Red Light Therapy for Psoriasis: Does it work?

Created on October 20, 2022

If you want to know why you have psoriasis and how red light therapy can effectively treat psoriasis problems, then you are in the right place. We read 37 scientific papers and clinical trial reports to summarize this detailed article.

After you read this article carefully,  you will clearly know how to effectively treat psoriasis with a red light physiotherapy device.  Let’s dive right in!

Psoriasis is characterized by unusual overabundance and rapid cellular proliferation in the epidermis of the skin. It is often diagnosed by the skin appearance, which is scaly, erythematous plaques, papules, or patches of skin that may be painful and itchy. The cascade of pathogenic processes in psoriasis results in abnormal skin cell synthesis (particularly during wound healing).

It is thought to begin with an initiation phase (involving skin trauma, infection, or drugs), which comes with a sequence of pathological events in psoriasis and leads to the activation of the immune system. followed by a maintenance phase of chronic disease development. Skin cells are supplanted every 3–5 days in psoriasis, rather than the usual 28–30 days of the metabolic process.

There are some hypotheses about the causes of the symptoms.

The major belief is that these changes stem from the prematuration and proliferation of keratinocytes induced by inflammatory propagation in the dermis involving dendritic cells, macrophages, and T cells (three subtypes of white blood cells). These immune cells migrate from the dermis to the epidermis and secrete inflammatory chemical signals (cytokines) such as tumor necrosis factor-α, interleukin-6, and interleukin-1β. These inflammatory signals are thought to trigger keratinocytes to proliferate. 

The picture below illustrated how cytokines derived from or receptors expressed in keratinocytes affects on the expression of proliferative and proinflammatory genes, as the study in Advances in the pathogenesis of psoriasis: from keratinocyte perspective stated that “Keratinocytes are critical cytokine responders in psoriasis, as keratinocyte-specific deletion of their receptors (such as IL-17RA and IL-36R) alleviated psoriasiform lesion in psoriatic mouse model. Keratinocyte-derived IL-17C, IL-17E, IL-36, and IL-23 could induce expression of proliferative and proinflammatory genes by multiple signaling pathways, leading to epidermal hyperplasia and amplification of inflammation and leukocyte infiltration. ”

Another hypothesis suggests that it can arise from a gene mutation. Deoxyribonucleic acid (DNA) discharged from dying cells functions as an inflammatory stimulus in psoriasis, and the receptors on particular dendritic cells are activated, resulting in the production of the cytokine interferon-α. Simultaneously, keratinocytes also secrete cytokines (including interleukin-1, interleukin-6, and tumor necrosis factor-α) as a response to the chemical messages from dendritic cells and T cells, which signal downstream inflammatory cells to arrive and cause additional inflammation.

Psoriasis has a strong hereditary component, and associated with it are many genes related to the immune system, but it is too complicated to identify how those genes work together.

There is no known definitive cure for psoriasis, but there are some approaches to reduce its symptoms. Many physicians and dermatologists are currently getting down to how light therapy can be applied to treat psoriasis. And there are numerous research results that suggest it becomes a worthwhile trial for this chronically plagued disease.

Phototherapy (Light Therapy) for Psoriasis

For many people with psoriasis, phototherapy (light therapy) is one of the most effective treatments. Phototherapy uses light to treat psoriasis by reducing the severity and duration of outbreaks. There are different types of light therapy that can be used to treat psoriasis—sunscreens, bright lights, and pulsed light therapies. Sunscreen light therapy is the most common form of phototherapy and is the least intense type of light. It uses ultraviolet (UV) light to treat psoriasis. Bright light therapy uses standard light bulbs that are adjusted to a higher intensity. Pulsed light therapy uses a controlled light source that pulses light at a specific frequency. While phototherapy may have some side effects, they are generally mild and tolerable. Apart from that, some people experience redness, itching, or skin sensitivity. Phototherapy is usually very effective in treating psoriasis and can be an affordable treatment option.

