Light has been used in medicine for many years, such as ultraviolet light for skin conditions and laser surgery.1
More recently, researchers have found that specific wavelengths of red and near-infrared (NIR) light can influence how cells function and support healing. This forms the basis of Photobiomodulation Therapy (PBMT), a non-invasive treatment that was first explored in the 1960s for wound healing.1
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PBMT was originally studied for its ability to speed up tissue repair. Since then, it has developed into a broader therapy used for pain relief, muscle recovery, inflammation reduction, and neurological support. As researchers continue to study how PBMT works, its potential uses in healthcare are becoming more apparent.
How Does Photobiomodulation Therapy Work?
PBMT uses red (600-700 nm) and near-infrared (700-1100 nm) light to penetrate tissues and interact with cells. When light reaches biological tissue, it can be reflected, scattered, transmitted, or absorbed. The therapeutic effects of PBMT are primarily driven by light absorption, particularly by mitochondrial chromophores.2,3
The key photo acceptor in mitochondria is cytochrome c oxidase (Cox), a critical enzyme in the electron transport chain. Cox facilitates electron transfer and contributes to the reduction of molecular oxygen, increasing the mitochondrial membrane potential. This process enhances the production of adenosine triphosphate (ATP), the primary energy carrier in cells.
Additionally, PBMT influences cellular signaling by promoting the generation of cyclic adenosine monophosphate (cAMP) and reactive oxygen species (ROS), both of which play roles in cellular metabolism and stress response.3,4
By increasing ATP availability and modulating cellular signaling, PBMT promotes cellular repair, reduces inflammation, and improves circulation. While some theories suggest that PBMT may also affect mitochondrial interfacial water layers, reducing viscosity and enhancing ATP synthase efficiency, the primary mechanism remains linked to mitochondrial activation.3
Photobiomodulation vs. Red Light Therapy
While PBMT and red light therapy (RLT) both use light to stimulate biological processes, they differ in wavelength range, depth of penetration, and medical applications.
RLT primarily uses red light with wavelengths between 600 and 700 nm, which can penetrate up to 2 cm into tissue. This makes it suitable for surface-level treatments, particularly in dermatology. RLT has been shown to stimulate collagen production, enhance skin elasticity, and reduce inflammation, making it effective for treating acne, fine lines, wrinkles, and other signs of photoaging.
It may also support wound healing by promoting keratinocyte migration and improving local circulation. Dermatologists have historically used RLT for conditions that do not require deep tissue penetration.5
PBMT combines both red light and near-infrared light, allowing for deeper penetration into muscles, joints, and nerves. This gives it a broader therapeutic range than RLT, which only targets superficial tissues. As a result, PBMT is more often used in clinical settings for musculoskeletal pain, recovery, inflammation, and neuroprotection.
Medical professionals (including chiropractors, physical therapists, and sports medicine experts) use PBMT as part of therapeutic and rehabilitative protocols.5
PBMT has more FDA-approved applications than RLT, particularly for pain management, tissue repair, and musculoskeletal conditions. While many RLT devices are marketed for general wellness or cosmetic benefits, many lack FDA clearance for specific clinical indications. In some cases, claims related to penetration depth and therapeutic efficacy are not supported by peer-reviewed data.
For PBMT to be effective, devices must deliver precisely controlled dosages, use multiple wavelengths to target different tissue depths, and operate at power levels sufficient to induce a biological response without causing thermal damage.6
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Key Applications of PBMT
Pain Management
PBMT has demonstrated significant pain-relieving effects in conditions such as arthritis, sports injuries, and chronic pain. It disrupts cytoskeletal and microtubular structures, which can block neuronal depolarization, limit afferent pain signaling, and reduce the transport of pro-inflammatory cytokines. These mechanisms help alleviate pain associated with neuropathic conditions, chemotherapy-induced pain, neck pain, and spinal cord injuries.7
A recent study by Tsai et al. introduced “Optianesthesia,” which explores transcranial PBMT as an adjunct to pharmacological anesthetics. The findings suggest that PBMT can modulate brain wave patterns, reduce seizure activity, and enhance anesthetic effects. This offers a non-invasive alternative for pain relief. Additionally, PBMT may support cerebrospinal fluid (CSF) clearance during sleep, helping to reduce neuroinflammation and improve pain management.8
Wound Healing and Inflammation Reduction
PBMT accelerates wound healing and inflammation reduction by influencing cellular signaling, gene expression, and epigenetic modifications. It enhances epithelial migration and tissue regeneration by modifying histone acetylation and DNA methylation, activating key proteins like CBP p300 and mTOR that drive cell proliferation and repair.
