Red Light Therapy, also known as photobiomodulation, has become hugely popular as an at home modality for skin rejuvenation in recent years. As a non-invasive treatment proven to reduce fine lines and wrinkles and improve skin tone and texture, the benefits are undisputable. Recently, however, I have noticed a debate brewing on YouTube around the possibility of Red Light Therapy being a risk for facial fat loss. This idea stems from information around the well-documented application of photobiomodulation to reduce adipose tissue mass in obese and diabetic individuals.
This blog looks at the evidence behind this idea and assesses the ‘risk’ of red light therapy for facial fat loss.
Healthy Adipose Tissue versus Unhealthy Tissue
One of the major functions of adipocytes is energy storage. In healthy individuals, insulin facilitates the uptake of glucose from the blood and transforms it into lipid, a more stable energy molecule. Adipose tissue stores energy in the form of lipid and controls lipid mobilisation and distribution to the body.
In obesity however, adipocytes become dysfunctional in two ways: hyperplasia (over production of cells) and hypertrophy (over-sized cells). Hypertropic adipocytes are swollen with excess lipids, which leads to inflammation and insulin resistance. These dysregulated adipocytes cause the release of free fatty acids and pro-inflammatory cytokines, promote hypoxia (inadequate oxygen delivery to the tissues) and reduce insulin sensitivity. Hypertrophic adipocytes also result in an increase in the level of reactive oxygen species, with the potential to damage DNA and disrupt intracellular signalling. All in all, not a pretty picture! The message here is that unhealthy cells have a very different physiology to healthy cells. Please hold this thought!
Whilst fatty tissue is not responsible for most of the body's insulin-stimulated glucose removal, its dysfunction has been shown to lead to whole body insulin resistance and progression to Type 2 diabetes. In obese and diabetic individuals, transporter proteins in adipose tissue are diminished and the ability for cells to take up glucose is inhibited.
As a non-invasive procedure, photobiomodulation offers an attractive alternative to surgery as a fat-reducing technique for body remodelling.
Research Studies - Effect of Photobiomodulation on Adipose Tissue
Several researchers have shown photobiomodulation as an effective method for reducing fat content and body contouring in vivo. Both red (630nm) and infrared (850nm) wavelengths are shown capable of restoring the cellular morphology and function of hypertrophic cells. More recent in vitro studies, performed by McColloch and Liu in 2021, help to characterise the effect of photobiomodulation on hypertrophic cells further and confirm its influence on reduction of lipids and restoration to normal adipocyte function. This paper is sound evidence that photo therapy influences unhealthy cells to become healthy again, rather than destroying unhealthy cells.
Two papers reviewed show that photobiomodulation could, in fact, have a positive impact on fat cells. In a 2011 study by Tanaka and Matsua, near infrared irradiation was shown to increase the mass of subcutaneous and bone marrow adipocytes. And a 2021 paper from a medical facility at a Turkish University shows that photobiomodulation improves the survival rate for fat grafts by increasing adipocyte viability.
It is worth noting, that in over 6000 published papers on photobiomodulation, and the less than twenty published papers related to the topic of photobiomodulation for fat loss, there is no convincing or direct scientific data indicating that photobiomomdulation, using red or near infrared light, has the potential to deplete facial adipose tissue to a level which can negatively impact the anti-aging benefits attributed to a healthy subcutaneous fat layer. At least in a British court of law (and also in the European Court of Human Rights), our red light friend has the right to a fair trial and is presumed innocent until proven guilty. Moreover, neither myself or Maysama’s research partners at the Nelson Mandela Institute, South Africa, could find any research literature which directly raises concern that photobiomodulation potentially contributes to any negative consequences of fat loss.
Whilst it is logical to assume that, if red light therapy can reduce fat where it is needed, it would also reduce fat in areas that are undesirable (like the face), this is a gross distortion of the facts. Our bodies constantly strive to maintain a state of balance, without being overcome by external stimuli that exist to disrupt the balance. This state of balance is known as homeostasis. In homeostasis, blood pressure, blood sugar, hormones, proteins, and temperature are constantly adjusted to respond to changes inside and outside the body, to keep them at a normal level. And homeostasis applies to cells and tissues within the body too, with the objective of keeping them healthy.
All the published scientific studies performed around photobiomodulation driven fat loss relate to obese or diabetic individuals. And, as we have already discussed, under conditions of obesity or insulin resistance, adipose tissue becomes dysfunctional (unhealthy). Dysfunction cells not only have a different physiological function but also different form, which could allow them to be identified and targeted. Whilst the stimulus of red light can impact fat loss from unhealthy adipose tissue, as is the case for diabetic and obesity, it does not necessary follow that it would impact fat loss from healthy tissue.
Dr Trevor Kokemoer from the Nelson Mandela Institute advises;
‘The precise molecular mechanism responsible for photobiomodulation driven fat loss remains poorly characterised and, from what has been proposed in the literature, it is clearly a multi-factor process with a myriad of potential possibilities, cautioning against oversimplifying a direct trajectory between photobiomodulation fat loss and any anticipated cosmetic outcome.’
Fat Loss Threshold
Indirect evidence suggests that there is a threshold limit for the efficacy of red light therapy driven fat loss, and a possible selectively which specifically targets excess fat or dysfunctional adipocytes.