Light therapy has been applied to treat psoriasis for a long ago. Phototherapies show much lower risk of side effects than other treatments may cause significant side effects, in comparison with other traditional treatments, such as topical medications, systemic treatments (methotrexate and cyclosporine), and biologic agents (targeting Tumor Necrosis Factor-α [TNF-α], Interleukin 12/23, or Interleukin 17A). There is an increased risk of skin atrophy from long-term use of topical corticosteroids and the risk of immune suppression from systemic treatments.

Narrowband ultraviolet B (NB-UVB) is a form of phototherapy that has been commonly used to treat plaque or guttate psoriasis. Targeted ultraviolet B (UVB) light therapy is applied to localized psoriasis. Topical PUVA may be of particular benefit to adults with palmoplantar psoriasis, but it is combined with psoralen, a medication that increases body sensitivity to light.

While blue and ultraviolet light have long been discovered for their effect on psoriasis treatment, recent studies also find that red light therapy has a similar result.

A study in the Journal of the European Academy of Dermatology and Venereology reveals that significant clinical improvement is seen in either the group with a high dosage of blue light or the group with a high dosage of red light. Though there are many studies about the effect of RLT on psoriasis, the research on this topic is still in its infancy. Many of them attribute the improvement of symptoms to its anti-inflammatory function, according to the study Combination 830-nm and 633-nm light-emitting diode phototherapy shows promise in the treatment of recalcitrant psoriasis: preliminary findings.

One small 2011 study pitted RLT and blue light therapy (BLT) against each other. Folks with psoriasis received high doses of light therapy three times a week for 4 weeks. They also applied 10 percent salicylic acid to their plaques during that time.

How does red light therapy work for psoriasis?

Psoriasis, as one of the chronic inflammatory diseases, receives much better improvement in appearance, since in many cases its autoimmune syndromes are caused by the overproliferation in the dermis. Inflammation isn’t just a symptom, but a complex process that takes place as the body’s programmed response to danger. It’s a part of the immune system as the first line of defense against infection, germs, irritation, and cell damage. Red light therapy alleviates chronic inflammation by increasing blood flow to the damaged tissues, and it’s been found in numerous clinical trials to increase the body’s antioxidant defenses.

Because the study on this topic is still in its cradle and there is a need to confirm the decisive biological rationale, the majority of the hypotheses revolve around the penetration ability and encouraging photobiomodulation of red and near-infrared light to human tissue. Nevertheless, there are sufficient clinical facts to show its alleviation of psoriasis symptoms and promotion in combination with other conventional treatments.

According to one study in the American Society for Photobiology, it explored the effects of red (650 nm) and NIR (808 nm) light on phagocytosis (respiratory burst), cytokine expression, mitochondrial activity, ROS generation, Ca2+ influx, and membrane depolarization in macrophages in vitro. The study stated that both the phagocytic capacity and adhesion of macrophages strongly increased, and along with the upregulation of phagocytosis came the lessened production of pro-inflammatory cytokines and the vibrant secretion of anti-inflammatory cytokines. It is noteworthy that the light-induced action of immune cells appears to be of biphasic dose response; it increases after irradiation with lower doses (0.3-1 J cm-2 ) and decreases after treatment with higher doses (18-30 J cm-2 ), which is apparently associated with the upregulation of ROS generation, followed by an increase in mitochondrial activity.

There are other studies that gave implications that ATP can actually reduce inflammation, and its metabolite adenosine can act as an immunomodulator to attenuate inflammation and cause an immunosuppressive response after inflammation. Studies have confirmed that adenosine balances the inflammatory action through three steps. First, adenosine is released in the vicinity of the immune cells in tissues subject to various forms of harmful stimuli, including ischemia and inflammation. Second, in most experimental systems, adenosine is immunosuppressive as a result of receptor occupation in various types of immune cells. Third, removing the signaling of endogenous adenosine exacerbates the immune activation and, consequently, aggravates the tissue dysfunction following an acute damaging stimulus. And the major reason behind the extracellular concentration of adenosine is the degradation of ATP, according to a study, ATP and Its Metabolite Adenosine. It declared the pathway of ATP/Ado generation in DCs (dendritic cells). The following picture illustrates the extrusion of Ado and the release and degradation of ATP.

