophthalmologist. Negative Aesthetic Results – A wide range of undesirable aesthetic outcomes can happen with Botox treatment, which vary depending on the area being injected. Drooping of the upper eyelid is estimated to occur with 1-5% of patients and can last for several weeks. Other undesirable outcomes include eyebrow raising, smile limitations, and asymmetry between the sides of the face. These can last until the toxin wears off. Repeated use of Botox injections over a long period of time can cause permanent changes to facial expression.   Botulism – Botulism is a serious side effect of Botox that can be life threatening. Botulism occurs when the toxin spreads throughout the body, causing muscle weakness, difficulty swallowing, and respiratory failure. Since 2008, Botox and related products have had a black box warning from the FDA that warned of this risk, but citizen safety groups are currently lobbying for a more severe warning to be applied.  Botox Resistance – Also known as “immunoresistance”, Botox resistance occurs when people develop antibodies against the Botox toxin. This can occur in up to 5 to 10% of people who get repeated, high dose Botox injections, although it’s much less common for people using Botox for cosmetic as compared to medical purposes. The antibodies block the response to Botox making the treatment ineffective. Muscle Atrophy – Because Botox partially or completely paralyzes facial muscles, the muscles themselves can atrophy over time. This is especially a problem with repeated injections. Given the increasingly common practice of starting Botox at younger ages, many women may find themselves with weakened atrophied muscles as they get older, which will ultimately prove counterproductive to their pursuit of a youthful appearance. One other concern related to the safety of Botox injections relates to the issue of autoimmune disease. Although the relationship between Botox and autoimmune diseases is unclear, there are anecdotal reports of Botox aggravating or inciting these conditions. As described by acupuncturist Dr. Megan Gray, as a foreign substance, Botox may trigger an already overreactive immune system to be even more reactive, which may create problems. Making the connection between Botox injections and aggravation of the immune system can be very difficult, but it is something people at risk of autoimmune disease should consider as a potential risk.  Dermal Fillers “Fillers” are soft substances that have a gel-like consistency. They are injected under the skin to fill and add volume to spaces in the face and sometimes other areas, like the hands. Adding dermal fillers under the skin has the effect of reducing signs of aging, such as under eye circles, hollowed cheekbones, and wrinkles.  There are several different types of dermal fillers, including natural and synthetic. Natural fillers include hyaluronic acid (Restylane, Juvederm), which is naturally found in the skin and helps with hydration and volume, and calcium hydroxylapatite (Radiesse), which is naturally found in bones. Natural fillers usually last for at least 6 months and then are gradually absorbed by the body. Autologous fat, which is when fat is taken from one area and injected into another, is another type of (natural) dermal filler, as is human collagen. Synthetic fillers include poly-L-lactic acid (Sculptra), which stimulates the body to produce collagen over a period of months after injection, and polymethyl methacrylate (Artefill, Bellafill), which is a semi-permanent filler. Most people report improvement in appearance following injection of dermal fillers. In a study of people getting hyaluronic acid filler, almost 94% reported improvements at month 3 and 76% reported improvement at month 12. People receiving calcium hydroxylapatite filler also report improvements of up to 12 months, as do people receiving synthetic filler.  All dermal fillers are capable of causing complications, with long-lasting synthetic fillers creating more of a risk due to their persistence. According to an analysis of side effects related to complications that have resulted in litigation, the most common are: Swelling – Swelling in the treated area can range from mild to severe. It will usually resolve in hours to a few days but can lead to the area looking “overtreated” while it’s inflamed. Infection – As with Botox, the injection associated with dermal fillers can result in infection, which can vary in severity. Another infection associated complication is the formation of biofilms, which can be difficult to treat.  