Photobiomodulation (Red Light Therapy) for Wound Healing

Photobiomodulation (PBM), also known as low-level laser therapy (LLLT) and Red Light Therapy, has been scientifically proven to be a safe and effective therapy for wound healing as it promotes cellular processes that aid in tissue repair and regeneration.

PBM light acts on cells in the skin known as fibroblasts, which play a role in production of collagen, a protein that makes up a large part of connective tissue and helps the skin to recover when it’s harmed. PBM has been proven to effectively treat and accelerate healing of wounds and other skin conditions.

Along with improving collagen synthesis, PBM promotes wound healing by:

Enhancing cellular energy production (ATP),
Reducing oxidative stress and inflammation,
Promoting blood vessel formation,
Stimulating cell proliferation (cell growth and division).

These combined effects create an optimal environment for faster and more effective wound healing, making PBM a valuable tool in both acute and chronic wound management.

How it Works:

Enhanced Cellular Energy Production (ATP)

Mitochondrial Stimulation: PBM primarily works by stimulating the mitochondria, the energy powerhouse of cells. The light from PBM (typically in the red or near-infrared spectrum) is absorbed by chromophores within the cells, particularly cytochrome c oxidase, a key enzyme in the mitochondrial respiratory chain.
Increased ATP Production: As a result, ATP (adenosine triphosphate) production is increased. ATP provides the necessary energy for cellular processes, including tissue repair, which speeds up the wound healing process.

Reduction of Inflammation

Decreased Pro-Inflammatory Cytokines: PBM reduces the levels of pro-inflammatory cytokines like TNF-α, IL-1β, and IL-6, which are often elevated during the early stages of wound healing. This reduction helps to prevent excessive inflammation, which can delay wound healing.
Increased Anti-Inflammatory Cytokines: It also promotes the production of anti-inflammatory cytokines, which contribute to resolving inflammation and initiating tissue repair.

Promotion of Collagen Synthesis

Collagen Production: PBM stimulates fibroblasts, which are responsible for producing collagen, a critical protein in wound healing that provides strength and structure to the newly formed tissue.
Accelerated Tissue Regeneration: With enhanced collagen production, tissue regeneration is faster and the wound heals more efficiently, resulting in improved skin texture and strength.

Increased Angiogenesis (Formation of New Blood Vessels)

Improved Blood Flow: PBM promotes the formation of new blood vessels, a process called angiogenesis. This is crucial for delivering oxygen and nutrients to the wound site, which supports the healing process.
Better Oxygenation: Enhanced oxygen supply helps remove waste products and promotes the synthesis of proteins and other molecules necessary for tissue repair.

Improved Cellular Proliferation and Migration

Keratinocyte and Fibroblast Activation: PBM encourages the proliferation and migration of keratinocytes (skin cells) and fibroblasts (connective tissue cells). These cells play a key role in the repair of damaged skin and the formation of new tissue at the wound site.
Enhanced Epithelialization: This process, in which new epithelial cells cover the wound, is crucial for closing the wound and forming a protective barrier.

Reduction of Oxidative Stress

Lower Reactive Oxygen Species (ROS): PBM helps reduce the levels of ROS, which can cause cellular damage if present in high amounts. By controlling oxidative stress, PBM creates a more favorable environment for wound healing.

Stimulation of Stem Cells

Stem Cell Activation: PBM is known to stimulate the activity of stem cells in the body, which can differentiate into various cell types needed for wound healing. These stem cells contribute to tissue repair and regeneration by replenishing damaged or lost cells.

Pain Reduction

Analgesic Effect: PBM has analgesic properties, helping to reduce pain at the wound site. It does this by reducing inflammation, modulating nerve conduction, and promoting endorphin release. This can improve patient comfort and compliance with wound care protocols.

Clinical Evidence for PBM in Wound Healing

Numerous studies have demonstrated the effectiveness of PBM in accelerating wound healing across various types of wounds, including:

Chronic Wounds: Such as diabetic ulcers, venous ulcers, and pressure sores, where PBM can improve healing rates and reduce the likelihood of infections.
Burns: PBM has been shown to reduce inflammation and promote faster healing of burn wounds, with less scarring.
Surgical Wounds: PBM can speed up the healing of incisions and reduce post-surgical complications.
Traumatic Wounds: Including cuts, abrasions, and other injuries.

