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Light Therapy for Inflammation
Inflammation is one of the most popular topics in healthcare, and rightfully so. It is a hallmark of many diseases currently ravaging modern society, such as arthritis, ulcerative colitis, inflammatory bowel disease, heart disease, diabetes, cancer, Alzheimer’s Disease, and depression. Inflammation is also associated with acute diseases involving the heart, pancreas, liver, and other organs, as well as trauma and infection. The personal and economic burden of these diseases cannot be overstated. Treatment of inflammation associated diseases makes up the majority of health care spending in the US, costing billions of dollars annually. There are also indirect costs of illness, such as reduced work and productivity. The most common treatments for inflammation are pharmaceuticals, including prescription (such as Celebrex) and the over-the-counter drugs (such as Aspirin and Alleve). However, many of these drugs have serious side effects, such as hypersensitivity reactions and ulcers. Given these risks, many people are turning to non-invasive therapies to fight inflammation, some of which are highly effective and have far fewer side effects than their pharmaceutical counterparts. One of these is treatment with red and near infrared light (also called red light therapy or photobiomodulation), which uses light waves at specific frequencies to decrease inflammation at a cellular level. Red Light Therapy The term “red light therapy” usually describes the use of both red and near infrared light, although only the red light produced by the device is visible to the naked eye. Infrared light can still be perceived by the body as heat when it contacts skin. Red and near infrared light therapy is the application of artificially generated light in the red and near infrared spectral bands. Red and near infrared light 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. Red light is part of this visible light spectrum, while near infrared light is not. 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 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. Inflammation The inflammatory process is mediated by the immune system, specifically the innate (or non-specific) component. Inflammation protects the body from injury and infection. There are many goals of the inflammatory response, including reducing the extent of injury, limiting the spread of infection, and restoring the body back into balance. While we mostly think of inflammation as being harmful, it’s actually a natural and essential physiological function. Inflammation becomes harmful when it is uncontrolled, lasts for a long time, or just generally occurs when it shouldn’t. There are three types of inflammation, which are mainly defined by their length. Acute inflammation is short term, lasting days. This is what happens when you sprain your ankle, and it swells up, becomes warm, and may show color changes. That response is designed to limit movement, which prevents further injury and allows the damaged tissue to heal. Sub-acute inflammation lasts from two to six weeks, and often follows acute inflammation as healing progresses. The response here is similar, but less intense, than acute inflammation. Chronic inflammation lasts for months or even years, and at this point, inflammation has ceased to be a normal (and healthy) response to a stimulus and has become pathological. Chronic inflammation is the type that is associated with most diseases. It is also associated with oxidative stress. Chronic inflammation is not associated with visible signs of inflammation (such as redness, heat, and swelling), so people often aren’t even aware it is happening. This contrasts with acute inflammation, which is usually visible and occurs because of trauma or infection. Red Light Therapy for Inflammation As described by Dr. Michael Hamblin, former Associate Professor at Harvard Medical School, “one of the most reproducible effects of is an overall reduction of inflammation”. Studies have found that light therapy affects levels of many molecules involved in inflammation, including reactive oxygen species, reactive nitrogen species, and prostaglandins. Light therapy has even been found to reduce inflammation in the brain, known as neuroinflammation. Red light therapy has been shown to have anti-inflammatory effects in the following conditions: Brain Disorders – Neuroinflammation is one of the foundational pathologies underlying a wide range of brain disorders. Light therapy has been found to decrease inflammation in Alzheimer’s Disease, as well as to improve cognitive function. Several clinical trials have been published which have shown positive results. Most studies have exclusively used near infrared light, which has been found to penetrate more deeply into the brain. Light therapy has also been found to decrease inflammation and improve recovery after a stroke. When used to treat brain disorders, light therapy is usually applied to the head area, using devices such as hats and helmets. Traumatic Brain Injury - Traumatic brain injuries (TBI) occur when there is a violent blow to the head. Approximately 17% of people with repeated TBI progress to chronic traumatic encephalitis (CTE), a brain disorder caused by repeated head injuries. Concussions are another common type of TBI. TBI’s result in acute neuroinflammation, which can become a chronic problem if not treated properly. Research using light therapy (both red and near infrared) for TBI has looked at both immediate and chronic effects in animal and human models. Animal studies have shown a reduction in the size of the brain lesion when light therapy was applied to the head immediately following trauma, which correlated with the severity