Allergic/Hypersensitivity Reactions – Allergic/hypersensitivity reactions can occur to dermal fillers but are much more common with synthetic as compared to natural fillers. There are factors that increase the risk of hypersensitivity reactions, such as exposure to viral illness or recent vaccination (such as against Shingles or COVID). Risk of some hypersensitivity reactions is increased when a person carries specific genes that drives the immune response. Nodules – Nodules are the second most reported complaint, next to swelling. Nodules are unintended lumps that can form immediately or have a delayed onset. Delayed onset nodules can even form years after filler injection. Nodules formed from hyaluronic acid can be dissolved with the enzyme hyaluronidase (which breaks down hyaluronic acid), but nodules from synthetic filler are more difficult to treat (and more common).  Negative Aesthetic Results – Nodules can result in negative aesthetic results, but these are not the only cause of poor outcomes. Others include asymmetry between the sides of the face and overfilling, which is most common in the lips and cheeks. Asymmetry can sometimes be fixed by adding more filler to the less filled side, while overfilling with hyaluronic acid filler can be dealt with by injecting the enzyme hyaluronidase. However, overfilling with synthetic fillers is harder to correct, and hyaluronidase breaks down not only the filler but also existing hyaluronic acid, which can be undesirable. Filler can also migrate to other locations, as discussed widely on social media (#lipfillermigration).  Pain – Pain is the third most common reported complaint and is more likely to occur with synthetic filler. Injection of fillers uses larger cannulas, as compared to Botox which uses needles, and these can cause more injection site pain.  Blood Vessel Complications – Dermal filler injections can result in trauma to blood vessels in the area. A rare complication is that fillers can be injected into blood vessels, which can block blood flow. This is a potentially severe outcome that must be diagnosed and treated immediately, or death of the tissue being fed by that blood vessel can occur.  Vision Problems – Dermal fillers can cause vision loss and blindness in rare circumstances. These effects can be permanent, although some people recover fully. Vision problems are usually caused by damage to blood vessels, which allows filler to get in and block the blood vessels that feed the eye. This is mainly a risk when injecting into the eye and forehead areas.   Nerve Damage – Damage to nerves can occur as a result of injection with a canula and can range from minor to severe. Usually, nerve damage will heal but sometimes it is permanent.  Tyndall Effect – The Tyndall effect is when a bluish hue appears within the skin when too much hyaluronic acid filler is placed superficially. It’s caused by scattering of different wavelengths of light when they hit the filler particles. This can appear like a bruise, but it doesn’t resolve within a few days, instead lasting for as long as the filler is present.  Like Botox, dermal filler should only be administered by a certified professional. Dermal fillers can be provided in the US by medical doctors, nurse practitioners, physician’s assistants, registered nurses, dentists (in some jurisdictions), and licensed aestheticians (in a few states). It is crucial that the provider be well trained and experienced, which will help to reduce the risk of negative outcomes.  Chemical Peels Chemical peels are a non-injectable anti-aging therapy in which a chemical solution is applied to the skin which removes the top layers of skin. Since the new skin that grows back is smoother, chemical peels are used to reduce the appearance of wrinkles, minimize scars, treat acne, and improve skin pigmentation.  Chemical peels are either light, medium, or deep. Light peels remove the superficial epidermis of the skin, while medium peels remove both the epidermis and some of the dermis. Deep peels can get even deeper, which is recommended for deep wrinkles and scars. The level of risk of adverse events goes up as the chemical peel gets deeper. Light chemical peels are most helpful for fine wrinkles, uneven pigmentation, and dry skin. The risks of light chemical peels are minor, and include redness, stinging, and skin flaking and irritation. Light peels may also cause acne flare ups, and all peels can activate latent herpes infections, trigger allergic reactions, and alter skin pigmentation.  Medium chemical peels are helpful for deeper wrinkles, acne scars, and uneven pigmentation. With medium chemical peels, in addition to the risks seen with light peels, the redness is more significant and can last up to several months. The effects of medium chemical peels on the skin are similar to a deep sunburn. Medium peels can rarely cause scarring. Deep chemical peels are most helpful for deeper wrinkles, sun damaged skin, scars, and blotchy skin. Deep chemical peels are quite intense and may require a local anesthetic. There are many potential complications, including: peeling, scabbing, redness, flaking and irritation of the skin for up to several months; scarring; and loss of skin pigmentation (potentially permanent). Deep peels that use phenol can also cause heart arrythmia and atrial fibrillation.  