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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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Red Light Therapy for Seasonal Affective Disorder
What is Seasonal Affective Disorder (SAD)? Seasonal Affective Disorder (SAD) is also known as the “winter blues” or “seasonal depression”. In the simplest terms, it is depression that follows a season pattern, usually occurring in the winter. SAD is considered a variant of Major Depressive Disorder or Bipolar Disorder, rather than a distinct condition. It is recognized in the Diagnostic Manual of Mental Disorders (DSM-5) and affects around 5% of US adults. January and February are the hardest months for people with SAD. The symptoms of SAD are similar to the symptoms of non-SAD depression, and include: feeling sad fatigue and loss of energy loss in interest or pleasure in activities changes in appetite and sleep (especially overeating and oversleeping) feeling worthless or guilty difficulty thinking, concentrating, or making decisions physical aches and pains thoughts of death or suicide. SAD occurs at a specific time of year and the diagnosis requires that it recurs at least two consecutive years in the same season. Symptoms last for around 4 to 5 months, and there is full remission of symptoms when the season ends. SAD usually occurs in the Fall or Winter. Risk factors for SAD include being female, living at a northern latitude, a family history of SAD, and being between 18 and 30 years of age. Both pharmacological and non-pharmacological treatments have been identified as first line therapies for SAD. Pharmacological treatments include antidepressant medications, such as selective serotonin reuptake inhibitors. Non-pharmacological treatments include cognitive behavioral therapy and light therapy. The goal of light therapy is to compensate for the loss of natural sunlight during the shorter and darker winter months, and most often involves exposure to bright white light. What is the relationship between light and SAD? The seasonal nature of SAD and its high prevalence during the winter months, along with resolution during warmer, sunnier seasons, suggests a causal relationship with sun and light exposure. Human biology is clearly linked with the rhythm of the sun, with people naturally following a sleep/wake cycle that is associated with night and day. This sleep/wake cycle is also known as our circadian rhythm. Circadian rhythms are the “physical, mental, and behavioral changes an organism experiences over a 24-hr cycle.” In addition to light and dark, circadian rhythms are also influenced by temperature, diet, exercise, stress, and social environment. Light, however, is the primary regulator, and it exerts this influence through effects on the brain. The influence of light on the brain starts with the eyes. Light enters the retina and activates cells called intrinsically photosensitive retinal ganglion cells. Retinal ganglion cells are active even in people who are completely blind, who show similar sleep and wake cycles to sighted people because of the response of these cells to light. Retinal ganglion cells show their greatest response to the blue light spectrum. Sunlight contains blue light, in addition to many other wavelengths of color. From the eyes, a signal is sent to the suprachiasmatic nucleus in the brain. Known as the “master circadian clock”, the suprachiasmatic nucleus is the most important circadian regulator. The clock in turn sends out many signals that regulate a wide range of processes in the body, including controlling the expression of up to 10% of our genes. Light is the primary regulator of this internal clock, although there are other non-light influences on this rhythm too. Melatonin and cortisol are the main hormonal mediators of the circadian rhythm, and the synthesis of both is regulated by light. Melatonin is secreted in response to the absence of light, triggering sleep. Cortisol is secreted in response to the presence of light, triggering wakefulness. The synthesis of both melatonin and cortisol is controlled by signals that come from the suprachiasmatic nucleus. In the winter months, decreased exposure to light causes the circadian rhythm to shift later in the day, which results in a misalignment between the sleep-wake cycle and the circadian rhythms’ natural processes. Exposure to certain types of light on winter mornings pulls the circadian rhythm back into alignment. Different types of light are known to have variable effects on the circadian rhythm. Both bright white and blue light suppress the release of melatonin, which promotes wakefulness. Blue light exposure can cause the circadian rhythm to shift even when applied later in the day, unlike bright white light which is more effective at causing a shift in the morning. Red light does not suppress melatonin levels or cause the circadian rhythm to shift. These variable effects of different wavelengths (colors) of light have important implications for light therapy, which is the application of external light sources to affect biology. Exposure to light has been clearly shown to be associated with mood. A study of over 400,000 people showed that increasing exposure to daylight associated with reduced risk of major depression and greater happiness. This may be mediated by serotonin, which is known as a “natural mood booster”. Serotonin is a critical link and regulator of both the circadian rhythm and mood, and levels increase with sun exposure. In contrast to the positive mood effects of sunlight exposure, exposure to artificial light later in the day can have adverse effects. In simple terms, the naturally stimulating effect of white and blue light on wakefulness is helpful in the early part of the day but is harmful in the evening and at night. The associations between light and levels of melatonin, cortisol, and serotonin provide clues as to how the dark, short days of winter can negatively impact mood. And while more research is needed to clearly understand the pathology of SAD, its positive response to light therapy suggest that light is one of the most important mediators. How is red light therapy for Seasonal Affective Disorder