of neurological symptoms, which may be due (in part) to decreased inflammation. Depression – Neuroinflammation is similarly found in people suffering from depression, and it is thought to be a key factor and therapeutic target in depressive disorders. Several clinical trials of light therapy in depression have been conducted, all of which used near infrared light applied directly to the head. A 2022 systematic review concluded that light therapy “can be classified as strongly recommended for moderate grade of major depressive disorder”. Similarly, a 2023 meta-analysis concluded that there is a “promising role of in the treatment of depressive symptoms”. Gut Disorders – Inflammatory gut diseases like colitis and inflammatory bowel diseases may benefit from red light therapy. Research has found that application of red light 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, with research currently ongoing to see if it helps patients with inflammatory bowel disease. When treating gut disorders, light therapy is usually applied directly to the abdomen. Pain - Pain creates a huge burden of disability, both personal and economic. There is evidence that red light therapy decreases many types of pain, including knee, neck, low-back, temporomandibular joint, and post-surgical pain. Red light therapy can also reduce pain associated with arthritis and fibromyalgia. One of the primary mechanisms of pain reduction by light therapy is by decreasing inflammation. Red light therapy also reduces pain by decreasing oxidative stress, reducing the sensitivity of neurons, and decreasing the transmission of pain related nerve impulses. Arthritis – In addition to reducing arthritis pain by decreasing inflammation, the anti-inflammatory effects of red light therapy on arthritis also yields other benefits. Inflammation in arthritis is responsible for much of the observed pathology, including cartilage breakdown. Treatment with red light therapy may have a range of positive effects, such as preserving joint function, avoiding joint deformities, and reducing drug side effects and toxicities. Delayed Onset Muscle Soreness – Delayed onset muscle soreness (DOMS) is pain that occurs in the muscles between 12 and 24 hours after a workout. DOMS is caused by tiny muscle tears that results in inflammation, which causes pain. Treatment with red light therapy to muscles after a strength training session has been shown to decrease markers of inflammation, as well as to improve other outcomes like decreased fatigue and increased protein synthesis. Injury – In addition to its anti-inflammatory effects on muscle tissue, including speeding recovery from post-exercise damage, red light therapy also reduces inflammation and speeds wound healing, such as from burn injuries. Red light therapy can also reduce inflammation and speed healing from injuries to bone, including fractures and more complex bone injuries that require the use ceramic materials. Tendon injuries also benefit from red light therapy. Skin Disorders – Many skin disorders are characterized by inflammation, including acne, psoriasis and eczema. Light therapies treat acne through anti-inflammatory and antimicrobial effects, and by decreasing the production of oil. Inflammatory acne is more responsive to light therapy than non-inflammatory acne, and studies have even found it to be superior to some medications. Red and near infrared light is also recommended in the treatment of psoriasis in part because of its anti-inflammatory effects. And in eczema, an inflammatory skin disease, treatment with near infrared light therapy has been found to decrease skin itching and lesions. Alopecia Areata – Alopecia Areata (AA) is an autoimmune disease that causes the body to attack its own hair follicles. This causes the hair to fall out, resulting in patches of baldness. AA can affect hair on any part of the body but is most common on the head. It is characterized by inflammation around hair follicles during the growth phase. The anti-inflammatory effects of light therapy may decrease this inflammation. In fact, treatment with red and near infrared light has been found to increase hair growth in bald patches. How To Use Red Light Therapy To Reduce Inflammation There is no single right way to use red light therapy to reduce inflammation. It all depends on what condition you are trying to treat and what your personal preferences are as far as treatment approach. The following are a few simple questions that can be used to guide you towards selecting the device that is most suitable for your needs: 1. What are your specific health concerns? Red light is usually applied to the affected body part, either directly in contact with the skin or at a distance of around 4 to 12 inches away. Some devices are location specific, such as knee wraps, head wraps or helmets, shoulder and neck wraps, or elbow and wrist red light wraps. Other devices are non-specific, such as square or rectangular light wraps, or red light panels. If you are dealing with a single, region-specific concern – such as knee arthritis or Alzheimer’s Disease - you may prefer to get a regionally targeted red light therapy device. However, if you are dealing with inflammation in more than one area of the body and want a device that can be used in multiple locations, a non-specific wrap may be preferable. Red light panels can also be used to address multiple body parts, although they may be difficult to position properly for some locations, such as the feet and ankles. 