Additionally, PBMT reduces methyl-CpG-binding domain proteins (MBD2), which promotes the transition from early-stage migration to later-stage differentiation, ensuring efficient and optimized tissue healing.9
Beyond wound repair, PBMT also regulates intracellular pathways involved in inflammation reduction and cell survival. It activates key signaling proteins, including signal transducer and activator of transcription 3 (STAT3), extracellular signal-regulated kinase (ERK), c-Jun N-terminal kinase (JNK), p70 ribosomal protein S6 kinase (p70S6K), and protein kinase B (Akt). These proteins help control inflammation, enhance cellular metabolism, and promote tissue regeneration.10-11
A Study by Cardoso et al. demonstrated that PBMT improves intracellular communication and glucose metabolism, making it especially beneficial for chronic wounds and age-related cellular dysfunction.11
Photobiomodulation for mucositis management
Neurological Benefits
PBMT has shown promise in neurological applications, particularly for conditions like Alzheimer’s disease (AD), Parkinson’s disease (PD), and cognitive enhancement. One of its key mechanisms is the modulation of neural oscillations, which are critical for brain function. In PD, impaired gamma oscillations in the cortico-basal ganglia loops contribute to motor dysfunction, including tremors.7
A study by Halje et al. suggests that transcranial PBMT can modulate gamma oscillations, potentially improving motor symptoms. Preliminary findings from the study, which used LED-based cranial devices, reported symptom improvement in more than half of PD patients, although larger clinical trials are needed for confirmation.12
In Alzheimer’s disease, PBMT may have a direct effect on amyloid-β pathology. Recent research by Yuan et al. suggests that amyloid-β, a hallmark of AD, has optical absorption properties that could interact with PBMT, potentially influencing protein aggregation and clearance.13 Additionally, PBMT has been linked to improved sleep regulation, which is crucial in neurodegenerative conditions.
Sports and Muscle Recovery
PBMT is widely used in sports and muscle recovery to accelerate healing, reduce fatigue, and enhance performance. Research by Ferraresi et al. has shown that PBMT increases ATP synthesis and matrix metalloproteinase activity in muscle tissue, with its maximum effect occurring 3 to 6 hours post-treatment and lasting up to 24 hours.14
Additionally, Rochkind and co-workers reported that PBMT enhances creatine kinase activity and acetylcholine receptor (AChR) levels, both of which play essential roles in muscle contraction and energy metabolism. These biochemical changes help maintain high-energy phosphate reserves, allowing for faster muscle repair and improved endurance.15 As a result, PBMT has become a valuable tool for athletes and fitness professionals seeking quicker recovery and enhanced physical performance.
Skincare and Anti-Aging
PBMT stimulates collagen production and skin rejuvenation by influencing cellular autofluorescence and metabolism. It interacts with light-absorbing molecules like flavins, aromatic amino acids, lipofuscins, and advanced glycation end products to enhance cell repair, elasticity, and wrinkle reduction.
PBMT also triggers epigenetic changes, accelerating keratinocyte migration and differentiation for skin renewal. By modulating ROS and biophoton release, it reduces oxidative stress, making it a non-invasive, effective anti-aging therapy for healthier, youthful skin.16
Explore Related Topics in Biomedical Optics and Photomedicine
PBMT has demonstrated measurable biological effects across a range of clinical and wellness applications. While ongoing research continues to refine treatment protocols, PBMT is gaining interest among healthcare professionals, researchers, athletes, and individuals managing chronic conditions. As evidence grows, so does the opportunity to integrate PBMT into broader therapeutic strategies.