As the website stated: “Pathways of ATP/Ado generation in DCs. Intracellular Ado can be produced by degradation of AMP by 5′ectonucleotidases. Nucleoside transporters (NT) lead to the extrusion of Ado. ATP can be released by cells via pannexin channels after injury and during inflammation, acting immune stimulatorthe by engagement of P2X receptors (P2XR). It can be degraded by the ectoenzymes CD39 and CD73, resulting in increased levels of Ado in the extracellular environment. Ado can be degraded by action of the enzyme Adenosine deaminase (ADA) intra- and extracellularly.” 

In a nutshell, red light wavelengths can penetrate into deeper tissue and increase the production of ATP; therefore, it is also capable of affecting and modulating the behaviour of immune cells and production of pro-inflammatory or anti-inflammatory cytokines. Both the metabolite of APT, i.e., Ado, and immune regulatory cytokines are crucial to inflammation symptoms, which lie the root of the cause of Psoriasis.

What are the benefits of red light therapy for psoriasis?

Here are the main reasons why red light therapy is a good option for patients with psoriasis.

Does red light therapy work for all types of psoriasis?

There are variants of psoriasis, including psoriasis vulgaris, inverse psoriasis, guttate psoriasis, pustular psoriasis, and erythrodermic psoriasis, which can develop into other kinds of psoriasis. There is no explicit conclusion for the effect of red light therapy on a specific variant of psoriasis, but in many clinical trials on different types, red light shows promise in the reduction of its symptoms and adjuvant therapeutic function in combination with traditional treatment.

One study, A Comparison of The Effects of Clobetasol and Photodynamic Therapy Using Aminolevulinic Acid and Red Light for Nail Psoriasis, concluded that the efficacy of ALA-PDT was greater at the 24-week follow-up than clobetasol.

A 2017 research review suggested that certain wavelengths of red light work against plaque psoriasis. People with plaque psoriasis were able to clear 60 percent to 100 percent of their skin with 2 red light sessions a week for 4 to 5 weeks.

One clinic trial in 2010 even showed hope for patients with psoriasis resistant to conventional treatments. The conclusion states that all patients completed their LED regimens (4 requiring 1 regimen, 5 requiring a second) with follow-up periods from 3 to 8 months, except for the two patients lost to follow-up, and clearance rates at the end of the follow-up period ranged from 60% to 100%. It further confirmed the anti-inflammatory effects of red and near-infrared light at 830 nm and 633 nm on psoriasis, and the light energy is well tolerated by all kinds of skin.

Conventional Psoriasis Treatments

Most current pharmaceutical treatments target specific pathogenesis that plays a role in psoriasis syndromes. Those pathways involve T cells, T cell autoantigens, keratinocytes, immune organ lymph, dendritic cells, and some of their secreted cytokines. The signaling of antimicrobial peptides (AMPs) that are secreted by keratinocytes in response to injury is characteristically overexpressed in psoriatic skin. The activation of the adaptive immune response via the distinct T cell subsets drives the maintenance phase of psoriatic inflammation. Th17 cytokines, namely IL-17, IL-21, and IL-22, activate keratinocyte proliferation in the epidermis. The TNFα–IL23–Th17 axis plays a central role in T cell-mediated plaque psoriasis, and the innate immune system appears to play a more prominent role in the pustular variants of psoriasis. Drugs targeting the relative cytokines or tumor necrosis factors like TNFα, IL-23, and IL-17, and the related signaling pathways are effective and widely used in the clinical treatment of plaque psoriasis. The primary target of most pathways is to modulate the aberrant proliferation and differentiation of keratinocytes. Other treatments are also aimed at modulating immune cell activation or the induction of Th17 and Th1 differentiation. The study, psoriasis pathogenesis and treatment, reviewed all of the current pathmechanisms and conventional treatments for psoriasis.

