Evidence-based consensus on the clinical application of photobiomodulation

Abstract

Background: There is a lack of evidence-based consensus to assist clinicians in using photobiomodulation (PBM).

Objective: To create a consensus on the safe and effective use of PBM.

Methods: A systematic literature review of Embase and MEDLINE was conducted in June 2022 to identify publications reporting research on PBM. An international multidisciplinary panel was convened to draft recommendations informed by the systematic search; they were refined through 2 rounds of Delphi survey, 2 consensus meetings, and iterative review by all panelists until unanimous consensus was achieved.

Results: A multidisciplinary panel of experts (n = 21) was assembled based on publication history. The key findings that informed the consensus developed by the expert panel were as follows: PBM is a safe treatment modality for adult patients and red light PBM does not induce DNA damage. PBM is an effective treatment option for peripheral neuropathy, androgenic alopecia, wound ulcers due to multiple etiologies, decubitus ulcers, pain attributed to diabetic foot ulcers, and acute radiation dermatitis.

Conclusion: The systematic literature search and structured Delphi consensus approach culminated in an evidence-based clinical practice guideline for safe and effective use of PBM in medical and aesthetic applications. Future research will further bolster our understanding of this evolving noninvasive technique.

Keywords: LLLT; PBM; acute radiation dermatitis; androgenic alopecia; cognition; cytochrome c oxidase; decubitus ulcers; low-level light therapy; musculoskeletal; near-infrared light; peripheral neuropathy; photobiomodulation; red light; sports performance; stroke; wound healing.