References and Further Reading
1. Markoulli, M.; Chandramohan, N.; Papas, E. B., Photobiomodulation (Low-Level Light Therapy) and Dry Eye Disease. Clinical and Experimental Optometry 2021, 104, 561-566. https://pubmed.ncbi.nlm.nih.gov/33689636/
2. Tripodi, N.; Feehan, J.; Husaric, M.; Kiatos, D.; Sidiroglou, F.; Fraser, S.; Apostolopoulos, V., Good, Better, Best? The Effects of Polarization on Photobiomodulation Therapy. Journal of Biophotonics 2020, 13, e201960230. https://pubmed.ncbi.nlm.nih.gov/32077232/
3. De Freitas, L. F.; Hamblin, M. R., Proposed Mechanisms of Photobiomodulation or Low-Level Light Therapy. IEEE Journal of selected topics in quantum electronics 2016, 22, 348-364. https://pubmed.ncbi.nlm.nih.gov/28070154/
4. Chung, H.; Dai, T.; Sharma, S. K.; Huang, Y.-Y.; Carroll, J. D.; Hamblin, M. R., The Nuts and Bolts of Low-Level Laser (Light) Therapy. Annals of biomedical engineering 2012, 40, 516-533. https://pubmed.ncbi.nlm.nih.gov/22045511/
5. Glass, G. E., Photobiomodulation: The Clinical Applications of Low-Level Light Therapy. Aesthetic surgery journal 2021, 41, 723-738. https://pubmed.ncbi.nlm.nih.gov/33471046/
6. Ailioaie, L. M.; Ailioaie, C.; Litscher, G., Photobiomodulation in Alzheimer’s Disease—a Complementary Method to State-of-the-Art Pharmaceutical Formulations and Nanomedicine? Pharmaceutics 2023, 15, 916. https://www.mdpi.com/1999-4923/15/3/916
7. Liebert, A.; Capon, W.; Pang, V.; Vila, D.; Bicknell, B.; McLachlan, C.; Kiat, H., Photophysical Mechanisms of Photobiomodulation Therapy as Precision Medicine. Biomedicines 2023, 11, 237. https://pubmed.ncbi.nlm.nih.gov/36830774/
8. Tsai, C.-M.; Chang, S.-F.; Li, C.-C.; Chang, H., Transcranial Photobiomodulation (808 Nm) Attenuates Pentylenetetrazole-Induced Seizures by Suppressing Hippocampal Neuroinflammation, Astrogliosis, and Microgliosis in Peripubertal Rats. Neurophotonics 2022, 9, 015006-015006. https://pubmed.ncbi.nlm.nih.gov/35345494/
9. Martins, M. D.; Silveira, F. M.; Martins, M. A.; Almeida, L. O.; Bagnato, V. S.; Squarize, C. H.; Castilho, R. M., Photobiomodulation Therapy Drives Massive Epigenetic Histone Modifications, Stem Cells Mobilization and Accelerated Epithelial Healing. Journal of Biophotonics 2021, 14, e202000274. https://pubmed.ncbi.nlm.nih.gov/33025746/
10. de Farias Gabriel, A.; Wagner, V. P.; Correa, C.; Webber, L. P.; Pilar, E. F. S.; Curra, M.; Carrard, V. C.; Martins, M. A. T.; Martins, M. D., Photobiomodulation Therapy Modulates Epigenetic Events and Nf-Κb Expression in Oral Epithelial Wound Healing. Lasers in medical science 2019, 34, 1465-1472. https://pubmed.ncbi.nlm.nih.gov/30820776/
11. Cardoso, F. d. S.; Mansur, F. C. B.; Lopes-Martins, R. Á. B.; Gonzalez-Lima, F.; Gomes da Silva, S., Transcranial Laser Photobiomodulation Improves Intracellular Signaling Linked to Cell Survival, Memory and Glucose Metabolism in the Aged Brain: A Preliminary Study. Frontiers in Cellular Neuroscience 2021, 15, 683127. https://pubmed.ncbi.nlm.nih.gov/34539346/
12. Halje, P.; Brys, I.; Mariman, J. J.; Da Cunha, C.; Fuentes, R.; Petersson, P., Oscillations in Cortico-Basal Ganglia Circuits: Implications for Parkinson’s Disease and Other Neurologic and Psychiatric Conditions. Journal of neurophysiology 2019, 122, 203-231. https://pubmed.ncbi.nlm.nih.gov/31042442/
13. Yuan, P.; Zhang, M.; Tong, L.; Morse, T. M.; McDougal, R. A.; Ding, H.; Chan, D.; Cai, Y.; Grutzendler, J., Pld3 Affects Axonal Spheroids and Network Defects in Alzheimer’s Disease. Nature 2022, 612, 328-337. https://pubmed.ncbi.nlm.nih.gov/36450991/
14. Ferraresi, C.; Kaippert, B.; Avci, P.; Huang, Y. Y.; De Sousa, M. V.; Bagnato, V. S.; Parizotto, N. A.; Hamblin, M. R., Low‐Level Laser (Light) Therapy Increases Mitochondrial Membrane Potential and Atp Synthesis in C2c12 Myotubes with a Peak Response at 3–6 H. Photochemistry and photobiology 2015, 91, 411-416. https://pubmed.ncbi.nlm.nih.gov/25443662/
15. Rochkind, S.; Geuna, S.; Shainberg, A., Phototherapy and Nerve Injury: Focus on Muscle Response☆. International Review of Neurobiology 2013, 109, 99-109. https://www.sciencedirect.com/science/article/abs/pii/B9780124200456000043
16. Lee, S.; Afandi, M. M.; Lee, J.; Kim, J., In Vivo Application of the Effects of Red-to-near-Infrared Light Spectroscopy on Skin-Brightening and Anti-Aging Properties Via Led Facial Masks. Cosmetics 2025, 12, 4. https://www.mdpi.com/2079-9284/12/1/4
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