Recently, the topic of green tea before red light therapy treatments has been discussed more than ever and I’ve received a lot of questions thanks to this video from Angie of Hot and Flashy. I’ve been a fan of this combination since making the switch to high powered LED devices last Spring and thought this was worthy of a deep dive.
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Now let me be very clear here: I follow Angie and I’m a fan of her and her content. We may not always align in our views but I really respect her contribution to the YouTube space. She is also entitled to her opinion regardless and I’ve always felt strongly that if you’re confident in yourself and your knowledge, someone else disagreeing shouldn’t cause offense. Do I always succeed? Nope, just your typical flawed human here. But I try and at the end of the day, Angie is giving her honest opinion to her audience, something she’s entitled to do and I support that fully.
So all that to say, this is not an angry tirade whatsoever. It’s not even really about her or any other content creator for or against green tea with red light therapy aside from appreciating that they brought this up so we could discuss it. It’s about examining the evidence here, as always. Science in general is always evolving as we find out more and I can’t be both committed to expanding my knowledge and also refuse to re-examine evidence. I can trust in my expertise and also be open to changing my stance if it means I get to keep learning.
This post will both explain why I have suggested green tea as a pre-treatment to any light based modalities and also look further into the science here to hopefully help give you the information needed to decide for yourself. So let’s get started.
To even dive into this topic, we have to understand what red light therapy (RLT) is to begin with. It falls under the category of photobiomodulation (PBM) which was formerly called low-level laser therapy (LLLT). Back in 1967, Endre Mester customized his own ruby laser and discovered that even with a fraction of the power of other lasers it still improved hair growth and wound healing in rats. Since this early research, we’ve discovered that monochromatic lasers aren’t necessary and that “non-coherent light-emitting diodes (LEDs) with comparable parameters to low power lasers performed equally well.” Source.
As a result, LLLT became PBM or PBMT (photobiomodulation therapy).
Note: photodynamic therapy requires the use of a photosensitizing agent and is different than PBM alone.
Interaction of Light with the Skin
We have many cellular processes in the body that involve light and photochemical reactions. In my previous blog post on skin hydration, I discussed how skin appearance is in part due to the penetration, absorption, and reflection of light in the skin. Our vision is a result of light and photoreceptors in the retina called rods and cons – they convert light energy into the electrical signals that the brain can receive (think action potentials) in a process called visual phototransduction.
In the skin specifically, we have photoreceptors that can detect light like we do in the retinas. In regards to this specific topic, the main thing you need to know about their structure is that they have an outer segment that contains the discs that house photopigments. These are responsible for absorbing light and each one is made up of a protein called opsin with an attached molecule called a chromophore.
It’s the chromophores that absorb photons (light energy) and trigger the reactions and cell processes that are responsible for the skin benefits from PBM. Interestingly though, the opsins that are why specific wavelengths are important. This is because “each opsin has a distinct absorption spectra and signaling transduction, the optimization of light therapy tailored to the features of each opsin will maximize the benefit that PBM can offer in clinic.” Source.
Red Light Therapy
In order to keep this post to a reasonable length, I’m going to focus mainly on red light therapy but I will discuss other light based modalities where applicable in this post and will briefly recap the visible light spectrum for anyone who has forgotten.
Light is essentially the visible part of the electromagnetic spectrum, ranging from violet to red.
“When light interacts with human skin, part of the radiation is reflected back due to the different refractive index in comparison to the atmosphere (Lister et al. 2012). The rest is able to penetrate the skin. The effects that this penetration may cause depend on wavelength, intensity and exposure of the light. High irradiance and low exposure times leads to photomechanical or ablative mechanisms, while medium irradiance and medium exposure times produce photothermal responses. Both mechanisms are able to stop skin functionality. However, when the energy is low enough not to cause these negative consequences (low irradiance and long exposure times), scattering and photoabsorption take place inside the skin (Boulnois 1986).” – The Role of Photoreceptors in Human Skin Physiology.
The excerpt above is a good explanation of how light interacts with the skin and how whether it is damaging or beneficial is dependent on the wavelength, energy, and duration. Like my aforementioned blog post on skin hydration, it mentions how some light is absorbed and some is reflected which has me again wanting to explore the link between skin hydration and red light therapy in future content.
Now, we know how light interacts with the skin and we have research showing the benefits. But it’s that area in between – the mechanism of action – that need to be researched and elucidated further. So while there’s research that’s been done here and more ongoing, please understand that some of this is theoretical still.
Science heavy section ahead, skip to the visual if you just want the overview.