The fat loss mechanisms behind photobiomodulation demonstrate that a restoration of adipose health and lipid metabolism are common features. Reduction in adipocyte hypertrophy, restoration of insulin sensitivity, inhibition of lipolysis and improved glucose uptake, all support the idea that red light treatments target the dysfunctional properties associated with obesity. Aligned with adipose tissue homeostasis, in the same way that healthy adipocytes resist excessive fat accumulation, they resist excessive fat loss. So effectively they maintain a threshold which can support other beneficial anti-aging effects of red light therapy.
Another aspect to consider are the fundamental properties of adipose tissue lipid dynamics. The fundamental function of healthy adipose tissue is to store fat. So, there is a natural resilience for adipose cells to accomplish this task. Anyone who has attempted to lose weight will know just how difficult it is to not only lose fat, but also to maintain this weight loss. Unless there is a concerted effort through diet and exercise, it is all too easy to regain the fat you have lost. It’s reasonable to argue that red light induced fat loss would be similar. This doesn’t mean that photobiomodulation driven fat loss is not effective, but it does highlight that depletion of adipose tissue in response to red light therapy might be more difficult to achieve than is given credit for. There is no indication that viability of adipocytes is compromised by red light therapy, so we would expect these cells to naturally replace fat.
Without a doubt there are many studies, both clinical and animal, which demonstrate significant fat loss in response to red light therapy but, in all these studies, obesity and diabetes plays a part. So, the adipose tissue is dysfunctional due to an excessive accumulation of fat, which renders the enlarged adipocyte incapable of maintaining proper lipid dynamics.
Dr Koekemoer explains;
‘According to current literature, photobiomodulation driven fat loss has the potential to decrease cell enlargement thereby restoring the functional capacity of these adipocytes, which includes maintaining a healthy fat content. From my understanding, it follows that photobiomodulation stimulates the removal of excess fat, restoring adipocyte function and, as a consequence, avoids the replacement of the lost fat. The end result being the measurable decrease in fat tissue observed in clinical and animal studies. If this is true, it follows that photobiomodulation driven fat loss is indeed disease dependent and will be less efficient in healthy individuals.’
Fat Loss Resistance in Healthy Adipose Tissue
Perhaps the most compelling evidence to support the safety of Red Light Therapy-driven fat loss comes from a 2019 study by Silva which evaluates the impact of photobiomodulation on adipose function using a rodent model rendered obese through a high fat diet. These researchers demonstrate that photobiomodulation improves numerous dysfunctional adipose tissue parameters including fat mass and body weight, further supporting the documented capacity of photobiomodulation to improve obesity. Included in their study design is an experimental group maintained on a healthy low-fat diet, providing a glimpse of what we may expect from photobiomodulation in healthy functional adipose tissue. In contrast to the High Fat Diet group, photobiomodulation had no significant effect on adipose tissue mass and animal body weight, providing direct evidence that healthy adipose tissue is resistant to the effects of sustained photobiomodulation driven fat loss.
In conclusion, the effect of photobiomodulation, with red and infrared, on dysfunctional hypertrophic adipocytes (similar to an obese condition) has been studied and shown to have lipolytic activity which provides an effective modality for fat-loss and body recontouring. The idea that LED light therapy induced fat-loss could subsequently defeat the cosmetic advantage of Red Light Therapy is an oversimplified rationale. Healthy and unhealthy adipose tissue have very different physiology. Studies support that red and near infrared photo therapy selectively targets hypertrophic (unhealthy) adipose tissue and restores its normal function, to store fat. The action of photobiomodulation for fat loss is therefore disease dependent and there is NO EVIDENCE that it affects facial fat loss in healthy individuals. Additionally, research studies in animal models supports that red light therapy has no impact on healthy adipose mass or function.
Fat cell protection with Aspalathin-enriched Green Rooibos
On a side note, preliminary studies from Maysama’s research partners at the Nelson Mandela Institute support that Aspalathin-enriched Green Rooibos Extract [AE-GRE], has a novel property shown to protect and repairs preadipocytes (fat stem cells). Aspalathin is the main flavonoid in green rooibos and Aspalathin-enriched Green Rooibos Extract, is used in the pharmaceutical industry to treat diabetes Type 2, on account of its blood sugar lowering properties. Understanding that green rooibos helps regulate the uptake of glucose, it is perhaps not surprising that it can help maintain and restore the health of the underlying fat stem cells and maintain a healthy subcutaneous preadipocyte population. You can learn more about this on Claudia Glows YouTube channel; Facial Fat Volume Loss and how to restore it NATURALLY | Promising new Study on Skin Aging & Rooibos - YouTube
This same Aspalathin-enriched Green Rooibos Extract is the hero ingredient in Maysama skincare. Maysama Green Rooibos Pressed Serum is proven to more than double outcomes for skin rejuvenation, when used as a co-treatment with Red Light Therapy treatments. The amplification is attributed to a biochemical reaction of Aspalthin, the main flavonoid in green rooibos, which helps mitochondria to uptake their food source (glucose) more effectively, improving mitochondrial energetics and increasing the rate of mitochondrial respiration. When paired with Red Light Therapy, which is known to increase the rate at which ATP is produced from mitochondrial respiration, Maysama Green Rooibos serum acts synergystically to amplify and accelerate the effects.
Food for thought.....if Aspalathin-enriched Green Rooibos is also understood to help protect and repair fat stem cells, Maysama's Green Rooibos Pressed Serum may bring further reassurance to red light therapy users to potenitally protect fat pads in the face.
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Maysama Green Rooibos Pressed Serum £46:00 / $62.95 for 30mls / 1.0 fl oz.
Maysama Green Rooibos Pressed Serum Tri-pack £121.45 / $166.20 for 3 serums.
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