used? Light therapy is widely accepted as a first line non-pharmacological treatment for SAD. Usually, this involves treatment with bright light (called Bright Light Therapy, BLT), but dawn simulation is also used. Dawn simulation delivers light that gradually increases during the last half hour of sleep, while BLT delivers very bright light (most often white, but sometimes blue) shortly after waking. Bright light therapy has been shown to be more effective for people with more severe depression, but both are beneficial. As already described, retinal ganglion cells in the eye respond to light, particularly in the blue spectrum. White light contains all visible light frequencies, including blue, and both white and blue light promote wakefulness, in part through suppression of melatonin. This is why white and blue light are the main sources of light used in SAD light therapy. Light intensity is measured in Lux, and bright light is typically considered to be at least 10,000 Lux. Light intensity varies greatly, sometimes in surprising ways. Here are some light intensities under different conditions: Bright sunlight = 120,000 Lux Bright sunlight = 110,000 Lux Shaded area on a sunny day = 20,000 Lux Overcast day, midday = 1,000 – 2,000 Lux Sunrise/Sunset (clear day) = 400 Lux Sunrise/Sunset (overcast) = 40 Lux Moonlight (clear night) = 1 Lux Office lighting = 200 – 400 Lux Home lighting = 50 – 200 Lux In BLT, an external light source (usually called a “light box”) is used that delivers light at around 10,000 Lux. It is recommended to use BLT in the early morning shortly after waking for approximately 30 minutes. The person should position themself 60-80cm from the light box, with the light at eye level. Lower intensity light can be used (2,500 - 5,000 Lux) but with lower intensity light the treatment duration is extended to 1 to 2 hours. Treatment should be done until the season ends. Light used in BLT will be delivered by either fluorescent or LED lights. Fluorescent lights deliver white light, either warm or cool, while LED lights can deliver both white and blue light. White light is referred to as “colorless daylight” and is made up of all the frequencies in the visible light spectrum (including red, yellow, green, blue, etc.). White fluorescent bulbs and LED lights will also contain all of the visible light frequencies but they can vary in their spectral characteristics, such as the particular wavelength distribution and intensity. When the spectrum of light from bright light devices is analyzed, it varies depending on the light source. Fluorescent lights, both warm and cool, emit light that shows several peaks that correspond to different colors, including red. White LED diodes usually have a sharp blue peak, but they also contain wavelengths of different colors. The main difference between white and blue BLT devices is that white light contains multiple colors (called polychromatic), even though it appears white or colorless, while blue light is a singular color (called monochromatic). It is sometimes claimed that SAD light boxes provide a “hefty dose” of blue light. This is not entirely true. The spectral analysis of devices that use both warm and cool fluorescent lights reveals a mixture of wavelengths (yes, including blue), but their calculated “blue light hazard” level is actually quite low. Warm fluorescent light is a bit better than cool fluorescent light, which showed around the same blue light hazard as white LED light. It’s also important to note that blue light is “disruptive” to the circadian rhythm precisely because our bodies are naturally designed to respond to the blue wavelengths of light from the sun. When used in the morning, exposure to blue light (even artificial) provides a cue for the system to wake up. It should go without saying that bright light therapy devices should not be used in the evening. BLT has been found to effectively reduce the symptoms of SAD, although white light shows more effectiveness than blue light. A meta-analysis published in 2015 found that bright white light therapy was effective, although the effects were weaker at some time points. A meta-analysis of bright blue light therapy for SAD did not find it to be beneficial. How Does Seasonal Affective Disorder Relate to Different Wavelengths of Light? SAD is related to the lack of daylight, or sunlight, during winter months. Sunlight consists of solar radiation, which is 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. 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. Near infrared light waves lie just beyond the “red” end of the visible light spectrum, so we don’t see them. Near infrared light is part of the “infrared” spectrum, which consists of both near infrared and far infrared light. 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). What this means is that BLT only partly mimics the natural effects of sunlight, since it delivers only visible light. Bright white light does not include light in the UV spectrum of the sun. This is done intentionally, since UV rays are the component of solar radiation that are the main culprits in causing skin cancer. Bright white light also does not include light in the infrared spectrum of the sun. This omission is less justified, since infrared light does not have harmful effects on the skin (quite the opposite, in fact), and infrared light makes up a significant amount of natural sunlight. BLT that uses blue light excludes not only UV and infrared light but also the non-blue wavelengths of light, including red, orange, yellow, green and violet. Does Red Light Therapy Improve Seasonal Affective Disorder? 