Red and near-infrared photobiomodulation for burn, hypertrophic, and post-surgical scars: a scoping review of clinical trials

红光和近红外光生物调节治疗烧伤、增生性瘢痕和术后瘢痕:临床试验范围综述

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Abstract

PURPOSE: Scars may lead to pain, pruritus, functional impairment, and cosmetic concern despite standard therapies. Photobiomodulation (PBM) delivered by light-emitting-diode (LED) or low-level laser therapy (LLLT) has emerged as a non-invasive option to modulate scar remodeling. However, available data derives from small, heterogenous studies. This scoping review evaluates whether red and near-infrared PBM improves clinical outcomes in burn, hypertrophic, and post-surgical scars and summarizes treatment parameters used. METHODS: PubMed, Embase, and MEDLINE were searched through October 2025 for randomized or prospective clinical studies in which red (633-670nm) or near-infrared (808-830nm) LED or LLLT was used as monotherapy or where its contribution could be independently assessed. Seven studies (n=297) met inclusion criteria. Data on scar type, wavelength, fluence, regimen, outcomes, and adverse events were extracted. RESULTS: Red LED improved VSS scores, pigmentation, and thickness in pediatric and adult burn scars, with greater benefits observed in scars < 12 months. In post-surgical scars, red LED reduced induration and improved POSAS scores, with a biphasic dose-response favoring moderate fluence levels. Near-infrared PBM improved color and elasticity in hypertrophic scars and reduced thickness, malleability, pain, and pruritus following hernia repair, thyroidectomy, and blepharoplasty. Across studies, PBM was well tolerated; transient erythema and warmth were most common, with rare blistering at higher fluences. CONCLUSION: Red and near-infrared PBM appears to be a safe, non-invasive adjunct to standard scar management, particularly for early burn and post-operative scars. Larger controlled trials are needed to define optimal wavelength, fluence, timing, and treatment parameters across diverse scar phenotypes and skin phototypes. CLINICAL TRIAL REGISTRATION: Not applicable.

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