Mechanism of Action of PBM in the Skin:
- cytochrome c oxidase
- photolysis of nitrozated proteins to generate nitric oxide
- light activation of calcium ion channels
- reactive oxygen species (ROS production)
Cell metabolism, or the interaction of light with cytochrome c oxydase, is the most accepted explanation. During this interaction, PBM excites an electron within its structure which triggers the transfer of electrons through the respiratory chain and ultimately the increase in ATP synthesis and cell metabolism. Due to this, cell proliferation, migration and adhesion are increased. Activation of transcription factors also likely explains the enhanced wound healing as they enhance growth factor production, extracellular matrix deposition, and cell proliferation and motility.
Did I lose you? Here’s a simple overview I did for Instagram.
Research Behind PBM
Okay, so the above explanation is nice and all but you may be thinking but has red light therapy actually been proven to do anything?
The answer is yes, there’s a pretty compelling body of research. However, the percentage that is relevant to skin is a very small amount compared to the overall research on other applications. Platinum Therapy has compiled this document with a few of the many articles out there for anyone curious. But we’re here to talk about the benefits for skin and the aesthetic applications of this treatment.
This article supports the prior information converted on the mechanism of action, stating “electron transport, adenosine triphosphate nitric oxide release, blood flow, reactive oxygen species increase, and diverse signaling pathways are activated. Stem cells can be activated, allowing increased tissue repair and healing. In dermatology, LLLT has beneficial effects on wrinkles, acne scars, hypertrophic scars, and healing of burns. LLLT can reduce UV damage both as a treatment and as a prophylactic measure.” It also mentions that due to the anti inflammatory effect, it’s beneficial for inflammatory skin disorders like acne.
A biology textbook even mentions “Research shows that light therapy can both benefit the look of skin and heal the underlying issue that is causing the condition. When red and near infrared light is absorbed by the skin, it stimulates new skin cells to grow in a healthier way, provides protection against damage, and helps heal a variety of skin problems.”
And then there are a decent amount of studies and trials on skin rejuvenation but please keep in mind that a lot of them are not independent and sample sizes are small. I couldn’t possibly summarize them all but I’ll link the majority I found for those interested:
- A study to determine the efficacy of combination LED light therapy (633 nm and 830 nm) in facial skin rejuvenation
- A Controlled Trial to Determine the Efficacy of Red and Near-Infrared Light Treatment in Patient Satisfaction, Reduction of Fine Lines, Wrinkles, Skin Roughness, and Intradermal Collagen Density Increase
- The use of light-emitting diode therapy in the treatment of photoaged skin
- A prospective, randomized, placebo-controlled, double-blinded, and split-face clinical study on LED phototherapy for skin rejuvenation: clinical, profilometric, histologic, ultrastructural, and biochemical evaluations and comparison of three different treatment settings
- Clinical experience with light-emitting diode (LED) photomodulation
- Regulation of skin collagen metabolism in virtro using a pulsed 660 nm LED light source: clinical correlation with a single-blinded study
- LED photoprevention: reduced MED response following multiple LED exposures
- The Efficacy and Safety of 660 nm and 411 to 777 nm Light-Emitting Devices for Treating Wrinkles.
- A study to determine the efficacy of combination LED light therapy (633 nm and 830 nm) in facial skin rejuvenation.
If you skim through them, you’ll notice quickly that wavelengths of 633nm and 660mm as well as high powered devices show up consistently in the research we do have. I think this is an important thing to note because LED masks simply do not deliver the necessary irradiance to meet the output supported by research. The research on green tea and red therapy is by no means conclusive, and we will get to that, but the same standard should be applied to weak masks and handheld devices too.
So if photobiomodulation with red light therapy is so great, why use green tea?
PBM and Green Tea
We’re finally here. Give yourself a pat on the back if you made it to the part where we really dig into the actual topic of discussion. If I put you to sleep, I apologize and hope you at least learned something new.
The whole green tea thing came from this article where they claim that using green tea can give you results 10x faster than RLT alone. The issue becomes clear once you track down the full article – it’s a single study and they’re using a single patient. It’s essentially a case study where someone used red light therapy alone for 10 months then pre-treated with green tea prior to the red light for month. It’s obviously not conclusive and while I can’t speak for anyone else, I’ve tried my best to stress that it’s preliminary at best.
Skincare often lacks science. Your typical skincare ingredients won’t have clinical trials backing them like prescription medications. I strongly believe that skincare content should be grounded in evidence but I also think that unless you’re a minimalist, you’ll come situations like that where something you’re interested in may still require further study.
What I think we have to ask ourselves is:
- Is there a compelling argument for using it?
- Could using it be detrimental or decrease efficacy?
- Is the cost and effort worth the potential benefit?
The above questions are what I will be addressing in the final part of this post.
Production of ROS
We know that red light therapy increases production of reactive oxygen species (ROS). We also know that some of that is actually key to how photobiomodulation works. We have something calling the “hormesis effect” occurring where mild metabolic stress actually strengthens our defenses and it’s what is actually triggering a lot of the processes that result in the benefits RLT has for skin.
