The Ultimate Guide to Treating Melasma with LED Therapy: Tailored Protocols for Fair and Dark Skin
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Melasma is a persistent and often frustrating form of hyperpigmentation, affecting millions of people globally. Characterized by irregular, dark patches on the skin—particularly the face—melasma is a skin condition that is notoriously difficult to treat. A growing body of research supports LED light therapy as a non-invasive treatment for melasma, hyperpigmentation and freckles. This therapy uses specific wavelengths of red (600-660nm) and near infrared (800-1000nm) light to penetrate the skin and stimulate cellular activity.
So Why is Red Light Therapy Making My Melasma Worse?
Despite numerous studies in support of using LED Light Therapy to treat pigmentation disorders, there is significant anecdotal evidence reporting that, for some individuals, LED therapy is making their melasma worse. Whilst it is evident that dosing plays an important part in optimising therapeutic outcomes from LED treatments, a recent review of published data suggests that skin type and tone particularly based on melanin content—plays a significant role in determining the best treatment protocol.
In this extensive guide, we’ll dive deep into
- Understanding melasma
- How LED therapy works to treat melasma
- Best LED wavelengths for treating Melasma
- Melanin Structure and Distribution by Fitzpatrick Skin Type
- LED protocols for fair skin versus darker skin tones
- Clarifying ‘Heating’ In relation to LED Therapy
- Pulsed LED Therapy for Treating Melasma: A Game-Changer
- Recommended LED Beauty Devices
- Topical Skincare for Melasma
We'll also reference multiple studies to support our findings, giving you a solid, science-backed approach to treating melasma with LED therapy.
Understanding Melasma
Melasma is a skin pigmentation issue causing uneven skin tone and dark spots in individuals. It is characterized by brown or grey-brown patches, primarily on the face, often triggered by hormonal changes and sun exposure. Hyperpigmentation, on the other hand, refers to the darkening of the skin due to an excess of melanin, which can be caused by various factors such as inflammation, sun damage, or certain medications.
Melanin, the pigment responsible for skin colour, varies significantly among different skin tones. It is produced by melanocytes in a process called melanogenesis and is then absorbed by skin cells, called keratinocytes. The most common type of melanin is eumelanin, a dark pigment, while pheomelanin is a lighter pigment. Skin pigmentation is a highly controlled complex process involving keratinocytes, melanocytes, and fibroblasts that communicate with each other through secreted mediators and their receptors. Melanin production is controlled by a hormone from the pituitary gland, which binds to a receptor on melanocytes, which increases with UV exposure. These interactions then affect signalling pathways and lead to activation of transcription factors.
Melasma is primarily caused by:
- Hormonal fluctuations, particularly during pregnancy (also known as the "mask of pregnancy") or while using hormonal contraceptives.
- Sun exposure, which can stimulate melanocytes, the cells responsible for producing melanin.
- Inflammation or skin irritation, which can lead to post-inflammatory hyperpigmentation (PIH).
Melasma often affects the cheeks, forehead, nose, and upper lip, and the pigmentation can vary in severity. It can be exacerbated by sun exposure, heat, and even some skincare treatments. This is where LED light therapy comes in as a promising treatment.
How LED Light Therapy Works to Treat Melasma
LED (Light Emitting Diode) therapy is regularly used for skin rejuvenation. It emits wavelengths of light that penetrate the skin to stimulate cell repair, reduce inflammation, and even out skin tone. When it comes to treating pigmentation disorders, the action of LED therapy is less well understood but data supports that it helps to reduce oxidative stress, increase cell turnover and inhibit the enzyme responsible for melanin production.
A recent small clinical trial performed by Dai used amber LED light (590nm) to successfully treat melasma in patients. Dai’s study showed that LED therapy helped reduce the growth of new blood vessels, which triggered the recycling of melanocytes – the cells that produce melanin.
A mice model study by research scientist, Oh, looked at how LED therapy works to reduce melanin production in the skin and saw that 660nm LEDs inhibited tyrosinase activity, the enzyme responsible for melanin production.
