Red Light Therapy Contraindications
What are some red light therapy contraindications? A contraindication is a term used to indicate that a treatment or service is not suitable for someone with a particular ailment. In the context of red light therapy, the information provided is not a replacement for medical care or advice; instead, it is a guide to help you decide whether this treatment is right for you. Please consult with your medical provider before making any health decisions.
Following FDA guidelines, we advise individuals with open wounds or lesions, active implantable devices (e.g., pacemakers or defibrillators), or metallic implants to avoid receiving red light therapy in these areas. Additionally, we recommend wearing eye protection throughout your red light therapy session.
While red light therapy is generally safe, photosensitive individuals should be cautious. If you are taking any of the medications listed above or any other photosensitizing medication and experience skin irritation, redness, or burning after red light therapy, consider whether your medication might be contributing to the issue. When in doubt, consult with your doctor to determine the best course of action.
Bottom Line:
- Red light therapy is not known to trigger photosensitivity; however, certain medications may increase skin sensitivity to light.
- If you are taking a potent photosensitizer (⚠️), you may be more prone to irritation.
- Consult your doctor before treatment, and if you experience unusual skin reactions after red light therapy, especially if you are on tetracyclines, NSAIDs, or diuretics.
Potential Red Light Therapy Contraindications
This article serves as a guide to help you explore potential red light therapy contraindications, enabling you to be an informed advocate in your wellness journey.
Red Light Therapy Contraindications:
Illnesses
Lupus
Individuals with Lupus should consult with their physician before receiving red light therapy. Most people with lupus experience photosensitivity, which means their skin is susceptible to sunlight and certain indoor lights that emit ultraviolet (UV) rays. Anyone can experience skin damage from excessive UV exposure, but individuals with photosensitivity tend to react more strongly.
UV rays damage cells in the body, and normally, the immune system clears away these damaged cells. In Lupus, the immune system doesn’t clear out dead cells properly. Instead, it attacks healthy cells, leading to rashes, inflammation, and other symptoms. Red Light Therapy does not contain ultraviolet radiation; however, individuals with Lupus may be hypersensitive to light or be taking photosensitizing medications, which could cause irritation or discomfort.
While some studies suggest that red light therapy may reduce inflammation, which could help alleviate joint pain, fatigue, and skin healing, we strongly recommend seeking advice from a medical professional before undergoing red light therapy.
For those with Lupus we suggest:
- Check with your rheumatologist or dermatologist before trying red light therapy.
- Test a small area of skin first and monitor for any reactions.
- Limit session time if you’re unsure.
Cancer
Individuals with cancer should consult with their physician before receiving red light therapy. The primary concern people may have with using red light therapy with people with cancer is its ability to stimulate cell growth, theorizing that this may encourage tumor growth. However, no conclusive evidence indicates that red light therapy causes tumors to grow faster or slower. Additional research suggests red light therapy may be a beneficial treatment for melanomas due to its ability to interact with cytochrome c oxidase, which may cause cancer cells to undergo self-destruction (apoptosis) or stop them from spreading (metastasis).
In vitro, red light therapy has been shown to slow melanoma cell growth, increase oxidative stress and apoptosis, and activate p53. This protein helps control cell division and prevent cancer. In animal studies, it has been shown to reduce melanoma tumor growth and enhance immune activity in the tumor environment, thereby supporting the body’s ability to fight cancer. [14] While this research is exciting, further investigation is needed to understand how red light therapy affects cancer cells and whether it could be an effective treatment method.
Epilepsy
Individuals with epilepsy should consult with their physician before receiving Red Light Therapy. People with epilepsy or who experience photosensitive seizures may be exposed to bright, pulsed, or flickering light in a red light therapy session, which may put them at risk.
Researchers are investigating the use of red and near-infrared light therapy for the treatment of epilepsy. Though potentially risky, it is lower risk compared to the medication, surgeries, and serious side effects of standard treatment. Early studies in animals with epilepsy show that photobiomodulation may help by targeting mitochondria. In theory, this will help reduce abnormal brain activity and protect brain cells from damage and death. Why is red light therapy promising? It is a non-drug, non-invasive treatment with easy-to-use devices that has an excellent safety record with little to no side effects. [15]
Pregnancy
Pregnant women should consult with their physician before receiving red light therapy. No substantial evidence suggests harm, but there is limited research on red light therapy during pregnancy.