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 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. Like BLT, red and near infrared light therapy does not involve the use of UV rays. The red light 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 near infrared light used in light therapy usually ranges from 800 to 1100nm. Interestingly, there are no clinical trials of red light therapy to treat SAD, but there are many that have been done looking at the effects of red light on non-SAD depression. All of the non-SAD clinical trials of red light therapy used near infrared light applied directly to the head. A 2022 systematic review concluded that near infrared 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”. These results demonstrate that red light therapy has positive effects on mood. Another challenging symptom of SAD is sleep disturbance, which is another issue that red light therapy has been found to help. Application of red light therapy during wakefulness improves sleep quality in people with cognitive decline, Guillain-Barré Syndrome, fibromyalgia and stroke. Interestingly, sleep duration decreased with full body red light therapy in elite athletes, while other parameters such as exercise recovery improved. 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. So, red light therapy is beneficial when applied when either awake or sleeping, and the benefits relate more to improving sleep quality and physiology, rather than to increasing sleep duration. As already described, increased exposure to outdoor light is associated with reduced risk of major depression and greater happiness. Since outdoor light is a combination of visible light (including blue and red), infrared, and UV light, this contrasts with the light used in BLT, which includes only white visible light or blue monochromatic light. With so many studies showing a benefit to using red light therapy (especially infrared light), it is possible that the addition of red light in the treatment of SAD could be beneficial. Combining Bright and Red Light Therapy to Improve Seasonal Affective Disorder Red light therapy can easily be combined with BLT in the treatment of Seasonal Affective Disorder. Since the rising sun appears red when first coming up over the horizon, exposure to red light followed by exposure to BLT is recommended. This is a practice that I’ve been doing for several years, following decades of winter seasons in which I suffered from some degree of seasonal depression. Initially, my doctor recommended that I purchase a fluorescent light box, which I used successfully for a few years. After gaining knowledge of red light therapy, I combined the two and now use them in tandem. My recommended practice is as follows: Shortly after waking, use a red light therapy panel (that delivers both red and near infrared light) for 10 minutes, sitting comfortably 6 to 12 inches away. If you prefer, or if it’s uncomfortable to keep your eyes open in front of the red light panel, you can close them – light still penetrates through to the retinal ganglion cells. However, it is safe to open your eyes as long as your red light panel is low to moderate intensity. The 10 minutes spent in front of the red light panel provides a great opportunity to work on breathwork or mindfulness, which have positive effects on mood. After 10 minutes of red light therapy, use a light box that delivers white light (preferably using warm fluorescent bulbs, which have a lower blue light hazard ratio) for 20 minutes. It is possible to do normal activities while in front of the light box, so people usually set them up in an office (so that they can work on a computer or read) or on a kitchen island. I recommend setting it up in an office space and spending that 20 minutes engaged in an activity that generates a positive mood. For most people, this means avoiding reading the news, but you can do things like sending emails to friends or reading something uplifting. Taking time to be calm and to orient your attention in a positive direction uplifts mood. Avoid bright light, especially blue light, at night. Exposure to blue light (especially bright blue light) is disruptive to sleep, which is why it is not recommended to use electronic devices (like iPads or e-readers) that emit blue light at night. Keep household lighting dim in the evening and at night. Red light therapy may also be used at night, although you should position yourself farther from the panel so that the light is less intense. Red light panels can even be used as a source of evening/nighttime illumination. Red LED light bulbs may also be used as a source of illumination at night. Conclusion We often hear the recommendation by health experts these days to “view morning sun” as a way to optimize health, including mental health. While it is no doubt ideal to have exposure to natural light in the morning, for people that live in cold winter climates this can be very difficult. Under these circumstances, light devices – both bright and red light - can be used to mimic sunrise and sun exposure. Although the combination of bright and red/near infrared light has yet to be subject to intensive research, there is strong evidence that both exert a positive influence on mood. Since daylight consists of a combination of light wavelengths, including near infrared light, there is good reason to believe that these two may work in tandem as a powerful tool in the prevention and treatment of Seasonal Affective Disorder. For more information about Fringe light products, go to: https://fringeheals.com/shop-all-products/
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What is Earthing?
Earthing means connecting the body to the earth’s surface electric charge. Earthing is said to be a form of “electric nutrition” and a “universal regulating factor in Nature” because research has shown that it has a profound impact on human health (Menigoz et al., 2020). In fact, the simple act of regular contact with the earth has been shown to positively influence immune function, enhance muscle healing, improve bone health, reduce blood pressure, increase blood flow, enhance nervous system functioning, and improve sleep and mood. The earthing movement came out of Germany in the late 19th century and promoted sleeping on the ground outdoors and being barefoot outside as ways to achieve health (Just, 1903). In the 1920’s, Dr. G.S. White reported that sleeping on the ground, or connected to the earth such as by copper wire attached to grounded pipes, resulted in improved sleep (White, 1929). However, it wasn’t until the late 20th century that these ideas gained traction, when Clint Ober (Ober, 2000) and Sokal and Sokal (Sokal & Sokal, 2011) in Poland confirmed through research studies that there were many health benefits to being