DETAILS:

Chronic Ulcers

Study: “Photobiomodulation therapy in the treatment of chronic diabetic foot ulcers: A randomized controlled trial” (2020)
Objective: To evaluate the effect of PBM on healing diabetic foot ulcers.
Results: Patients who received PBM therapy showed significant reductions in wound size and faster healing compared to the control group. PBM was found to enhance wound closure and reduce inflammation.
Conclusion: PBM improved the healing rate of chronic diabetic foot ulcers, making it a useful adjunctive therapy for chronic wounds.

Burns

Study: “Effects of low-level laser therapy (photobiomodulation) on second-degree burns in rats and clinical implications” (2017)
Objective: To assess the impact of PBM on second-degree burns and its potential for human application.
Results: PBM significantly accelerated the healing process, reduced inflammation, and minimized scarring in the treated groups compared to untreated control burns.
Conclusion: PBM could be a promising tool for treating second-degree burns in clinical settings.

Surgical Wounds

Study: “Photobiomodulation therapy for postoperative wound healing in oral surgery: A double-blind, randomized controlled trial” (2016)
Objective: To assess the efficacy of PBM on postoperative wound healing in patients who underwent oral surgery.
Results: Patients receiving PBM therapy exhibited faster wound closure, reduced pain, and better healing outcomes compared to the placebo group.
Conclusion: PBM was effective in enhancing postoperative wound healing and reducing recovery time for surgical patients.

Pressure Ulcers

Study: “Effect of photobiomodulation on pressure ulcer healing: A double-blind, randomized controlled trial” (2019)
Objective: To determine the impact of PBM on the healing of pressure ulcers in immobile patients.
Results: PBM-treated patients showed a faster reduction in ulcer size and a higher rate of tissue regeneration compared to those receiving standard care alone.
Conclusion: PBM therapy significantly improved pressure ulcer healing, suggesting its use as a valuable treatment for patients with limited mobility.

Wound Healing in Diabetic Patients

Study: “Low-level laser therapy for diabetic wound healing: A meta-analysis of randomized controlled trials” (2018)
Objective: A meta-analysis to assess the efficacy of PBM (low-level laser therapy) in diabetic wound healing.
Results: Across multiple trials, PBM was shown to enhance the healing rate of diabetic wounds, reduce healing time, and improve overall wound closure compared to standard care alone.
Conclusion: PBM is an effective complementary therapy for improving wound healing in diabetic patients, particularly those with non-healing or chronic wounds.

Traumatic Injuries

Study: “Low-level laser therapy accelerates wound healing in traumatic injuries: A controlled clinical trial” (2015)
Objective: To evaluate the effects of PBM on healing traumatic wounds in patients with severe injuries.
Results: Patients treated with PBM experienced significantly faster healing, less pain, and better cosmetic outcomes than the control group.
Conclusion: PBM demonstrated a beneficial effect on the healing of traumatic wounds and should be considered in treatment protocols.

Skin Grafts and Flaps

Study: “Low-level laser therapy enhances skin flap viability and healing: A randomized clinical trial” (2017)
Objective: To assess the role of PBM in the survival and healing of skin grafts.
Results: PBM significantly improved skin flap viability, reduced the risk of necrosis, and promoted faster healing compared to the untreated group.
Conclusion: PBM enhances the success of skin grafts and flaps, making it a potential therapy in reconstructive surgery.

Key Findings from Clinical Trials:

Faster Wound Closure: PBM consistently reduces the time required for wounds to close, especially in chronic wounds, burns, and surgical sites.
Reduced Inflammation: PBM lowers inflammatory markers, helping to prevent complications like infections and promoting an optimal healing environment.
Improved Blood Flow: Enhanced angiogenesis (new blood vessel formation) improves oxygen and nutrient delivery to the wound site, accelerating tissue regeneration.
Better Cosmetic Outcomes: PBM reduces scarring and improves skin texture and appearance in healed wounds.

Clinical Trial Examples:

Conclusion:

Photobiomodulation therapy has shown considerable promise in multiple clinical trials for wound healing, including chronic wounds, surgical wounds, burns, and traumatic injuries.

Photobiomodulation promotes wound healing by enhancing cellular energy production, reducing inflammation, improving collagen synthesis, promoting blood vessel formation, stimulating cell proliferation, and reducing oxidative stress. These effects create an optimal environment for faster and more effective wound healing, making PBM a valuable tool in both acute and chronic wound management.