2. What are your preferred treatment conditions? Treatments using red light panels are most often done in a seated position, with the panel oriented towards the face, neck, torso, or other affected body part. They can also be done in a standing position, although this is not as relaxing. Lying down is possible if the treatment location allows it. Red light panels are wired and require the user to stay in the same position throughout the duration of the treatment. In contrast, treatments using red light wraps can be done in any position, including standing, sitting, and lying down. They can even be worn while moving around. Some red light wraps are wired, while others are wireless, with wireless models providing more flexibility. 3. What device specs should you look for? At home red light therapy devices almost always use LED’s as the light source. However, they do vary in other parameters, such as light wavelength(s) and intensity. When it comes to choosing the optimal wavelengths, you should look for light in the red and/or near infrared spectrums - but avoid the range of 700-780nm which has been found to be ineffective. Multi-wavelength devices including both red and near infrared light may be the most versatile. In terms of intensity, it has been found that it is ideal to mimic the intensity of the sun, which is around 24 mW/cm2 at the skin. 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. Many devices on the market are at a much higher intensity than the sun, so choose a sun-mimicking product and don’t overdo it when it comes to treatment frequency and duration. Conclusion Red light therapy (with red and near infrared light) may be used to reduce inflammation in a wide range of diseases, both acute and chronic. There are very few contraindications to red light therapy, and it 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. For more information about Fringe light products, go to: https://fringeheals.com/shop-all-products/
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Red Light Therapy for Anti Aging
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, which is visible as the color red, and/or near infrared light, which is not visible but can be felt as heat. Blue light is also often used in light therapy for skin conditions. Different colors of light have different depths of skin penetration, with red light and near infrared light penetrating the deepest. Light therapy can support skin health in a variety of different ways. Through its effects on mitochondria, light therapy can increase cellular energy production and modulate oxidative stress. In the skin, this increased energy can be used to support normal processes such as collagen and elastin production. And by modulating ROS production and oxidative stress, there is a shift towards skin rejuvenation rather than skin breakdown. The anti-aging effects of light therapy are often referred to as “skin rejuvenation”. This includes 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. The effect of red light therapy on wrinkles can be quite dramatic, with one study showing a 30% decrease in eye wrinkle volume. Most skin rejuvenation studies use both red and near infrared light. Importantly, the use of light therapy to regenerate skin is gentle and “non-ablative”, which means that it doesn’t harm the epidermis of the skin and require downtime for healing. This contrasts with many popular anti-aging treatments such as microneedling, chemical peels, and microdermabrasion, which stimulative collagen synthesis and improve appearance by damaging and resurfacing the outer layer of the skin. At Fringe, we view aging as something to be embraced and supported using natural therapies, which is why we developed the Fringe red light face mask. Our mask is hands free, wireless, and uses 234 hard working LED light chips to deliver red and near infrared light to the entire face. It also has the option to deliver blue light if blemishes are a problem. Use the healing power of light and treat yourself to healthy, radiant looking skin in the comfort of your own home! For more information about Fringe light products, go to: https://fringeheals.com/shop-all-products/
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Light Therapy for Acne
Red & Blue Light for Acne Red and near infrared light therapy is the application of artificially generated light in the red and near infrared spectral bands. Other forms of light therapy include light in the blue spectrum, which is often used in light therapy for skin conditions. Blue light has the shortest wavelength, red light is intermediate, and near infrared light wavelengths are the longest. Different colors of light have different depths of skin penetration, with red and near infrared penetrating the deepest. Blue light from light therapy devices mimics the blue light generated from the sun, without any harmful UV rays. In contrast, artificial blue light generated from electronic devices has different spectral properties and can be harmful to the skin. Red, near infrared, and blue light have all been found to effectively treat acne. Acne is a common skin condition, affecting nearly 10% of people worldwide. Prevalence is highest in adolescents, with up to 85% having acne at some time during this period. Acne is not only painful, but it can also have adverse effects on many aspects of life, including social, psychological, and economic. Since acne has been observed to respond positively to sun exposure, a variety of treatment approaches using light therapy have been used. Light therapy for acne is treated in a variety of ways. Molecules in the skin called porphyrins absorb blue light which has antimicrobial effects that kill the bacteria associated with acne. Red and near infrared light also have antimicrobial effects but work via a different mechanism. The longer light wavelengths also reduce the activity of sebaceous glands, which are responsible for oil production. Treatment with blue, red, and near infrared light has been found to effectively treat acne, especially when used in combination. The Fringe Red Light Face Mask delivers both red and near infrared light as well as blue light to support skin health, including the treatment of acne. Made of soft silicone and battery powered, the mask is comfortable to wear and easy to use. The mask has three modes of use, which can deliver blue, red, or red and near/infrared. These can be combined in sequence for exposure to multiple wavelengths. Our recommended treatment protocol of light therapy for acne is to use blue daily and follow this with red/near infrared 3 to 4 times per week. For more information about Fringe light products, go to: https://fringeheals.com/shop-all-products/
