Melasma LED treatment

Absolutely, especially if you don’t know what you are doing. There are 4 variables to consider when employing LEDs for melasma. 

1. Wavelength. Blue light increases pigment, especially in darker skin types as pigment cells contain the OPSN receptor. Conversely light in the 585, 590, 630 nm spectrum can, in theory (more on that in the comment below), reduce pigment production.
2. Fluence or power. Too low & it won’t do anything, too high & it increases pigment. The sweet spot is around 10 mj/cm2. Do not exceed 20 mj/cm2. 
3. Duration of treatment. Depending on the output of your device, treatment time ranges from 3 to 12 minutes. 
4. Frequency. Again depends on the papers you read, & the above factors. Ranges from 1-2 applications over one week, to daily for 8 weeks. 

Whilst there are no robust studies on LED DIY at home melasma treatment, a sensible starting point is to find one that delivers wavelengths in the 585-595, 630-633 & or near IR 830 wavelength. One such device is the LED Light Therapy Face Mask by CurrentBody. This device has 132 LEDs with adequate power output. It doesn’t come cheap at over $500 AUD. 

Remember, the chances of this working to clear your melasma is much less than with medical therapy (such as pigment correctors, pico lasers or peels), however it may be an attractive option for those who would like to ‘have a go’ at DIY solutions. Here is the summary-

• Use both 633 & 830 nm mode
• Cook for 5 minutes once a week
• Increase the time & frequency as guided by the company
• This treatment works best with topical pigment correctors 

In our option this device is probably equally as effective* as in-office LED devices, minus the hassle & costs. 

*Efficacy is expressed as a percentage of having a good clinical result. As a guide, LEDs by themselves are dismal with only ¼ or less of patients responding. Pico & medical management is the highest at just under 85%, Cosmelan peels around 60%.

Whilst we don’t usually recommend LEDs for melasma (they can be awesome for treating acne in pregnancy), you can consider the Omnilux or the CurrentBody LED masks. They both have wavelengths in the 630 & 830 nm spectrums. Though not cheap, they both are reputable companies.

As an anti-aging device, LEDs can be incorporated into your daily skin care routine.  LEDs are best used as a preventative (hence by definition you will not see results). 

Currentbody & Omnilux are good brands that are sold in Australia. 

*Each manufacturer will have their own guidelines for melasma treatment.

At home pigment treatments are not as effective as in-clinic treatments, however a safe & simple at home melasma routine is as follows:

Sunscreen: SPF 50+ am, reapplication in the afternoon. You must have some sort of tint in your sunscreen & or foundation. Tinted means it contains iron oxides (red, yellow, black). This key ingredient blocks visible light by up to 98%.

AM routine: Vitamin C, 15%, vitamin E & ferulic acid. Vitamin C acts as a pigment corrector and an antioxidant.

PM routine: Azelaic acid 15 to 20%, as tolerated. *

*Other pigment inhibitors include tranexamic acid, retinol, niacinamide, arbutin, bearberry extracts & botanicals. 

**You can attempt at home DIY LED treatments with reputable masks like Omnilux or CurrentBody. 

***The above routine is effective in 20-40% of cases. 

So, by now you would have figured out that LED is not the best for melasma, however it is useful for – 

• Acne treatments: LED light therapy, particularly blue light, is effective in managing acne by reducing the bacteria that contribute to breakouts. It can also help calm inflammation and is ideal for pregnancy associated with acne, or for those who want to avoid taking tablets. It is best combined with topical retinoids. 
• Anti-Aging: LED light therapy is widely used to treat the signs of aging, such as fine lines, wrinkles, enlarged pores. Regular treatments can help improve skin texture and tone, resulting in a more youthful appearance. In the scheme of things, it provides very low level biostimulation. 
• Post-Treatment Healing: LED light therapy is often employed to aid in the healing process after chemical peels or laser resurfacing. It can promote faster healing, minimize discomfort, and reduce the risk of complications. We use both the Healite & Omnilux for these indications. 
• Skin disorders such as rosacea, dermatitis & psoriasis can respond to LED phototherapy. As light helps reduce inflammation & improve overall skin health.

Microcurrent, no, but handheld devices possibly. It depends on the wavelength of light & the intended use. The wavelength to absolutely avoid is blue light at around 410 to 430+ nm. Blue LEDs stimulate pigment cells to increase their melanin production, making melasma worse. 

Light in the longer wavelengths can potentially flare melasma via the generation of heat, especially in the IR or infrared wavelengths. Keep your application times short & your wavelength selection precise & chances are your pigment won’t flare. 

As with all melasma treatments, it has to be taken into context. Though studies have suggested that up to 1.5 mm microneedling can be safe & effective, it is rarely the case. Microneedling itself has been lost in context over the past decade as marketing has taken over the science. Microneedling can be marginally effective if the depth is shallow, ie. less than 0.2 mm. This treatment is best employed to increase the penetration of pigment correctors such as tranexamic acid (again marginal at best), vitamin C, arbutin, & botanicals. 

Additionally, companies like Sylfirm X promote their RF microneedling devices as a treatment for melasma & pigmentation. With pulse wave technology & depths of less than 300 microns, RFM, can in theory (& very limited papers) treat melasma via 2 main mechanisms, namely repair of photodamage of the basement membrane (separating the epidermis & dermal layer), & reduction of abnormal vasculature within the upper papillary dermal layers. Whilst this holds true, we do not employ RF microneedling as first line treatment (as other treatments are far more effective & safer), however it can be considered for recalcitrant melasma or dermal melasma. Even then, the efficacy rate is less than 25%.