grounded to the earth. Ober, who worked with cable TV, realized this association through his experience with electrical systems, which require contact with the ground in order to be electrically stable. When these systems are connected to the negative charge on the earth’s surface they are said to be “grounded”. The term “grounding” is used synonymously with the term “earthing”. There are two ways to connect to the flow of electrons over the surface of earth: (1) directly, by putting the body in contact with natural conductive surfaces such as grass, soil, gravel, stone and sand; (2) putting the body in contact with grounded conductive mats, pads, body bands, or patches (usually while sitting or sleeping). The earth’s electron flow comes primarily from lightning strikes, solar radiation, and other atmospheric phenomena. These electron sources are continuous and give the earth a natural negative electric charge, since free electrons are negatively charged. (Menigoz et al., 2020). Until quite recently, it was the natural human state to be grounded virtually 24 hours a day. Humans walked barefoot and slept on the ground for most of our evolutionary history. Even when we adapted to wearing footwear and using bedding, it was made from animal skins that when moistened with ground moisture or sweat were able to conduct electrons from the ground to the body. Only recently have we shifted to wearing footwear with synthetic soles, living primarily on top of concrete. In this way, we might be said to be disconnected from our “electric roots” (Sinatra et al., 2017). The theory of “electron deficiency syndrome” states that as a consequence of the loss of an electric connection to the earth, that a natural source of electron flow to the body has been lost, which will have significant adverse physiological consequences (Oschman et al., 2015). Following this, it is possible that the loss of electric connection to the earth, a relatively recent phenomenon, might underlie (at least in part) the rise in global illness of the 21st and 22nd century (Menigoz et al., 2020). Humans As Bioelectrical Beings The idea that electron flow from the earth may play an important role in regulating human physiology is consistent with our understanding of humans as bioelectrical beings. Internal bioelectric signals regulate the function of the cardiovascular, nervous, immune and endocrine systems. The measurement of the body’s electrical character is called electrophysiology. The flow of electrons over the surface of the earth can be transferred into the human body through direct contact. Electrons have a negative charge, and in the body, like to occur in pairs. These electrons can act to neutralize free radicals, which have an unpaired electron that makes them unstable. Some free radicals are also known as reactive oxygen species. Free radicals are readily produced in the body and can do damage to surrounding cells and tissues. The free electron of a free radical can be “quenched” by an electron donor, stabilizing it in a pair. This is how antioxidants work – they act as electron donors to neutralize free radicals. In this way, the earth is seen as a giant antioxidant (Menigoz et al., 2020). Probing into this mechanism more deeply, it has been proposed that the electron flow provided by earthing may be able to break through the “inflammatory barricade” that can slow the healing response. This barricade develops in response to trauma or infection and serves to wall off damaged tissues and prevent bacteria, pathogens, or debris that result from an injury from travelling to (and harming) nearby tissues. However, the barricade also prevents treatments like antioxidants from accessing the site of injury, which can reduce the rate of healing. Because the barricade is made of the connective tissue collagen, which is a semi-conductor, electrons are able to cross through and perform their healing antioxidant action at the site of damage. In fact, all proteins act as semi-conductors which could have profound implications for the movement of electrons throughout the body. This may be particularly relevant for chronic inflammatory diseases (Sinatra et al., 2017). The effect of earthing on the electrical potential of the body has been demonstrated in research. Measurements of the body’s electrical induced fields in the left breast, abdomen, and left thigh were measured while both grounded and ungrounded, and it was found that the measured voltage in the grounded state was equalized with the Earth’s electrical potential. This voltage stayed constant despite the application of an electrical field. In contrast, when ungrounded, the application of an electrical field to the three body positions resulted in a large increase in electrical potential at the surface of the body, which is thought to disturb the electrical charges of molecules inside the body (Applewhite, 2005). As described by Nobel Prize winner Richard Feynman, when the electric potential of the body is the same as the Earth’s electric potential (which is what has been shown to occur during grounding), the body becomes an extension of the Earth’s electrical system in a phenomenon known as the “umbrella effect”, which results in the person being unaffected by electrical disturbances (Feynman et al., 1963). Earthing has also been shown to result in rapid changes in measures of body electrophysiology as measured by brain electroencephalograms (EEG’s) and muscle electromyograms (EMG’s) (Chevalier et al., 2006). This evidence clearly indicates that the concept of earthing affecting the electrical nature of the body is not merely theoretical. Effects of Earthing on the Body Immune System: The immune system regulates inflammation. Earthing has been shown to alter the inflammatory response to an injury, especially chronic infection. This is thought to be accomplished by passage of electrons through the inflammatory barricade previously described, which allows for healing following infection and injury. Inflammation has been shown through infrared imaging to decrease within 30 minutes of earthing, which is accompanied by metabolic changes that suggest tissue healing (Oschman et al, 2015). Earthing the human body has also been shown