What is absolutely critical though is the levels of ROS being produced.
This article does a wonderful job summarizing everything and states that “Mechanistically, this cellular or biological process, referred as Photobiomodulation (PBM), is achieved by the generation of oxide free radicals in cells and tissues.”
But it’s this line from the conclusion of the article that I think is most important:
“The proliferative response and wound healing properties of 636 nm laser (red light) in fibroblasts is affected by modulating oxidative stress. Our understanding is red light at 5 J/cm2 is appropriate in stimulating proliferation, migration and wound healing of fibroblasts, while, fluences above 16 J/cm2 cause excessive oxidative stress.”
As mentioned above, wavelength is also important. Here they found that levels were increased when using 660 nm but add that they “found that the various wavelengths differentially modulate ROS production. In particular, the 660 nm laser light increases ROS production when applied either before or after an oxidative stimulus. In contrast, the 970 nm laser light exerted a moderate antioxidant activity both in the saliva of OM patients and in both cell types. The most marked reduction in the levels of ROS was detected in cells exposed either to the 800 nm laser light or to the combination of the three wavelengths.”
If you’re in the Skincare and Beauty 101 Facebook Community, then you know that I’m a big fan of Ari Whitten and respect his knowledge on this topic immensely. He actually states himself that the reason “overdosing” on red light therapy likely decreases benefits (referred to as the biphasic dose response) is because you’re generating too much ROS.
To summarize the above: production of ROS is actually key to photobiomodulation. However, the irradiance, wavelength, and treatment time are just a few factors that can result in much higher levels than we need being generated and this can decrease the benefits that we see.
In the short term, we know PBM is pro-oxidant but in the long term it’s likely antioxidant. And provided ROS levels are low, our body’s own antioxidant system will deal with the ROS generated (more info here). However, if you’re using high powered LED devices at home like you should be to get the results shown research wise…. that may not be the case.
Which is where the argument for green tea comes in.
Just a quick add on – while this article is on blue and violet light, I find it interesting that they found that when they simulated aging with a high output and a photosensitizer, the high levels of ROS generated actually resulted in endogenous antioxidant activity being reduced.
Should We Use Antioxidants with RLT?
We’ve covered photobiomodulation and red light therapy and I think you can see why the argument for antioxidants to address ROS generated during these treatments can be made.
Now here’s one question I know I will be asked:
“Won’t using antioxidants mean we won’t get the ROS production we need for this treatment to work?”
My answer is no based on what I’ve read and here’s why: If the ROS generated was low enough, it would be addressed by your endogenous antioxidants anyway. You only need the ROS to be generated to trigger the processes mentioned, not hang around and cause damage. So a topical antioxidant should work similarly and basically not interfere but also scavenge any free radicals not neutralized by your natural defenses.
Before we wrap this up, I do realize that it’s hard to make a decision on an argument based on theory and what we know about PBM. I did dig up a few other studies that related to this topic but again please understand they’re very small and limited.
A study looking at very high irradiance RLT and its benefit for skin fibrosis found that “reactive oxygen species (ROS) free radicals generated by high fluence LED-RL inhibit the migration of skin fibroblasts, the main cell type involved in skin fibrosis.” What’s of interest to us though is that when they added resveratrol, an antioxidant, they found that “these LED-RL associated increases in ROS were prevented by pretreatingy cells with 0.0001% or 0.001% resveratrol.”
Now this study features a home laser, a different light based treatment of course, but they did a blind, split face trial and found that the side that also used topical antioxidants improved significantly more in regards to photodamage and overall treatment outcomes. And then lastly, this one is the least relevant but the study found that the group using red and blue LED with Vitamin C and glycolic acid had a much better outcome than the group using GA and Vit C alone.
Does This Change My Opinion?
Ultimately, no. I think the potential benefit outweighs the fairly minimal time and cost involved in slapping on some green tea before my red light treatment. I will say that I think it’s worth pointing out that it probably doesn’t have to be green tea. If it’s a light, easily absorbed product that’s rich in antioxidants and doesn’t have ascorbic acid (becomes oxidized easily once it scavenges free radicals), I’m sure it’s fine.
However, if you read all this and came away with a different conclusion I 100% support that too. That’s the goal here, to provide you with the information to make your own decision.
As always, hope that was helpful and if you have any questions or comments on the post please post below!
Want practical information on how to use RLT? Check out The Ultimate Guide to Red Light Therapy PDF from Ari Whitten and the incredible book version. You can also shop my Red Light Starter Kit for everything you need to get started and of course join the Facebook group for information and protocols.
Bonus tip: I’ve been testing DNA Repair Enzymes for future content and recently began to use them after PBM as they really enhance the treatment by facilitating removal of DNA within cells. In addition to this though, certain types like photolyase are actually light activated. See the Red Light Starter Kit for the my favorite formulation so far.