Red Light Therapy Contraindications:
Photosensitizing Medications
People who are taking photosensitive medications should consult with their physician before receiving red light therapy.
If you’re taking medications that cause photosensitivity, you might wonder whether red light therapy could trigger a reaction. While red light therapy does not contain UV light (a common cause of drug-induced skin sensitivity), some medications make your skin more reactive to all types of light, including visible red and near-infrared light. Understanding how these drugs work can help you make an informed decision and prevent unwanted reactions.
Medicines such as tetracyclines, Retinoids, NSAIDs, Diuretics, antifungals, or chemotherapy can cause photosensitivity; however, in many cases, the incidence rate is very low.
Medications marked with ⚠️ are known to be strong photosensitizers; therefore, if you use them, we suggest consulting with a medical professional before receiving red light therapy. This includes ⚠️Amiodarone, Chlorpromazine, Doxycycline, Hydrochlorothiazide, Nalidixic acid, Naproxen, Piroxicam, Tetracycline, Thioridazine, and Vemurafenib, Voriconazole.
A recent meta-analysis on photosensitivity [35] reported how often these medications caused light-sensitive reactions in users:
- Amiodarone (heart medication): 10–75% of users experience photosensitivity.
- Voriconazole (antifungal): has an unknown incidence rate.
- Chlorpromazine (antipsychotic): 2–3% of users experience photosensitivity.
- Lomefloxacin (antibiotic): 1–3% of users experience photosensitivity.
- Naproxen (pain reliever): has an unknown incidence rate.
- Doxycycline (antibiotic): 4–42% of users experience photosensitivity.
- Hydrochlorothiazide (blood pressure medication): 0.001–0.01% of users experience photosensitivity.
- Vemurafenib (cancer drug): 12–63% of users experience photosensitivity.
⚠️Tetracyclines
People who are currently using or have previously used Tetracyclines should consult a doctor before undergoing red light therapy. Tetracyclines are broad-spectrum antibiotics used to treat various bacterial infections, including chlamydia, mycoplasma, rickettsia, and certain parasites. They are one of the most well-known drug classes associated with photosensitivity, meaning they can make the skin more sensitive to sunlight.
Tetracycline and doxycycline have been reported to cause sunburn-like reactions, ranging from mild redness and burning in sun-exposed areas to more severe sun-induced rashes (photodermatitis). In rare cases, they can also trigger solar urticaria (hives from sunlight), actinic granuloma (skin inflammation), and lichenoid reactions (a lichen planus-like rash).
In addition to skin reactions, tetracyclines can cause nail damage (photo-onycholysis), where the nails detach from the nail bed due to sun exposure. This has been reported with tetracycline, doxycycline, minocycline, and lymecycline. Doxycycline is particularly notable for causing severe nail damage in children, sometimes affecting all 20 nails, even at low doses (20 mg/day). Importantly, these nail changes can appear up to two weeks after sun exposure.
- The photosensitivity caused by doxycycline is thought to be due to UVA1 radiation (340–400 nm) and appears to be dose-dependent. Studies from the UK found that 3% of people taking 100 mg of doxycycline experienced phototoxicity. The incidence increased to 20% at 150 mg and 42% at 200 mg. However, the actual frequency of these reactions is unclear, as they are often underreported, with estimated incidence rates for doxycycline ranging from 3% to 16% in different studies. There has also been research on the potential link between tetracycline use and skin cancer. An extensive U.S. study found that tetracycline use increased the risk of basal cell carcinoma (BCC) by 11%. Still, no significant increase was observed for squamous cell carcinoma (SCC) or melanoma. [23, 34]
The following are types of Tetracyclines,
- ⚠️ doxycycline (Acticlate®, Adoxa®, Doryx®, Vibramycin® and others)
- minocycline (Amzeeq®, Arestin®, Ximino®, Solodyn® and others)
- ⚠️tetracycline (Acticlate®, Adoxa®, Doryx®, Vibramycin® and others)
- lymecycline
- sarecycline (Seysara®)
- demethylchlortetracycline
- chlortetracycline
- metacycline.