And a team of research scientists, led by Lee, tested the effects of photobiomodulation in artificial human skin models and concluded that wearing a 630nm LED patch effectively treated hyperpigmented spots.
Best LED Wavelengths for Treating Melasma:
The two most commonly used wavelengths for treating skin conditions like melasma are:
Red Light (620–660 nm): Penetrates the skin at a more superficial level, usually up to 2-3 millimeters. It’s typically used for skin rejuvenation, targeting conditions like acne, wrinkles, and surface-level hyperpigmentation. Red Light is mainly absorbed by chromophores (light-absorbing molecules) in the skin, such as haemoglobin and melanin.
Near-Infrared Light (800-1000 nm): NIR light is commonly used for pain relief, muscle recovery, and deeper inflammatory conditions, but it’s also valuable for hyperpigmentation treatments in melanin-rich skin because it bypasses the melanin in the epidermis in darker skin tones, reducing the risk of melanin overproduction. Near infrared light is largely absorbed by water, deeper into tissues, where it influences mitochondrial activity, promotes cell regeneration, and reduces inflammation.
Melanin Structure and Distribution by Fitzpatrick Skin Type:
The Fitzpatrick scale classifies skin types based on their reaction to UV radiation. It ranges from Type I (very fair skin) to Type VI (very dark skin). These skin types differ not only in how they respond to UV light but also in how they react to LED light therapy.
Fitzpatrick I-III (Fairer Skin):
- Melanin Type: Higher ratio of pheomelanin to eumelanin.
- Melanin Structure: In lighter skin, melanin is often smaller and more clumped together within the skin’s keratinocytes (the predominant type of skin cell).
- UV Response: Less eumelanin in the skin leads to a higher susceptibility to sunburn and UV damage, since pheomelanin offers little protection. Individuals with Fitzpatrick I and II skin types (fair skin) tend to burn easily and tan minimally.
- Melasma Risk: People with Fitzpatrick I-III skin are less prone to hyperpigmentation and melasma but may still experience freckling or sun-induced pigmentation over time due to their lower levels of UV protection.
Fitzpatrick IV-VI (Darker Skin):
- Melanin Type: Higher concentration of eumelanin, which provides greater UV protection.
- Melanin Structure: In darker skin, eumelanin is more uniformly distributed and is found in larger granules within the epidermis. This even distribution helps provide better protection against UV rays and lowers the risk of DNA damage from sun exposure.
- UV Response: Darker skin tones (Fitzpatrick IV-VI) produce more eumelanin in response to UV exposure, which helps the skin to tan rather than burn. The higher levels of eumelanin also reduce the risk of skin cancer and other UV-related damage.
- Melasma Risk: While darker skin tones are less prone to sunburn, they are more susceptible to post-inflammatory hyperpigmentation (PIH) and melasma, especially in response to skin irritation, inflammation, or hormonal changes. This is due to the higher activity of melanocytes, which produce more eumelanin as a protective response.
LED Protocols for Fair Skin versus Darker Skin Tones
When it comes to treating melasma with LED Light Therapy, one size does not fit all. It’s ‘fair’ to say that, on account of differences in melanin in fair and darker skin tones, and the depth to which melanin resides in the skin according to skin phenotype, it is necessary to make adjustments to protocols for treating melasma. Whether red light or near infrared light is best for treating melasma will depend on where you lie on the Fitzpatrick scale.
Fair Skin (Fitzpatrick I-III)
In fair skin (Fitzpatrick I-III), melasma tends to be occur in the epidermis, which is the superficial layer of the skin. Melanin in fair skin is less concentrated than darker skin and of the pheomelanin type.
Red light (620-660 nm) can effectively target the epidermis because it penetrates 2-3 mm deep—just enough to reach the pigmented areas without going too deep. This makes red light therapy safe to treat surface-level pigmentation like melasma in fair skinned individuals. Since there is less melanin to absorb the light, red light penetrates the skin without causing overheating* or excess melanin production, making it ideal for those with fair skin. Red light effectively targets superficial pigmentation in fair skin individuals without causing overstimulation of melanocytes, which could lead to further pigmentation issues.