to speed up the immune response following vaccination. This has been demonstrated by measuring levels of immune markers in the blood following vaccination (Sokal & Sokal, 2011). Musculoskeletal System: Earthing helps muscles to recover from exercise. Three studies have shown that earthing is able to reduce delayed onset muscular soreness (DOMS) that occurs 24-72 hours after unusual or strenuous exercise. In the first study, 4 healthy men experienced a reduction in DOMS as well as pain and inflammation compared to a control group (Brown et al., 2010). In the second study, a larger group of 16 healthy men experienced similar effects (Brown et al., 2015). In the third study, subjects slept on an earthing sleep mat and compared to a control group, experienced positive effects such as a faster recovery, decreased inflammation, and less muscle damage (Müller et al., 2019). Earthing during cycling exercise has also been shown to significantly reduce the level of blood urea, which is an indicator of muscle and protein breakdown (Sokal et al., 2013). Based on these findings, it appears that earthing may be a simple and effective method to enhance recovery after exercise, which is important as very few interventions are known to help with DOMS. Bone health has also been shown to benefit from earthing. After a single night of sleeping grounded, subjects showed decreases in levels of the minerals calcium and phosphorus in both the blood and urine, which suggest a reduced rate of bone loss (Sokal & Sokal, 2011). Cardiovascular System: Earthing has been shown to improve blood flow in adults. Specifically, earthing has been found to increase the Zeta potential of red blood cells. The zeta potential is an indicator of the strength of the negative charge on the surface of red blood cells that helps to maintain the spacing of the blood cells while in the blood, which reduces the “viscosity” or thickness of the blood. When the zeta potential is higher, blood cells repel each other and there is less clumping and improved blood flow. In one study, the zeta potential increased by an average of 270% within two hours of earthing (Chevalier et al, 2013). The relationship of this effect to negative charge, and the speed of the effect, seems to clearly illustrate the electrical influence of earthing on the body. Earthing has also been shown to reduce blood pressure. In a study of 10 patients with hypertension, all subjects experienced a decrease in blood pressure with earthing. Blood pressure decreased when patients grounded themselves for at least 10 hours per day using a grounding mat. Systolic blood pressure decreased by an average of 14% (Elkin & Winter, 2018). Other cardiovascular related effects have been found with earthing. A placebo-controlled study found an increase in respiration rate, stabilization of blood oxygenation, and an increase in the pulse rate and perfusion index (a measure of blood flow) variability when grounded. These changes are thought to indicate the onset of a healing response that requires an increase in oxygen consumption (Chevalier, 2010). Autonomic Nervous System: Earthing affects the function of the autonomic nervous system (ANS) in both infants and adults. The ANS is responsible for regulating body processes such as heart rate, blood pressure, respiration and digestion. When earthing patches were placed on the skin of premature babies, within minutes increases in heart rate variability (HRV) were observed, which indicate better functioning of the ANS. This may help to reduce the risk of necrotizing enterocolitis, which is severe illness that affects about 10% of premature infants and can cause death (Passi et al., 2017). In adults, earthing has been found to cause a shift from an overactive expression of the sympathetic nervous system (“fight or flight”) to a parasympathetic (“rest and digest”) state that regulates heart rate, respiration, digestion, and other functions (Chevalier, 2010). Earthing also exerts a normalizing effects on levels of the stress-related hormone cortisol (Ghaly & Teplitz, 2004). In this way, earthing has the effect of reducing stress. Skin: Earthing has been found to increase blood flow to the skin. Following earthing, there was a rapid increase in blood flow to the face in a placebo-controlled study in which the control group was given a “sham” earthing experience (Chevalier, 2014). This might explain the results of a survey that found that women reported having better facial complexions after earthing (The Earthing Institute). Increased blood flow to the face, neck and torso has also been shown following earthing (Chevalier, 2015). The effects of earthing on the skin have also been studied in the context of wound healing. A case study of an 84 year old woman with an eight-month old open wound near her ankle responded dramatically to two weeks of using an earthing patch after several unsuccessful treatments at a specialized wound center (Sinatra et al., 2017). This is consistent with animal research that shows that electric currents increase energy production and protein synthesis in rat skin (Cheng et al., 1982). Sleep: Many people report better sleep with earthing. The first report of improved sleep with grounding came in the 1920’s from Dr. G.S. White (White, 1929). More recently, in a study of 12 participants, 11 subjects reported that they fell asleep faster and all subjects reported fewer nighttime awakenings after 8 weeks. Subjects also showed normalization in their 24-hour profile of cortisol secretion (Ghaly & Teplitz, 2004). Similarly, in a controlled, blinded study of 60 subjects who reported disturbed sleep and chronic muscle and joint pain, the group who slept on the grounded sleep mats reported a wide variety of benefits, including improved sleep and sleep apnea after one month (Ober et al., 2010). Mood: Earthing has been shown to improve mood. In a double-blind, placebo-controlled study of 40 adult men and women, those who spent an hour sitting comfortably in a recliner on a grounded mat, with their head on a grounded pillow, and with grounding patches on their palms and soles showed significantly improved mood compared to the control group, who used the same products that were not grounded. Specifically, participants reported a more pleasant mood, feeling less tired and more relaxed, and feeling more positive (Chevalier, 2015). Clinical Recommendations Earthing represents an incredibly safe, inexpensive, and effective intervention that can easily be integrated into one’ life. There are three ways that health care providers can recommend earthing to their patients. These are: 1. Earthing outdoors. Sessions of 30-40 minutes daily have been shown to be effective (Sinatra 18). This is also the most inexpensive method of earthing. People can go barefoot outdoors or can buy outdoor conductive footwear. Unfortunately, time and weather may be limiting factors. Also note that in order for electron transfer to occur, one must be on a natural conductive surface, such as soil, sand, gravel, grass or stone. 