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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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Light Therapy for Skin Health
Social media is ablaze these days with stories and images of people using light therapy to improve their skin health. Women of all ages can be seen irradiating their faces with devices ranging from illuminated panels to Halloween-like face masks, which they claim reduces the appearance of lines and wrinkles, improves skin elasticity, and treats breakouts. Is this just more social media hype, or can light therapy really be used to improve skin health? And what exactly is light therapy anyways? What is 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. Blue light (BL), which ranges from around 450 to 495nm, is also used in many light therapy products. RL, BL, 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. BL and RL are part of this visible light spectrum, while NIRL is not. Although the amount of solar radiation is not constant, approximately 40% percent of the light from the sun is visible light, which can be divided by color and wavelength. RL and BL are part of visible light. NIRL waves lie just beyond the “red” end of the visible light spectrum, so we don’t see them. NIRL is part of the “infrared” spectrum, which consists of both NIRL and far infrared light (FIRL). Infrared light makes up 50% of the solar radiation that reaches the earth. The remaining 10% of the light from the sun is also invisible, falling just beyond the opposite “violet” end of the visible spectrum to IR. This is called ultraviolet light (UVL). 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. Red and NIRL therapy does not involve the use of UV rays, although UV can (and is) sometimes used in some forms of light therapy. Other forms of light therapy include light in the blue, green and/or yellow spectrums. RL/NIRL is the most used form of light therapy, although BL is also often used in light therapy for skin conditions. Different colors of light have different depths of skin penetration, with RL and NIRL penetrating the deepest. Wait a minute – isn’t the sun bad for my skin? According to most national health agencies, sun exposure should be limited because it increases the risk of skin cancer. The FDA recommends avoiding the sun between 10am and 2pm and using sunscreen and sun blocking clothing and sunglasses the rest of the time, even on cloudy days. The CDC gives guidelines to schools to provide shade for students and employees that work outside, and to encourage them to use sunscreen while at work and school. And the American Academy of Dermatology Association recommends that everyone use sunscreen or sunblock, every day. However, excessive sun avoidance may also be harmful to human health. It has recently been estimated that around 340,000 excess deaths per year in the US are due to insufficient sun exposure. This is, at least in part, because sun is needed for vitamin D production, which is essential to health. Vitamin D is made in the skin when exposed to UV light. Many people are modern society are vitamin D deficient, which can have serious consequences, including the development of age-related diseases, diabetes, cardiovascular disease, multiple sclerosis, and infectious diseases. This suggests that sun exposure plays an important role in health, which is consistent with the evolution of life on earth alongside solar radiation for billions of years. UV rays are the component of solar radiation that are the main culprits in causing skin cancer. But as already mentioned, the sun contains many other different types of light rays. Like UV rays, these other types of rays are important regulators of physiological processes including circadian rhythms and hormone production, but they do not show a similar association with cancer. This suggests that we should aim to increase our exposure to healthy solar radiation while limiting UV exposure, although some UV exposure is essential. One way to do this is by using light therapy devices that do not emit UV light. It should be noted that there is some controversy over whether BL can have harmful effects on the skin. While BL from electronic devices may not be healthy, BL from light therapy devices has been shown to be beneficial in the treatment of some skin conditions, such as acne, as will be described later. There is also some controversy over whether NIRL can have harmful effects on the skin, with some sunscreens advertising that they protect against “harmful” UVL and IRL. However, evidence of harm from NIRL came from studies using light at very high intensity that were not representative of the IRL dose obtained from the sun. As such, experts in the field have concluded that when it comes to the skin, IRL does “more good than bad”. Harm can be avoided by using IRL devices that mimic the intensity of the sun, but do not exceed it. How does light therapy improve skin health? There are a wide range of biological effects of light therapy which are induced by the application of light to the body. Effects occur both when light is applied to the skin as well as when it enters through the eyes. 