Laser Peels Laser peels, also known as laser skin resurfacing, are similar to chemical peels in that the goal is to improve appearance by getting rid of older, damaged skin. While chemical peels use a chemical solution to remove skin, lasers use concentrated light beams to remove damaged skin. Laser peels can reduce the appearance of wrinkles, scars and blemishes. Potential side effects of laser peels are similar to those of chemical peels, and include: infection, scarring, changes in pigmentation, allergic reactions, redness, acne flare ups, and reactivation of herpes infections.  Dermabrasion As with laser and chemical peels, the goal of dermabrasion is to resurface the skin. With dermabrasion, the top layer of the skin is removed using a high speed rotating brush. Dermabrasion can help to reduce the appearance of fine lines and minimize scars. Potential side effects of dermabrasion include reactivation of herpes infections, changes in skin pigmentation (which can be permanent), infections, persistent redness, and thickened skin.   My Story As I approached my late 30’s, I decided to try using Botox and filler to slow down the signs of aging. I actually had no visible lines at the time, and I wanted to keep it that way! Using Botox to prevent lines from developing in the “active” areas of my face, like between my eyebrows and around my eyes, seemed like a good preventive measure. I also noticed that my face seemed to be a bit less plump than when I was younger, which I thought could be improved with dermal filler.  Since this was all new to me, I did my due diligence and looked around for a reputable provider. I learned that people with different qualifications were doing injectable treatments, and I decided that if I was going to do this, I wanted the most highly credentialed therapist I could find: a dermatologist. I chose one who came highly recommended by a friend and set up a consultation. The doctor recommended injection of a small amount of hyaluronic acid filler under my eyes and around my cheekbones, and some Botox between my eyebrows and around my eyes. The Botox was only a tiny bit uncomfortable, but I found the injection of filler (which uses a canula rather than a fine needle), to be unpleasant. It’s not so much that it was painful, but it was strange feeling a canula being moved around in such a delicate area. Since there was a small amount of filler left in the vial after doing my eye and cheekbone area, the doctor suggested that we put this into my lips. I wasn’t too keen, as my lips are already pretty full, and I’d seen enough overfilled lips to be concerned about appearing unnatural. But since I had to pay for the filler regardless, and as the doctor assured me that it was such a small amount that it would barely be visible, I agreed. I was surprised to discover that Botox doesn’t work immediately – you have to wait a couple of days for the effects of the toxin to be seen. And filler can feel a bit hard at first, which scared me as it felt unnatural in my face. It softened within a few days, and the Botox set in, and overall, I was pretty happy with the results. It was super subtle, and I’d say that I just looked a bit more refreshed and rested. I definitely still looked exactly like “me”, just a little bit better, which was my original goal. However, after a month or two I noticed that my eyes seemed to have bags underneath them that had never been there before. And as time went on, it got more noticeable. So much so that I returned to the doctor to discuss my concerns. It turned out that I had filler migration. I don’t recall being told that this was a potential risk, although it may have been part of the small print in the informed consent form. Migration of filler from the tear trough to the orbital area of the eye can apparently occur up to several years after injection.   The recommended solution was to use hyaluronidase to break down the filler. Because hyaluronidase dissolves not only hyaluronic acid filler, but also the body’s own hyaluronic acid, it can reduce volume even further. According to realself.com, when hyaluronidase spreads outside of its zone of injection its outcome can be “somewhat unpredictable”. In people who have been using it for a long time, hyaluronidase reveals the signs of aging as well as the damage caused when filler stretches the skin. Thankfully, since this was my first foray into the filler world, I largely escaped unscathed. However, years later I still have some residual under eye puffiness that I attribute to this ill-fated (and costly) anti-aging experiment. Back to my lips. That little bit of filler there also turned out to be a bad idea. I was looking at a picture of myself a couple of years after the injections and noticed that my smile looked a tiny bit lopsided. Sure enough, my lips were now a little bit uneven. Although patients are told that temporary fillers dissolve, it turns out that sometimes they last for much longer – perhaps even forever. In my case, I suspect that the filler has dissolved unevenly, leaving me with a slight asymmetry between the two sides.  