- Demeclocycline
- Rolitetracycline
- Eravacycline (Xerava®)
- Omadacycline (Nuzyra®)
There may be Tetracyclines not mentioned on this list. If you are taking medicine for the following health conditions, please consult with your physician to ensure you can receive red light therapy.
-
- Acne, Actinomycosis, Amebiasis, Anaplasmosis (tick bite infection), Chlamydia, Early Lyme disease, Ehrlichiosis, Legionnaires’ disease, Leptospirosis, Melioidosis, Pelvic inflammatory disease, Pneumonia, bacterial respiratory tract infection, Rickettsial infections, Staph infections, Syphilis, Traveler’s diarrhea, Tularemia, Whipple’s disease.
- Additionally, Tetracyclines may be prescribed to individuals with anthrax and food poisoning if they cannot take penicillin. [24]
There’s no research showing that red light therapy harms people with photosensitivity. However, if you’ve taken tetracycline antibiotics, you should talk with your doctor before trying red light therapy.
Retinoids
People who are currently using or have previously used retinoids should consult a physician before undergoing red light therapy.
Topical retinoids (adapalene, isotretinoin, tretinoin, trifarotene) are used to treat mild to moderate acne. They are a first-line treatment for clogged pores (comedonal acne) and inflammatory acne. Retinoids can also help reduce acne scars and alleviate post-inflammatory hyperpigmentation (dark spots that occur after acne), particularly in individuals with darker skin tones.
Retinoids, such as tretinoin, isotretinoin, adapalene, and trifarotene, have various dermatological uses. When used long-term (over six months), tretinoin can help reduce freckles, sunspots, fine lines, clogged pores, fragile skin, and precancerous lesions (actinic keratoses) caused by sun damage. It is also commonly combined with skin-lightening ingredients to treat melasma (dark patches on the skin).
In addition to acne treatment, topical isotretinoin, tretinoin, and adapalene have been effective in improving localized Darier disease, a rare skin disorder. Other topical retinoids serve specific dermatological purposes.
- Alitretinoin is FDA-approved for Kaposi sarcoma (an HIV-related skin cancer).
- Bexarotene is used for cutaneous T-cell lymphoma.
- Tazarotene is prescribed for facial acne, post-inflammatory hyperpigmentation, chronic plaque psoriasis, and sun damage.
- Trifarotene is approved for treating various forms of ichthyosis (thick, scaly skin disorders), including X-linked ichthyosis, epidermolytic ichthyosis, and erythrokeratoderma variabilis. [32]
Even though there is no evidence that red light therapy harms people with photosensitivity, knowing these differences can help you understand the potential side effects. If you are on either medication, it’s wise to discuss red light therapy with your doctor to ensure you take the proper precautions.
NSAIDs
⚠️Piroxicam, ⚠️Naproxen
Since NSAIDs can have the potential of making your skin more sensitive to light, talk to your doctor before trying red light therapy to avoid any possible reactions.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are a group of medications used to relieve pain, inflammation, and fever. Some NSAIDs have been reported to cause photosensitivity, meaning they can make the skin more sensitive to sunlight. While NSAIDs may make the skin more sensitive to sunlight, leading to photosensitivity reactions, scientists don’t fully understand how this happens, and the symptoms don’t always match typical phototoxic or photoallergic reactions. While some NSAIDs can directly cause phototoxic reactions, others may trigger skin sensitivity in a different way that still isn’t fully understood. [33]
- Benoxaprofen was one of the worst offenders, with over 50% of its side effects related to photosensitivity, sometimes leading to severe skin damage. Due to these risks, it was removed from the market in the early 1980s.
- Piroxicam, still available today, has been associated with blistering (vesiculobullous) rashes, eczema-like rashes, and lichen-like skin reactions. Among the commonly used NSAIDs, naproxen appears to be the most likely to cause photosensitivity, often leading to pseudoporphyria (skin fragility and blistering), sunburn-like reactions, and rashes like erythema multiforme.