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. In the skin, this increased energy can be used to support normal processes such as collagen and elastin production. And by modulating ROS production and oxidative stress, there is a shift towards skin rejuvenation rather than skin breakdown. The effects of light on cells extend beyond ATP and ROS, although these are the most well-known. Other effects include modulation of nitric oxide (NO), increased angiogenesis (blood vessel formation), and increased antioxidant enzyme activity. A deep dive into the science shows a vast network of cellular pathways that are influenced by light, many of which support the development and maintenance of healthy skin. Light truly has powerful effects on human biology. What skin conditions are helped by light therapy? Acne – Acne, also known as acne vulgaris, is a common skin condition, affecting nearly 10% of people worldwide. Prevalence is highest in adolescents, with up to 85% having acne at some time during this period. Acne is not only painful, but it can also have adverse effects on many aspects of life, including social, psychological, and economic. Since acne has been observed to respond positively to sun exposure, a variety of phototherapy treatment approaches have been used. Light therapies treat acne through anti-inflammatory and antimicrobial effects, and by disruption of sebaceous gland function. RL, IRL, and BL have all been found to effectively treat acne. Inflammatory acne is more responsive to light therapy than non-inflammatory acne, and studies have even found it to be superior to some medications. Anti-Aging – The anti-aging effects of phototherapy are often referred to as “skin rejuvenation”. This is an umbrella term that includes 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 RL and NIRL. Importantly, the use of light therapy to regenerate skin is “non-ablative”, which means that it doesn’t harm the epidermis of the skin. This contrasts with many popular anti-aging treatments such as microneedling, chemical peels, and microdermabrasion. Psoriasis – Psoriasis is an inflammatory autoimmune skin disease that causes scaly dry patches made up of a buildup of skin cells. Psoriasis is most commonly found on joints (like elbows and knees) but it is possible to find them on any part of the body. Psoriatic patches are referred to as “plaques”. Psoriasis is a common condition, affecting up to 3% of the population or approximately 7.5 million US adults. Both red and NIRL therapy are recommended in the treatment of psoriatic plaques, even in patients resistant to conventional treatment. Red and NIRL therapy improves psoriasis through many different mechanisms, including improving mitochondrial function and decreasing inflammation. Hair Loss – Hair follicles are found embedded in the dermis of the skin. The ability of light therapy to induce hair growth was observed in studies conducted more than 50 years ago. Early clinical trials used primarily RL, and the effectiveness of these studies led to the development of several RL therapy devices for hair loss. Subsequent studies have shown that NIRL light also stimulates hair growth, with RL and NIRL 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. Eczema - Eczema (also called atopic dermatitis) is defined by the World Allergy Organization as “an inflammatory, chronically relapsing, non-contagious and extremely pruritic skin disease.” The prevalence of eczema is estimated to be 2-5% in the general population, and it is even more common in children and younger adults. Eczema is characterized by skin inflammation, so anti-inflammatory treatments are often helpful. In a study of patients with eczema associated with orthopedic implants, 50% of those who were treated with NIRL showed a decrease in skin itching and lesions. This may be due to modulation of the immune system. Melasma/Hyperpigmentation – Hyperpigmentation of the skin is caused by an overproduction of the pigment melanin. Hyperpigmentation is most often seen in melasma, a condition characterized by dark colored patches, usually on the face. Because melasma and hyperpigmentation are triggered by exposure to UV light, which increases melanin production, patients are advised to limit sun exposure. However, exposure to RL and NIRL does not have the same effect, and in fact, may decrease hyperpigmentation. Most studies have combined topical medicines with light therapy from lasers, but LED lights have also been shown to decrease hyperpigmentation. Wound Healing – Wound healing is a complicated process that includes inflammation, growth of new blood vessels, and skin repair. Application of both red (RL and NIRL) and BL have been found to help with wound healing, with some studies showing that BL may be more effective than RL, although both are beneficial. BL is especially effective at killing bacteria that colonize wounds, impair healing, and cause infection, while RL stimulates fibroblasts, blood vessel formation, and collagen synthesis. This suggests that RL and BL could be used together for a synergistic effect on wound healing. Scars – There are many ways that light therapy can decrease scars. As already mentioned, RL and BL can decrease the severity of acne, which reduces the likelihood of scarring. RL and BL also speed up wound healing, which similarly minimizes scar formation. In addition, light therapy (specifically NIRL) can decrease the formation of keloid and hypertrophic scars. These types of scars are due to an excessive growth of scar tissue. RL has similarly been found to reduce post-operative scarring. Cold sores – Cold sores are caused by the herpes simplex virus type 1 (HSV-1). The World Health Organization estimates