This unfortunate experience let me to do two things. First, I decided to embrace aging. I will wear my life experiences with pride and recognize that happiness will never be found by forcing my body to conform to an unrealistic and ill-conceived idea of beauty. And second, I searched for alternatives to injectable and invasive anti-aging therapies that I knew I could use safely and without concern about adverse outcomes.  Alternative Anti-Aging Therapies Topical Products – There are loads of topical anti-aging products that can safely be used on the skin and that have anti-aging effects. While these aren’t expected to cause dramatic results, many have been shown in clinical research to reduce signs of aging, such as fine lines and uneven skin pigmentation. They include ingredients like vitamin C, niacinamide (vitamin B3), retinol, and tranexamic acid (from the amino acid lysine). Since what goes on your body goes in your body, make sure that all ingredients in your products are safe. The Environmental Working Group’s Skin Deep database is an amazing resource for this – just type in your product and they’ll give you a safety report.   Red Light Therapy – Red light therapy (also known as photobiomodulation) is the application of red light, which is visible as the color red, and/or near infrared light, which is not visible but can be felt as heat. Red light therapy has been shown to be effective for “skin rejuvenation”, including outcomes like increased collagen synthesis, increased elastin production, extracellular matrix regeneration, regulation of oil production, and regulation of the pigment producing cells of the skin. Clinically, these manifest as reduced wrinkles, improved skin appearance, and improved skin pigmentation. Studies show results such as smoother skin; wrinkle reduction and improved skin elasticity; and normalization of skin pigmentation. Most skin rejuvenation studies use both red and near infrared light. Red light therapy has an amazing safety profile and can be used safely by most people, especially at low to moderate intensities.   Cosmetic Acupuncture – Cosmetic acupuncture is acupuncture applied to the face, head and neck. Since acupuncture does involve piercing the skin with needles, there is a small risk of infection, which can be greatly minimized by using safe practices like using sterile needles and disinfecting the skin before treatments. Side effects are extremely rare. Cosmetic acupuncture has been found to improve facial elasticity and restore muscle tone.  Face Yoga – Face yoga involves doing exercises to strengthen the muscles in the face. By increasing muscle mass, the facial atrophy that is associated with aging can be reduced. Although the effects are not dramatic, face yoga has been found to improve measures of facial appearance, particularly cheek fullness. This contrasts with Botox, which is known to cause muscle atrophy because the paralyzed muscle is not being used. There are no risks at all involved with doing face yoga.  Conclusion Author Leo Tolstoy is credited with saying “It is amazing how complete is the delusion that beauty is goodness.” Perhaps this is why the pursuit of youthful beauty goes back to humanity’s earliest civilizations. Exacerbated in the modern world through the digital spotlight of social media, the increasing normalization of altering appearance using anti-aging therapies has led to a diminished consideration of associated risks, which can be significant and life-altering. Fortunately, there are many safer alternatives that have can be used to support natural and graceful aging.  For more information about Fringe light products, go to: https://fringeheals.com/shop-all-products/

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November 19, 2022

Transcranial Photobiomodulation for The Management of Depression

Authors: P. Askalsky, D.V. Iosifescu Background: Depression is a major public health problem that affects 322 million people worldwide with a lifetime prevalence of 20%. Depression is widely treated with antidepressants, but some patients have a poor response and many experience side effects. A novel non-pharmaceutical approach to treating depression is the use of light therapy, called photobiomodulation. This is a type of “neuromodulation” in which the skull (cranium) is exposed to light at specific wavelengths. A 2019 article provided a comprehensive review of the research in this area, which is summarized here. Research Highlights: Studies have shown that near-infrared light penetrates the skull better than red light, although penetration with both is impeded by bone. Longer wavelengths (measured in nm) penetrate better and pulsed emission is better than continuous. Lasers penetrate more deeply than LED lights. 