2. Earthing products. There are a number of grounding products that are available commercially. These include sleep mats, blankets, bands, patches, chairs, and mats. These products are connected via an electrical cord to a grounded outlet, or less commonly, to a grounding pole placed in the earth. Prices vary but are quite reasonable. 3. Earthing in clinic. Health care practitioners can provide treatments to patients while lying on an earthing mat, or can provide in-clinic earthing sessions where patients use grounding products like chairs, mats, and patches. Conclusion Our modern lifestyles provide us with many benefits, but they also have served to disconnect us from the earth. It is becoming increasingly clear that this may have adverse effects on our health, and conversely, that health can be improved by reconnecting with the “electric nutrition” of the earth in some way. While earthing outdoors is a free and easy way to get grounded, there are many accessible products available that can facilitate this connection. Given the ease and safety of this intervention, it is recommended that everyone incorporate earthing into their routine of health maintenance and disease prevention. For more information about Fringe light products, go to: https://fringeheals.com/shop-all-products/ References Applewhite R. (2005). The effectiveness of a conductive patch and a conductive bed pad in reducing induced human body voltage via the application of earth ground.” European Biology and Bioelectromagnetics; 1: 23–40. Brown, D., Chevalier, G., & Hill, M. (2010). Pilot study on the effect of grounding on delayed-onset muscle soreness. Journal of alternative and complementary medicine (New York, N.Y.), 16(3), 265–273. https://doi.org/10.1089/acm.2009.0399 Brown, R., Chevalier, G., & Hill, M. (2015). Grounding after moderate eccentric contractions reduces muscle damage. Open access journal of sports medicine, 6, 305–317. https://doi.org/10.2147/OAJSM.S87970 Cheng, N., Van Hoof, H., Bockx, E., Hoogmartens, M. J., Mulier, J. C., De Dijcker, F. J., Sansen, W. M., & De Loecker, W. (1982). The effects of electric currents on ATP generation, protein synthesis, and membrane transport of rat skin. Clinical orthopaedics and related research, (171), 264–272. Chevalier G. (2010). Changes in pulse rate, respiratory rate, blood oxygenation, perfusion index, skin conductance, and their variability induced during and after grounding human subjects for 40 minutes. Journal of alternative and complementary medicine (New York, N.Y.), 16(1), 81–87. Chevalier G. (2015). The effect of grounding the human body on mood. Psychological reports, 116(2), 534–542. https://doi.org/10.2466/06.PR0.116k21w5 Chevalier, G. (2014). Grounding the human body improves facial blood flow regulation: Results of a randomized placebo controlled pilot study. Journal of Cosmetic, Dermatological Sciences and Applications, 4, 293-308. Chevalier, G. (2015) One-hour contact with the Earth’s surface (grounding) improves inflammation and blood flow – A randomized, double-blind pilot study. Health, 7, 1022-1059. Chevalier, G., Mori, K., & Oschman, J.L. (2006). The effect of Earthing (grounding) on human physiology, European Biology and Bioelectromagnetics, 2(1), 600-621. Chevalier, G., Sinatra, S. T., Oschman, J. L., & Delany, R. M. (2013). Earthing (grounding) the human body reduces blood viscosity-a major factor in cardiovascular disease. Journal of alternative and complementary medicine (New York, N.Y.), 19(2), 102–110. https://doi.org/10.1089/acm.2011.0820 Elkin, H. K., & Winter, A. (2018). Grounding Patients With Hypertension Improves Blood Pressure: A Case History Series Study. Alternative therapies in health and medicine, 24(6), 46–50. Feynman, R., Leighton, R., & Sands, M. (1963). The Feynman Lectures on Physics, vol.II, Addison-Wesley, Boston, Mass, USA. Ghaly, M., & Teplitz, D. (2004). The biologic effects of grounding the human body during sleep as measured by cortisol levels and subjective reporting of sleep, pain, and stress. Journal of alternative and complementary medicine (New York, N.Y.), 10(5), 767–776. https://doi.org/10.1089/acm.2004.10.767 https://earthinginstitute.net/rapid-benefits-an-earthing-1-hour-time-trial/ Just, A. Return to Nature: The True Natural Method of Healing and Living and The True Salvation of the Soul. New York, NY: B. Lust; 1903. Menigoz, W., Latz, T. T., Ely, R. A., Kamei, C., Melvin, G., & Sinatra, D. (2020). Integrative and lifestyle medicine strategies should include Earthing (grounding): Review of research evidence and clinical observations. Explore (New York, N.Y.), 16(3), 152–160. https://doi.org/10.1016/j.explore.2019.10.005 Müller, E., Pröller, P., Ferreira-Briza, F., Aglas, L., & Stöggl, T. (2019). Effectiveness of Grounded Sleeping on Recovery After Intensive Eccentric Muscle Loading. Frontiers in physiology, 10, 35. https://doi.org/10.3389/fphys.2019.00035 Ober C, Sinatra ST, Zucker M. Earthing: The Most Important Health Discovery Ever? Laguna Beach, Calif, USA: Basic Health Publications; 2010. Ober, C. Grounding the human body to neutralize bioelectrical stress from static electricity and EMF’s. ESD Journal Web site: http://www.esdjournal.com/articles/cober/ground.htm. Accessed June 27th, 2021. Oschman, J. L., Chevalier, G., & Brown, R. (2015). The effects of grounding (earthing) on inflammation, the immune response, wound healing, and