- Celecoxib, a type of NSAID known as a COX-2 inhibitor, has also been linked to photoallergic reactions and pseudoporphyria.
- Other NSAIDs with reported photosensitivity reactions include oxaprozin, nabumetone, ampiroxicam, tiaprofenic acid, sulindac, and meclofenamate sodium. Diclofenac has been linked to photo-onycholysis, a condition where sunlight causes nail damage but not skin rashes.
- Ibuprofen is not considered a potent photosensitizer, with only one reported case of photosensitivity. However, later tests showed that this patient had increased UVA sensitivity while taking ibuprofen.
While no known research exists on whether NSAIDS may cause adverse effects on those using red light therapy, we advise speaking to a healthcare professional before scheduling a treatment session.
Diuretics
⚠️ Thiazides (hydrochlorothiazide)
Thiazide diuretics are some of the most commonly prescribed water pills, first introduced in the 1950s to help reduce fluid retention and lower blood pressure. Soon after their release, doctors began reporting photosensitivity reactions in patients taking these medications.
The most commonly reported culprit is hydrochlorothiazide, with over 60 documented cases of people experiencing severe sunburn-like reactions, eczema-like rashes in sun-exposed areas, lichen-like rashes, and dark/light skin discoloration (photoleukomelanoderma). In some cases, chronic eczema-like photosensitivity lasted for months or even years after stopping the drug. Some patients were successfully treated with PUVA therapy (a combination of light therapy and medication).
Studies have shown that both UVA and UVB rays can trigger thiazide-induced photosensitivity, and photopatch testing has confirmed hydrochlorothiazide as a photosensitizer in some cases. However, indapamide, another thiazide-like diuretic, has not been reported to cause skin reactions, although there have been cases of nail damage (photo-onycholysis).
Furosemide, another widely used diuretic, is also linked to sun-induced skin reactions. However, unlike thiazides, furosemide-related photosensitivity usually appears as large blisters (bullous eruptions), sometimes resembling a rare blistering condition called Brunsting-Perry-type bullous pemphigoid. Some studies confirmed this link through rechallenge testing (where patients developed reactions again after taking the drug).
Other less common diuretics, such as triamterene (a potassium-sparing diuretic), have also been reported to cause photosensitivity. [34]
Antiarrhythmics
⚠️Amiodarone
Amiodarone is a potent antiarrhythmic medication that treats and prevents irregular heartbeats, including ventricular arrhythmias and atrial fibrillation. One possible side effect is photosensitivity.
In some studies, more than 50% of patients taking Amiodarone experienced sun-related skin reactions, but newer studies suggest the actual rate is closer to 7%. The typical response includes a burning or tingling feeling in sun-exposed areas, followed by redness (erythema) and eczema-like rashes. In some cases, pseudoporphyria (a skin condition that causes blistering and fragility) has also been reported.
After long-term use, 1–2% of patients develop a distinctive blue-gray discoloration of the skin in sun-exposed areas. This photosensitivity reaction usually fades within months after stopping the drug, but in some cases, it can last longer. Skin discoloration generally fades over 1–2 years.
- Studies show that both UVA and UVB rays contribute to these reactions.
- A newer antiarrhythmic drug called dronedarone is chemically similar to Amiodarone but appears to cause much fewer skin reactions. However, some cases of photosensitivity have still been reported.
Another antiarrhythmic, quinidine, has also been linked to sun-related skin reactions, which can appear as eczema-like rashes, lichen-like eruptions, or purplish patches (livedoid purpura). In some cases, quinidine-induced photosensitivity was confirmed through phototesting and photopatch testing (skin tests that check for light-related reactions). [34]
Red Light Therapy Contraindications:
Final Thoughts
Wellness Treatments In O’Fallon
If you live in the O’Fallon area and are searching for red light therapy schedule a session in at Jennifer Brand Spa. We are located between Highway 70 and 364, at 2717 Hwy K O’Fallon, MO, 63368.
Shawn is a member of the International Association for the Study of Pain (IASP), Alliance for Massage Therapy Education (AFTME), and Associated Bodywork & Massage Professionals (ABMP).