A study by Schroeder et al. (2009) showed that red light therapy effectively treated pigmentation in fair-skinned individuals without increasing the risk of hyperpigmentation. The study emphasized that red light stimulates collagen production and helps reduce skin discoloration.
Dark Skin (Fitzpatrick IV-VI)
Darker skin tones are melanin-rich, with a higher content of eumelanin the higher the number on the Fitzpatrick scale. With skin tones IV – VI, melanin exists not only in the epidermis but also in the deeper layers of the skin, the dermis.
For individuals with darker skin tones, LED therapy requires more caution. Melanin-rich skin is more prone to adverse effects such as post-inflammatory hyperpigmentation (PIH), especially when energy levels are too high or when treatment protocols are not specifically adjusted for darker skin tones.
Reduced light penetration: In melanin-rich skin, because a significant amount of light is absorbed by melanin at the surface, the energy reaching the deeper layers is diminished. As a result, the cells deeper in the skin (such as fibroblasts responsible for collagen production) may receive less of the intended therapeutic dose. This can lead to less effective treatment outcomes compared to lighter skin tones, where more light can penetrate the dermis.
Localized heating: When melanin absorbs light, it can generate heat in the upper layers of the skin. This is because eumelanin, the darker pigment present in melanin-rich skin, is more likely to absorb red light. This localized heating can over stimulate melanocytes, the cells that produce melanin, potentially triggering increased melanin production in response to the heat. Treatment with red LED light in dark skinned individuals can lead to an increased risk of pigmentation issues if treatment isn't carefully managed. This can exacerbate conditions like melasma or cause post-inflammatory hyperpigmentation (PIH).
Near-infrared light (800-1000 nm) is a better option for darker skin tones because it can penetrate deeper into the skin without being absorbed by the melanin in the epidermis. This reduces the risk of overstimulating melanocytes and triggering hyperpigmentation.
The energy settings should be kept low to moderate (2-10 J/cm²) to prevent overheating of deeper tissues, which can still lead to pigmentation issues in some cases.
Goldberg’s research study shows that NIR light can treat melasma effectively in darker skin by reducing inflammation and bypassing the melanin-rich surface
And Alexiades-Armenakas (2006) found that NIR light was more effective than red light for treating pigmentation disorders, especially in darker skin tones. This study highlighted that NIR light can treat hyperpigmentation effectively without the risk of worsening melasma or triggering excess melanin production.
Can Fair Skinned Individuals Combine Red and Near Infrared?
While red light alone is often sufficient for treating melasma in fair-skinned individuals, there are some cases where combining red and NIR light can be beneficial. For example:
- If inflammation is present: If melasma is accompanied by inflammation or if deeper layers of the skin are affected (e.g., due to other skin conditions or more stubborn cases of melasma), NIR light could help by reducing inflammation and promoting healing in the deeper tissues.
- When additional skin rejuvenation is needed: NIR light has been shown to promote collagen production and improve skin elasticity in deeper layers. If you’re looking for overall skin rejuvenation in addition to treating melasma, combining red light (for pigmentation) with NIR light (for deeper tissue repair) could offer comprehensive benefits.
If your main concern is superficial pigmentation, however, consider using red light only. Adding NIR could unnecessarily target deeper tissues that are unaffected by melasma in fair skin individuals. This is especially true for Fitzpatrick I-II, where there is minimal risk of pigmentation issues associated with deeper tissue damage. While LED therapy is considered a non-thermal modality, near-infrared light can cause mild heating in deeper tissues because it’s absorbed by water molecules within the skin. In fair-skinned individuals, where melasma is generally surface-level, this deeper penetration and the resulting mild warming are unnecessary and could potentially cause discomfort without additional benefits.