prevention and treatment of chronic inflammatory and autoimmune diseases. Journal of Inflammation Research, 8, 83–96. https://doi.org/10.2147/JIR.S69656 Passi, R., Doheny, K. K., Gordin, Y., Hinssen, H., & Palmer, C. (2017). Electrical Grounding Improves Vagal Tone in Preterm Infants. Neonatology, 112(2), 187–192. https://doi.org/10.1159/000475744 Sinatra, S. T., Oschman, J. L., Chevalier, G., & Sinatra, D. (2017). Electric Nutrition: The Surprising Health and Healing Benefits of Biological Grounding (Earthing). Alternative therapies in health and Medicine, 23(5), 8–16. Sokal, K., & Sokal, P. (2011). Earthing the human body influences physiologic processes. Journal of alternative and complementary medicine (New York, N.Y.), 17(4), 301–308. https://doi.org/10.1089/acm.2010.0687 Sokal, K., & Sokal, P. (2011). Earthing the human body influences physiologic processes. Journal of alternative and complementary medicine (New York, N.Y.), 17(4), 301–308. https://doi.org/10.1089/acm.2010.0687 Sokal, P., Jastrzębski, Z., Jaskulska, E., Sokal, K., Jastrzębska, M., Radzimiński, L., Dargiewicz, R., & Zieliński, P. (2013). Differences in Blood Urea and Creatinine Concentrations in Earthed and Unearthed Subjects during Cycling Exercise and Recovery. Evidence-based complementary and alternative medicine : eCAM, 2013, 382643. https://doi.org/10.1155/2013/382643 White, G. The Finer Forces of Nature in Diagnosis and Therapy. Albuquerque, NM: Sun Publishing; 1929.
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Red Light Therapy for Alzheimer’s
Red Light Therapy for Alzheimer’s and Dementia Alzheimer’s Disease (AD) and other forms of dementia affect more than 1 in 10 US adults over the age of 65. These diseases are devastating, causing memory loss, disorientation, behavior changes, and an eventual loss of independent functioning. Effective treatments are limited but are desperately needed, especially ones that are safe and have minimal side effects. In recent years one treatment that has shown success in reducing the symptoms of AD and dementia is therapy with red and near infrared light (often referred to as “red light therapy”). In 2021, a comprehensive review of 10 studies of dementia patients treated with red light therapy found that every one of them reported positive results. Red light therapy for AD is usually applied to the brain, but it can also be applied to the gut. This is because light therapy to the gut affects the gut microbiome. The gut microbiome is known to communicate extensively with the brain (called the gut-brain axis) and to influence functions like mood and patterns of brain communication. A 2022 clinical trial combined red light therapy to the brain and gut in patients with mild to moderate AD. Patients receiving red light therapy showed improved cognitive function relative to the control group. Research has also shown that red light therapy benefits patients with AD when combined with exercise. There are many benefits of light therapy in AD and dementia that occur on a cellular level. These include improving the production of cellular energy, decreasing brain inflammation, and reducing cellular stress – which may ultimately decrease the production of amyloid plaques, which buildup in the brain of AD patients. Red light therapy has also been shown to improve blood flow to the brain. Benefits are from direct absorption of light into the brain as well as by superficial blood and lymphatic vessels in the head. The brain may also benefit when light therapy is applied to other locations on the body, such as the gut and various acupuncture points. As a comfortable tool for targeted cellular healing, cognitive function, and brain health, the Fringe red light therapy head wrap contains 450 LED light chips to provide light therapy and light coverage over the forehead, top, sides and back of the head. With wavelengths of red (650nm), near infrared (810nm), and deep penetrating near infrared light (1050nm), it delivers light to the front, back, and sides of the head. Unlike most devices on the market, the Fringe red light therapy head wrap is wireless and flexible, making it both comfortable and portable. 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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Red Light Therapy for Stroke
Ischemic stroke is a type of cardiovascular disease in which the blood flow to the brain is disrupted. Annually, close to 800 000 people have strokes in the US, with an economic cost of close to 57 billion dollars. Although some people recover fully from a stroke, it can cause permanent disability and death. The risk of stroke increases with age, but it can occur across all age groups. One little-known lifestyle factor that influences our cardiovascular system health is sunlight. In contrast to our ancestors, who spent approximately half the day exposed to sunlight, our modern lifestyles have us spending close to 90% of our lives indoors. This reduction in sun exposure is increasingly being recognized as a “real public health health problem”. Exposure to the primary wavelengths of light that are found in the sun – which are red and near infrared light – can be supplemented using red light therapy. Red light therapy is the application of artificially generated light in the red and /or near infrared spectral bands. 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. The red light 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 near infrared used in light therapy usually ranges from 800 to 1100nm. Red light therapy has shown small, but promising, effects in studies with stroke patients. Using near infrared laser light technology, it was found that treatment improved outcomes when used within 24 hours after a stroke. A larger follow up study showed smaller effects, but there was still a positive trend towards better outcomes. Studies in animal models have shown many benefits when light therapy is used shortly after a stroke occurs. These include increasing the production of new neurons (neurogenesis), decreased inflammation, and improved mitochondrial function. The effects of light on mitochondria is very important in improving stroke outcomes, since mitochondria are responsible for protecting and maintain neurons. Light therapy may work synergistically with other non-invasive treatments for stroke, such as Coenzyme Q10. When using red light therapy to support stroke recovery and the cardiovascular system of the brain, the Fringe red light therapy head wrap is the best option. With wavelengths of red (650nm), near infrared (810nm), and deep penetrating near infrared light (1050nm), it delivers light to the front, back, and sides of the head. Unlike most devices on the market, the Fringe red light therapy head wrap is wireless and flexible, making it both comfortable and portable. For more information about Fringe light products, go to: https://fringeheals.com/shop-all-products/