2. Mitochondrial function, which is responsible for energy production, is reduced in patients with depression, and improvement in function with light therapy is thought to be the primary mechanism of benefit. 3. Transcranial light therapy may also help by increasing blood flow to the brain, possibly via effects on nitric oxide, and by increasing brain antioxidant levels. 4. Research using animal models has shown that light therapy reduces anxiety and depression-like behavior, as well as cortisol and glucose levels. Most animal research used laser light. 5. Research in humans has shown that light therapy can improve mood and reduce depression. Benefits are seen immediately following treatment although longer treatments may be more effective. Some studies used LED lights while some used lasers. 6. Transcranial light therapy is safe and well-tolerated. Fringe Commentary: Although research in humans is still limited, evidence suggests that transcranial light therapy may be effective in the treatment of depression. Most high-quality home light therapy devices have both red and infrared settings, offering the near infrared light that is recommended for this treatment. Home light therapy devices also use LED lights, which although not as penetrating as laser lights have still shown therapeutic benefit. Light therapy appears to be an effective non-pharmacological treatment for depression, which can be used safely by most patients. Link: https://pubmed.ncbi.nlm.nih.gov/31819453/

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November 19, 2022

Photobiomodulation and Pain Reduction in Patients Requiring Orthodontic Band Application:

Authors: M.F. Sfondrini, M. Vitale, A.L.B. Pinheiro, P. Gandini, L. Sorrentino, U.M. Iarussi, A. Scribante. Citation: BioMed Research International (2020), Article ID 7460938 Background: Light therapy, or photobiomodulation, involves the application of a light source such as a laser to an area of the body for therapeutic purposes. Light therapy works on the principle that cells absorb light which triggers chemical and physical reactions including stimulation of mitochondria, which produce cellular energy. One of the effects of light therapy is the reduction of pain. Objective: To determine if application of low-level light therapy would reduce pain associated with orthodontic band application in a randomized placebo-controlled study. Who Was It? Twenty-six patients requiring orthodontic band application participated in this study. They ranged in age from 7 to 20 years. What Was Done? Subjects were randomly assigned to the placebo group or the light therapy group. After application of the orthodontic bands, subjects received one session of light therapy to four points around the banded teeth. Researchers were blinded to what group the subjects were in. This study used laser light therapy, which is different from the LED light therapy used in home photobiomodulation devices. Although debated, LED light therapy is thought by many to be comparable or even superior to laser light therapy. The main difference between the two is the narrow focus of laser light, which makes it suitable for targeting a small area of treatment, as in this study. What Happened? The subjects who received light therapy had significantly lower pain at 5 minutes, 1 hour, and 12 hours after treatment as compared to the control group. Subjects in the light therapy group still reported experiencing some pain, which followed a similar pattern to subjects in the control group, albeit at a lower intensity. Fringe Commentary:  As a mom of two kids with braces, I couldn’t help but be intrigued by this study. I know how much orthodontics can hurt, and to learn that pain can be reduced simply by the application of light therapy is quite remarkable. It is especially remarkable that pain intensity was decreased with a single session! Light therapy is proving to be extremely versatile, with applications for a range of different outcomes, as we will be exploring in our newsletter this month. Stay tuned next week as we explore the use of light to improve sleep quality. FYI: The technical definition of photobiomodulation is “A form of light therapy that utilizes non-ionizing forms of light sources, including LASERS, LEDs, and broad-band light, in the visible and infrared spectrum. It is a non-thermal process involving endogenous chromophores eliciting photophysical (i.e. linear and non-linear) and photochemical events at various biological scales. This process results in beneficial therapeutic outcomes including but not limited to the alleviation of pain or inflammation, immunomodulation, and promotion of wound healing and tissue regeneration.” (North American Association for Photobiomodulation Therapy, https://www.naalt.org). Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7273483/pdf/BMRI2020-7460938.pdf

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