Clarifying “Heating” in Relation to LED Therapy
LED light therapy is typically considered non-thermal, meaning it doesn’t directly generate heat like other types of light therapy (e.g., lasers or intense pulsed light (IPL)). However, heating in LED therapy, particularly with NIR light, can occur indirectly due to the absorption of light energy by the skin’s water molecules. This absorption can generate mild heat, which is generally safe but may cause discomfort if the energy is too high or the exposure is too long. While LED therapy uses low-energy light, repeated or prolonged exposure can result in the accumulation of heat in the tissues, especially with NIR light. And, some LED devices operate at higher intensities, particularly for treating deeper issues. In these cases, NIR light may cause slight warming, even though the light itself is considered non-thermal.
Whelan found that NASA LED light therapy could induce mild heating when using NIR wavelengths (800-880 nm), especially at higher energy settings. This heating effect was primarily observed in water-rich tissues.
In darker skin tones (Fitzpatrick IV-VI), the risk of localized heating is higher because eumelanin absorbs more light. This can lead to overstimulation of melanocytes (the cells that produce melanin) and potentially worsen hyperpigmentation or trigger post-inflammatory hyperpigmentation (PIH). For this reason, pulsed NIR light or lower energy levels are often recommended for melanin-rich skin.
Pulsed LED Therapy: A Game-Changer for Treating Melasma
One of the most important aspects of using LED therapy for melasma is the application of pulsed light, which involves emitting light in bursts rather than continuously. Pulsed light therapy allows for better control over the energy delivered to the skin, minimizing the risk of overheating and melanin overstimulation, particularly in darker skin types.
A team of scientists, led by Barolet, carried out a split-face trial using pulsed near infrared LED light [(940 nm, at 90 mW/cm2 and a dose of 13.5 J/cm2] combined with microdermabrasion. This combination therapy significantly improved facial melasma in patients who had failed prior treatments.
Pulsed light therapy has been shown to improve the skin's ability to repair itself, stimulating collagen production and reducing inflammation, both of which are important for treating melasma. Pulsing also allows light to penetrate deeper tissues without overstimulating the melanin-rich surface layers of the skin. Brondon’s research demonstrates the positive impact of pulsed LED for light penetration and proposed the advantage of pulsed LED for penetrating melanin rich skin.
The optimal pulse frequency range for treating melasma is considered to be 10-100 Hz. This range of pulsed LED allows light to penetrate deeper without causing excessive heating or damage to the surface layers, making it particularly effective for melanin-rich skin. Lower pulse frequencies (e.g., 30 Hz) give the skin more time to cool between pulses, reducing the risk of overheating and melanin overproduction. This is especially important for Fitzpatrick IV-VI skin types, which are more prone to post-inflammatory hyperpigmentation when exposed to continuous light therapy.
Renowned photobiomodulation scientist, Dr Michael Hamblin supports our findings and said on the subject;
Conclusion:
When to Use Red, NIR, or Both
- Fair Skin (Fitzpatrick I-III): Red light alone is typically sufficient for treating melasma because the pigmentation is primarily superficial. There’s less risk of deep tissue damage, and NIR light may cause unnecessary heating in the deeper layers. Combine Red and NIR light if there’s deeper tissue inflammation or if additional skin rejuvenation is desired.
- Darker Skin (Fitzpatrick IV-VI): NIR light is preferred because it penetrates deeper without being absorbed by the melanin in the surface layers, reducing the risk of post-inflammatory hyperpigmentation (PIH). Red light should be avoided or used with caution due to its higher absorption by melanin, which can worsen pigmentation issues.
- Pulsed LED increases light penetration, amplifies cellular energy production and accelerates cell turnover, which can potentially help reduce pigmentation faster. Most importantly for melanin-rich skin, pulsed LED allows for ‘cooling’ of the skin between pulses, mitigating the risk of stimulating melanocytes to produce melanin and potentially worsening pigmentation issues.
By understanding these nuances and tailoring your approach to your skin type, you can optimize LED light therapy for treating melasma safely and effectively.
Recommended LED Therapy Devices:
For fair skinned individuals who would like to use red light only, Maysama’s PRANA LED Light Therapy Mask is the perfect solution. Maysama’s PRANA LED mask offers the option to use red LED only (without near infrared) in line with science studies that support treating pigmentation issues in fair skin individuals. Pulsed LED can be selected as an option, which improves light penetration and outperforms regular red light for the production of cellular energy and collagen and improves the absorption of skincare active ingredients.
