Is red light therapy effective for treating under-eye concerns such as dark circles, puffiness, or fine lines?

Red Light Therapy for Under-Eye Concerns

Red light therapy has limited evidence supporting its effectiveness for under-eye concerns such as dark circles, puffiness, or fine lines, and should not be recommended as a primary treatment option.

Understanding Under-Eye Concerns

Under-eye concerns are multifactorial in nature and can be caused by:

• Vascular congestion and permeability
• Melanin accumulation
• Hemoglobin degradation-related pigmentation
• Skin laxity
• Superficial location of vasculature
• Periorbital edema
• Postinflammatory hyperpigmentation

Evidence Assessment for Red Light Therapy

Safety Concerns

Red light therapy, while generally considered safe for many applications, presents several concerns when used around the eye area:

• Eye Safety Risk: High-intensity light poses potential hazards to the eye, with blue light (400-450 nm) potentially causing irreversible damage to photosensitive neurotransmitters in the macula 1
• Protective Measures Required: Staff and patients should wear suitable filter spectacles during treatments to prevent eye damage 2
• Pigmentation Changes: Hyperpigmentation or hypopigmentation can occur in treated areas, usually resolving within 6 months, but prolonged hyperpigmentation has been observed in some cases 2

Efficacy for Under-Eye Concerns

The most recent evidence regarding red light therapy for under-eye concerns comes from a small study:

• A 2024 study evaluated a LED device emitting red (633 nm) and near infrared (830 nm) light for under-eye rejuvenation 3
• While participants self-reported improvements in under-eye wrinkles, texture, dark circles, bags, pigmentation, and erythema, objective photographic digital analysis showed no statistically significant improvement in under-eye wrinkles
• The study had significant limitations including small sample size (11 participants) and lack of control group

Better-Supported Alternatives

Topical Treatments

Evidence suggests that targeted topical treatments may be more effective:

• A 2024 study demonstrated that a multicorrective topical eye cream (MTEC) with Tetrahexyldecyl ascorbate (vitamin C), prebiotic Inula Helenium, bioavailable peptides, botanical extracts, chrysin, and caffeine significantly improved infraorbital dark circles and puffiness 4

• A gel containing 2% phytonadione, 0.1% retinol, 0.1% vitamin C, and 0.1% vitamin E was moderately effective in reducing dark under-eye circles, especially in cases of hemostasis, and slightly decreased wrinkles 5

Professional Treatments

For more severe cases, professional treatments may be considered:

• Intense pulsed light (IPL) has been shown to improve meibomian gland function and gland structure, with secondary improvement of periocular appearance 2
• However, IPL should be used with caution for more darkly pigmented individuals (above Fitzpatrick skin type IV) due to increased risk of burns and pigmentation changes 2

Recommendations for Under-Eye Concerns

1. First-line approach: Evidence-based topical treatments containing:

   • Vitamin C derivatives
   • Retinol
   • Peptides
   • Caffeine
   • Vitamin K (phytonadione)

2. For persistent concerns: Consider professional evaluation for:

   • Underlying medical conditions (allergies, dermatitis)
   • Sleep disturbances
   • Nutritional deficiencies

3. Sun protection: Essential for preventing worsening of hyperpigmentation

Conclusion

While red light therapy shows some promise based on patient-reported outcomes, the lack of objective evidence and potential safety concerns around the eye area make it difficult to recommend as a primary treatment for under-eye concerns. Topical treatments with specific active ingredients have more substantial evidence supporting their efficacy and safety for addressing dark circles, puffiness, and fine lines.