that up to 67% of people worldwide are infected with HSV-1, although many people don’t have symptoms. Symptomatic HSV-1 causes painful blisters on the lips that last 10-14 days, and there is no curative treatment. Although there haven’t been many studies in this area, research to date has been promising. RL has been shown to decrease both the frequency of symptomatic HSV-1 episodes and also to prolong the asymptomatic interval. These effects are probably mediated by the action of light therapy on the immune system. Radiodermatitis – Radiodermatitis is a common side effect of radiation therapy, affecting as many as 95% of treated patients. In radiodermatitis, skin cells are damaged by radiation, causing itching, dryness, redness, swelling, loss of body hair, pain, skin atrophy, and fibrosis. Both RL and NIRL have been found to be beneficial when used as an adjunct treatment along with radiation therapy to decrease its adverse effects on skin. Specifically, light therapy decreases the severity of radiodermatitis and increases patient’s quality of life. Importantly, light therapy had no harmful effects on tumor growth or overall survival in these studies. A recent systematic review concluded that light therapy “in the red or near-infrared spectrum (630–905 nm) is safe and efficient in the management of various complications of oncological therapy and can be applied throughout radiotherapy and/or up to 30 days after.” Choosing a Light Therapy Device With so many light therapy devices currently on the market, how can you know which device is best for you? Here are five issues to consider. Light source - 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. Laser powered devices are still a favorite in medical offices, which makes sense given their high cost and higher risk of adverse effects such as skin irritation. LED powered devices are more often sold for at home use, although some medical clinics also use them. Consumers can rest assured that using LED powered devices for the treatment of skin disorders is well supported by research evidence. 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, different light wavelengths including red, blue, and near infrared have been used in studies of light therapy to treat skin disorders. While some studies show benefits specifically to using one light wavelength, others have observed benefits from more than one form of light. Some conditions, such as acne and skin wounds, are especially well suited to combination light therapy. As a result, multi-wavelength devices will be the most versatile. Ideally, users should be able to control each type of light independently, and to combine them if desired. Light Intensity – Light intensity refers to the amount of light being delivered by a device. It is also referred to as irradiance. This describes the amount of light energy your skin receives over a period of time and is usually measured in mW/cm2. The amount of light your skin receives, which is a function of time and intensity, is referred to as the “dose”. In terms of intensity, it has been found that it is ideal to mimic the intensity of the sun, which is around 24 mW/cm2 at the skin. 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. Many devices on the market are at a much higher intensity than the sun. Exposing the skin to too high an intensity, especially for a prolonged period of time, will likely do more harm than good. When it comes to light therapy, more is not better, so choose a sun-mimicking product and don’t overdo it when it comes to treatment frequency and duration. Device Type – Light therapy devices come in many shapes and sizes. To choose the right one for you, first identify what area(s) of the body you want to treat. If there are multiple body parts to be treated, you should choose a versatile device like an LED panel that can easily be applied to different target areas. LED panels can be used to treat most body parts, including the face, chest and back. Or, if you want to target a particular body part (such as the face), you can choose a product that is designed specifically for that area (for example, a mask). Second, you should consider how and where you intend to use the product. If you would prefer to lie down while doing a treatment, you would do better with a portable LED device rather than an LED panel. Portable devices are also the best choice if you would like to have the option of moving around during your treatment. Every person’s needs are unique, but there are many different device options to choose from. 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. Fringe Light Therapy Products At Fringe, we’ve developed evidence-based education and light therapy products that can be used for a wide range of clinical and cosmetic applications. We’ve engineered all our light therapy products to deliver a ‘sun-like’ intensity of healing light, using cutting edge technology. Whether it is a red light therapy wrap, mask or panel – our efforts focus on creating safe, effective, science backed light therapy products. Conclusion As you can see, using light therapy to improve skin health is much more than just social media hype. Research has demonstrated that it is a safe and effective treatment for a wide range of skin conditions that afflict a large percentage of the population. With the increased availability of LED devices, people can now affordably use light therapy in the comfort of their own home. Choosing the right product is easy: Look for one that mimics the intensity of the sun, provides the right light wavelengths for the condition(s) you’re treating, and fits into your lifestyle. For more information about Fringe light products, go to: https://fringeheals.com/shop-all-products/
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