For darker skin tones (Fitzpatrick IV-VI), Maysama Pulse40 LED Light Therapy Panel provides a customisable resolution, with near Infrared only setting and incorporating pulsed LED light technology for enhanced outcomes for skin rejuvenation. Maysama’s Pulse40 panel is a targeted treatment device for face, neck and decolletage. The Pulse40 panel offers pulse light frequencies at 10,20 and 30Hz, which science studies support is ideal for treating melasma in melanin-rich skin. The shorter frequencies provide longer for cooling of the skin between pulses, mitigating overstimulation of melanocytes in the melanin-rich epidermis.
Topical Skincare for Melasma:
Combining energy-based devices with topical lightening agents can enhance treatment effectiveness further, so we wholly encourage you to take a multi-faceted approach to tackling melasma. By combining your LED Light Therapy with the right skincare regime can improve response rates, shorten treatment duration, reduce side effects and decrease recurrence rates.
Skincare actives such as retinol, AHAs and brightening agents like tranexamic acid and antioxidants can be effective in helping to reduce melasma.
Check out these two formulations from Maysama, which may help to treat melasma, pigmentation or simply brighten skin.
Maysama’s ABP11 Green Rooibos Gentle Resurfacing Toner
Maysama’s divine, tea-scented, light-weight exfoliating toner is fortified with Green Rooibos Extract and 11% gentle resurfacing acids. Formulated with 5% Lactic acid (AHA), 1% Salicylic acid (BHA) and 5% Gluconolactone (PHA), our toner gently exfoliates dead skin cells, whilst moisturising and brightening. Regular use will improve skin tone and texture and reveal more radiant skin. With a natural aroma of sweet rooibos tea, no added fragrance or colour, no essential oils, Maysama’s ABP11 toner is formulated for all skin types, including sensitive skin.
Maysama’s Green Rooibos Brightening Mask
Maysama’s luxurious, wash-off Green Rooibos treatment mask is formulated with a novel, high-performance brightening complex at 11%. Our brightening actives include 3% tranexamic acid, 4% niacinamide, 2% alpha arbutin, 2% kombucha, plus 1% Green Rooibos Extract as an anti-inflammatory agent. This indulgent formula gradually improves the appearance of discolouration, dullness and uneven texture and leaves skin hydrated and silky smooth with longer term brightening benefits. Regular use may help treat melasma and post-inflammatory hyperpigmentation, or simply brightens skin tone for improved radiance.
If you are affected by skin pigmentation issues, or melasma we hope that this blog has been useful to you and offers some potential therapies that will assist with your treatments.
Wishing you great skin health!
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Supporting Studies
- Schroeder, P., Calles, C., Krutmann, J. (2009). Photoprotection beyond ultraviolet radiation—effective sun protection has to include protection against infrared A radiation-induced skin damage. Lasers in Surgery and Medicine, 41(1), 80-86.
- Dai et al: 590 nm LED Irradiation Improved Erythema through Inhibiting Angiogenesis of Human Microvascular Endothelial Cells and Ameliorated Pigmentation in Melasma - PubMed (nih.gov)
- Oh et al: Inhibitory effect of 660-nm LED on melanin synthesis in in vitro and in vivo - PubMed (nih.gov)
- Lee et al: Research team develops a surface-lighting microLED patch with significant melanogenesis inhibition effect (medicalxpress.com)
- Goldberg et al: Laser treatment of pigmented lesions - PubMed (nih.gov)
- Alexiades-Armenakas; Laser treatment of pigmented lesions - PubMed (nih.gov)
- Whelan: Effect of NASA light-emitting diode irradiation on wound healing - PubMed (nih.gov)
- Barolet: Dual Effect of Photobiomodulation on Melasma - PMC (nih.gov)
- Brondon: Pulsing influences photoradiation outcomes in cell culture - PubMed (nih.gov)
- Hamblin: Photobiomodulation for Skin Pigmentation Disorders: A Dual Function Treatment.