Other conventional treatments of phototherapy which were discovered earlier as effective for psoriasis symptoms, are mainly applied by UVA light, UVB light, or blue light. Blue light has a short wavelength and high energy, and as it scatters more easily than other visible light, it has less penetration ability than red light and is not as focused as red light, which usually contributes to eye strain. Additionally, blue light can actually affect circadian rhythms. UVB and UVA lights have the potential to change DNA in skin cells and are the main reason to cause sunburn if overexposed to them.

What kind of product can really help patients with psoriasis?

Since we know that red and near-infrared light therapy can have a positive impact on reducing psoriasis symptoms, how should we choose a suitable device of light therapy for psoriasis treatment?

For patients with psoriasis, which usually is a disease plague spreading out a wide area of body, a devise with larger panel will be more convenient for treatment area, and a higher power of electricity output is crucial to deliver the light source from a distance, since keeping a distance from a light source can help to spread out the light to cover the whole disease area. From this point, a device with lower power cannot achieve. What’s more, the most accurate way to measure a light source is to measure its spectral power distribution (SPD), which is the fingerprint of a light source, for it illustrates how energy is split through the spectrum pattern. Some devises claim to provide the combination of different wavelengths are not really good choices, for we should be careful that the electricity energy of a light source will be split and contribute to different wavelengths, which may reduce the concentration of light energy of effective wavelength, and it will reduce optimal result; especially for patients who need to take photosensitizers this will reduce the effectiveness of treatment, since different photosensitizers are only activated by certain acceptable wavelengths. It should also be noted that psoriasis is a disease to causes a thickened skin layer with built-up cells on the surface, so the penetration ability of the wavelength is important, even with aid of salicylic acid or something similar to remove the surface layer of lesion.

In our X and Y series of products, we provide the large LED-panel device equipped with an irradiance of higher than 120mW/cm² at the surface and 73mW/cm² at 6 inches. To provide sufficient treatment for psoriasis patients with a large treatment area. And they are also equipped with higher power consumption, and make sure to provide effective specific wavelengths. The greater the power consumption, the better the effect you get. Power consumption is the most crucial element in determining the success of therapy. The therapeutic effect of applying 10 minutes of irradiation with our device is equal to 20 minutes of other devices, for they have higher power consumption and usually higher irradiance. By the way, our products are all free from EMF at 3 inches and have a 3-year warranty, so Bestqool ensures the safety and effectiveness of treatment. You can trust us and the designed devices.

Frequently Asked Questions

Does red light therapy work better than traditional treatments for treating Psoriasis?

There is limited research on the effectiveness of red light therapy compared to traditional medications for treating psoriasis, but early studies suggest that red light therapy may have a specific and important function in the mitigation of psoriasis symptoms. There are facts found in established studies:

What are some risks and side effects of using red light therapy for psoriasis?

There are a few potential risks and side effects associated with using red light therapy for psoriasis. However, considering the fact that red light has been shown to be effective in treating various situations of psoriasis, the risk of side effects is worth taking if it results in improved symptoms.

Red light therapy has the same side effects as commonly occur in phototherapy of high-level light intensity. In terms of cosmetic effect, it may cause the skin to darken. Additionally, concerning the sensitivity of different patients and the intensity and dosage of light, some side effects of red light therapy for psoriasis include skin irritation, temporary reddening, pruritus, pain, blisters, or swelling. However, these side effects are usually mild, self-limiting, and short-term, which occur during treatment or within the first 24 h after the treatment. Wearing sunscreen can be a wiser option when being closer to any type of light with high intensity.

Therefore, when using it properly, red light therapy is a safe approach for treating psoriasis.