Understanding the differences in light-based therapies: LED vs. laser (2024)

As light-based therapies continue to evolve and gain recognition in the healthcare industry for their ability to alleviate pain and reduce inflammation without pharmaceutical intervention or invasive procedures, it is crucial for DCs to understand the nuances between technologies.

While light emitting diode (LEDs) and lasers use similar scientific principles and mechanisms of action, there are differences to take into consideration. When deciding which technology is best for your practice, you must evaluate the options from both a technical standpoint and their implications for patient outcomes, practice workflow and potential income.

Light-based therapies: An overview

Decades of research have shown certain wavelengths of light can stimulate biological processes. Photobiomodulation therapy (PBMT) uses these principles by delivering light energy to tissues, initiating photochemical reactions within cells to enhance healing and alleviate pain and inflammation.¹

Both lasers and LEDs designed for therapeutic applications emit light at wavelength frequencies known for their analgesic and anti-inflammatory properties, typically within the approximate 650 nm to 1,200 nm range on the electromagnetic spectrum – known as the Therapeutic Window.² Despite their shared capability to deliver therapeutic photons, key differences affect their suitability for different medical indications.

Some notable distinctions between them include power output, wavelength specificity and beam characteristics from the diode.

LED therapy

LED therapy uses light to stimulate cellular processes at or just below the skin’s surface. The primary types of LED therapy for pain and inflammation management applications are red and infrared.

Red LED light therapy

Red LED light therapy reduces inflammation at superficial tissue layers and stimulates collagen production, making it effective for scar reduction and anti-aging treatments.³

Infrared LED light therapy

Infrared light penetrates slightly deeper than red light, capable of stimulating biological processes within the tissue to relieve pain, reduce inflammation and accelerate healing.³

LED devices come in various formats, including large panels for wide treatment areas and flexible pads that can wrap around extremities, enhancing their versatility. However, LEDs typically operate at lower power than lasers and have less efficient penetration due to their incoherent and divergent nature.^4,5 This divergence and incoherence (with photons oscillating at different wavelength frequencies and in different directions from the source) result in limitations, particularly when attempting to target tissue deep within the body.

Laser therapy

Laser light is distinctive for being both monochromatic and coherent, meaning all photons oscillate at the same wavelength frequency and move in the same direction from the light source. This minimizes scatter and reflection during tissue interaction, allowing lasers to more efficiently penetrate the tissue and stimulate cellular reactions.^5,6

Lasers offer significant flexibility in treatment capabilities, allowing practitioners to address both superficial and deep-seated conditions. Additionally, lasers generally have a narrower spot size, enabling precise and efficient treatment of small, targeted areas.

Unlike LEDs, lasers are regulated under the FDA’s Federal Laser Product Performance Standard and are classified into four major hazard classes (I-IV).⁷ Therapeutic lasers are most commonly classified within Class IIIB or Class IV. This regulatory framework ensures safety and efficacy, which can be reassuring for both practitioners and patients.

Class III lasers

Class III lasers operate with power outputs ranging from 5 milliwatts (mW) to 500 mW. Many therapeutic laser applications are possible with Class III lasers due to their ability to penetrate deep into tissues without generating excessive heat. Their lower power levels make them relatively safer, minimizing the risk of thermal damage to tissues. However, treatment sessions with Class III lasers may require longer durations to achieve the desired therapeutic outcomes, as their energy output is comparatively lower than higher-class lasers.

Class IV lasers

Class IV lasers operate at power outputs above 500 mW. These high-powered lasers offer more efficient treatment. With more power, the laser can deliver the necessary amount of photons to the tissue faster. The increased power output of Class IV lasers allow for more efficient energy delivery, which can lead to faster patient outcomes and fewer required treatment sessions. Higher energy levels may carry an increased risk of thermal injury, demanding meticulous application and strict adherence to safety protocols. Class IV lasers typically entail more stringent regulatory standards and higher costs, reflecting their advanced capabilities and broader therapeutic uses. Although, as technology advances, laser manufacturers are developing Class IV emission systems capable of delivering energy more efficiently than Class III lasers, while minimizing risk of thermal damage.

LEDs vs. lasers: Practical considerations

When choosing between LED and laser devices, practitioners should consider clinical applications, patient outcomes and associated costs.

Clinical applications

The type of conditions most frequently treated in the practice should guide the choice. While LED devices might appeal due to their lower price point and flexibility in treating large areas, their limited power and efficiency of penetration may not be ideal for deeper conditions, such as fibromyalgia, low back pain or osteoarthritis. In contrast, lasers can effectively target deeper tissues due to their coherent light emission and higher power output.⁵

Patient outcomes

Both LED and laser treatments are cumulative, requiring multiple sessions for optimal results. Lasers are generally more efficient in energy transfer, allowing for shorter treatment times, quicker results and potentially reducing the number of required sessions.

Practice workflow and income potential

While lasers may represent a more significant upfront investment, their efficiency, faster outcomes and broader clinical applications can enhance patient satisfaction and treatment outcomes. This can translate to higher patient retention, more referrals and increased revenue opportunities for the practice.

Final thoughts

Light-based therapies, including LED and laser treatments, offer promising non-invasive options for pain relief and inflammation reduction. Understanding the technical differences between these modalities and their implications for patient outcomes and practice operations is crucial for DCs making informed decisions about integrating these technologies into their practice. While LEDs provide an accessible entry point with versatile applications, lasers offer deeper penetration, faster results and broader treatment capabilities, potentially leading to enhanced patient experiences and greater practice growth.

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References

1. Anders J. Photobiomodulation. American Society for Laser Medicine and Surgery (ASLMS). June 2016. ASLMS website. https://www.aslms.org/for-the-public/treatments-using-lasers- and-energy-based-devices/photobiomodulation. Accessed July 26, 2024.
2. Huang Y-Y, et al. Biphasic dose response in low level light therapy: An update.Dose-Response. 2011;9(4). Sage Journals. https://journals.sagepub.com/doi/full/10.2203/dose-response.11-009.Hamblin. Accessed July 26, 2024.
3. Avci P, et al. Low-level laser (light) therapy (LLLT) in skin: Stimulating, healing, restoring.Semin Cutan Med and Surg. 2013:32(1):41-52. NCBI. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4126803/. Accessed July 26, 2024.
4. Kim MM, Darafsheh A. Light sources and dosimetry techniques for photodynamic therapy. Photochem Photobiol. 2020;96(2):280-294. Wiley. https://onlinelibrary.wiley.com/doi/10.1111/php.13219. Accessed July 26, 2024.
5. Hode T, et al. The importance of coherence in phototherapy. [Conference] International Society for Optical Engineering (SPIE). January 2009. Research Gate. https://www.researchgate.net/publication/233783045_The_importance_of_coherence_in_phototherapy. Accessed July 26, 2024.
6. Romano D, Fusi F. Laser-tissue interaction principles: Beam penetration in tissues (part II). Energy for Health. 2010;(6). https://celasers.com/knowledge-center/laser-physics-beam-penetration-tissue. Accessed July 26, 2024.
7. Laser products and instruments. Food and Drug Administration (FDA). December 2023. FDA website. https://www.fda.gov/radiation-emitting-products/home-business-and-entertainment-products/laser-products-and-instruments. Accessed July 26, 2024.