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Red Light for Hypertension
High blood pressure, also known as hypertension, is blood pressure that is higher than normal. There are often no signs that someone has high blood pressure, which is dangerous since untreated hypertension can lead to heart attacks and strokes. It can also damage the eyes, kidneys, and brain. Blood pressure is related to the widening of blood vessels, called vasodilation. Vasodilation is widening or relaxation of the blood vessels, and increased vasodilation reduces blood pressure. Vasodilation also increases the flow of blood throughout the body, which delivers more nutrients and oxygen to cells. When red and near infrared light are absorbed by molecules in mitochondria, the process by which ATP production increases also has the effect of increasing levels of nitric oxide. Increasing vasodilation would have a wide range of cardiovascular benefits including decreasing blood pressure. Studies in animals have shown clearly that red light therapy can lower blood pressure. Application of a red light laser to the abdomen of hypertensive rats has been shown to decrease blood pressure, with the effect being mediated by the release of nitric oxide. In rats, red light therapy has also been found to prevent the increase in blood pressure that is associated with eating a high fat diet. The strength of this research has led scientists to suggest that red light therapy could be used in humans to decrease blood pressure and reduce the risk of diseases like Alzheimer’s and Parkinson’s, for which high blood pressure is a risk factor. Research is currently underway to see if red light applied by a bracelet to the arteries in the wrist can lower blood pressure. Since research showing that red light reduces blood pressure has been done in animal models, recommendations regarding how to use red light therapy to affect blood pressure are based on inference, rather than on direct research. It is most likely best to cover as much of the body as possible with light, with a focus on the upper chest and neck. The neck contains cells that are specifically designed to regulate blood pressure, called baroreceptors. We recommend using the Fringe red light panel to shine light on the upper chest and neck for 10-20 minutes per day, 3-7 times per week. For more information about Fringe light products, go to: https://fringeheals.com/shop-all-products/
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Red Light After Heart Attacks
Heart attacks are due to blockage of blood flow to a part of the heart, which can cause that area of the heart tissue to die. Heart attacks are also known as “myocardial infarctions” – “myocardial” because they affect the heart muscle, and “infarction” because they cause muscle tissue death. Heart attack severity ranges from mild to fatal, and treatments often involve surgery and long term use of medications. Over 800,000 people in the US have heart attacks every year. Research looking at the effect of red light therapy on heart attacks has been focused on recovery and healing after a heart attack has occurred. Many studies have been conducted, using a wide range of animal models. In 2016, a review of 14 studies determined that red light therapy reduced “infarct size”; that is, the amount of damaged heart tissue. A more recent analysis published in 2021 further determined that benefits were due to reductions in mitochondrial damage, decreased inflammation, and formation of new blood vessels. While most research in this area has used laser lights, the authors cite many advantages to using LED light sources, including lower cost, ease of use, and better safety. Heart attacks increase the risk of heart failure, which is when the heart lacks the strength to distribute blood effectively throughout the body. Heart failure is also caused by problems with the valves in the heart, heart muscle disease, and congenital heart defects. In a small study of patients aged 35 to 65 with heart failure, treatment with red laser light to the quadriceps muscle in the leg reduced the perception of muscle fatigue and decreased the production of muscle lactic acid. Although it isn’t clear that light therapy impacted the cardiovascular system directly, it does appear to help patients suffering from heart failure and may be a useful adjunct to standard medical therapy. Although more research is needed to understand how red light therapy can be used to support recovery from heart attacks in humans, we do know that red light therapy has many heart friendly benefits, including as increasing energy production, decreasing oxidative stress, reducing inflammation, and increasing vasodilation. When using red light therapy to target the cardiovascular system, it is our recommendation to broadly apply light to areas including the upper chest and thighs to deliver light to as much of the body as possible for general cardiovascular health. We have a lot of blood vessels at the surface of the skin, all of which will benefit from the application of red and near infrared light. Light can be applied using a red light panel or wrap that goes around the body. Because red light therapy has an amazing safety profile, and since benefits are expected to be across multiple body systems, there really is no downside to incorporating it into a regular wellness regimen. For more information about Fringe light products, go to: https://fringeheals.com/shop-all-products/
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