With Dr Shabana Daya, Consultant Dermatologist

When we talk about anti-ageing in dermatology, we are not talking about stopping time. We are talking about biology. Specifically, how skin structure, function, and repair capacity change over time, and whether we can support those processes in a way that preserves skin health rather than forcing short-term cosmetic outcomes.

From a clinical perspective, anti-ageing is better understood as skin rejuvenation: supporting the mechanisms that allow skin to repair, regenerate, and maintain its structural integrity as we age. Red light therapy has emerged as one of the most compelling tools in this space because it works with skin biology at a cellular level, rather than acting purely on the surface.

What Actually Changes in Ageing Skin?

Skin ageing is driven by two overlapping processes: intrinsic ageing and extrinsic ageing.

Intrinsic ageing is largely genetically programmed. As we age, the proliferation of keratinocytes and fibroblasts slows. Collagen types I and III and elastin production decline. Both the epidermis and dermis gradually thin, vascular support is reduced, and wound healing becomes slower and less efficient. Clinically, this presents as fine lines, wrinkles, skin thinning, dryness, reduced elasticity, and loss of volume.

Extrinsic ageing is driven by environmental exposure. Ultraviolet radiation, particularly UVA, is the dominant factor, but pollution, smoking, chronic inflammation, and oxidative stress all accelerate structural breakdown within the skin. These external stressors compound intrinsic ageing by promoting inflammation and damaging collagen and elastin fibres over time.

Effective anti-ageing strategies need to acknowledge both pathways. This is where red light therapy becomes particularly relevant.

Where Red Light Therapy Fits Biologically

Red and near-infrared light therapy works through a process described as photobiomodulation. Specific wavelengths, typically at the 630–660 nm red light range and around 850 nm in the near-infrared range penetrate the skin and are absorbed within cells.

At a cellular level, these photons interact with mitochondria, specifically with an enzyme called cytochrome c oxidase. This interaction enhances mitochondrial efficiency and increases the production of adenosine triphosphate (ATP), the energy currency of the cell.

Skin cells, particularly fibroblasts, are highly energy-dependent. When ATP availability declines, repair processes slow and collagen production diminishes. By improving cellular energy availability, red light therapy supports fibroblast function, stimulates collagen and elastin synthesis, and improves overall skin resilience.

In addition, increased microcirculation and improved local blood flow support nutrient delivery and waste removal, contributing to improved radiance and repair. Red light therapy has also been shown to modulate inflammatory signalling, which is particularly relevant in extrinsic ageing.

Mitochondria, Fibroblasts and Collagen Pathways

Fibroblasts play a central role in maintaining the skin’s extracellular matrix. They are responsible for producing collagen, elastin, and other structural proteins that give skin its strength and elasticity.

Red light therapy has been shown in laboratory studies to enhance fibroblast activity, at least in part by improving mitochondrial function. As ATP production increases, fibroblasts appear better able to synthesise collagen types I and III and elastin, key components for maintaining skin structure and firmness.

Near-infrared wavelengths appear to support later stages of matrix maturation in experimental models, contributing to tissue remodelling and longer-term structural integrity. Rather than triggering injury-based repair responses, red light therapy supports normal physiological processes that gradually decline with age.

What Research Tells Us About Skin Quality Over Time

The growing body of research around red light therapy suggests consistent benefits for skin firmness, texture, and overall quality when used regularly.

By stimulating fibroblasts and increasing collagen and elastin production, red light therapy supports connective tissue integrity. Enhanced mitochondrial energy allows skin cells to repair more effectively, supporting turnover and regeneration without disrupting the skin barrier.

Improved local circulation and reduced inflammatory signalling further contribute to more even tone, improved texture, and healthier-looking skin. Importantly, these changes are cumulative and gradual, reflecting true biological support rather than superficial correction.

How Red Light Differs From Topical Anti-ageing Approaches

Topical anti-ageing products primarily work by delivering chemical signals to the skin. These may bind to receptors, alter enzyme activity, or influence the extracellular environment. While many topical agents are effective, they rely on barrier penetration and biochemical signalling.

Red light therapy works differently. It delivers physical energy that penetrates tissue and is absorbed directly within cells, primarily within mitochondria. Rather than altering signalling pathways from the outside in, it helps shift the cellular energy state itself.

This distinction is important. Red light therapy does not require barrier disruption, does not rely on irritation or controlled injury, and is therefore generally well tolerated, even in sensitive or post-procedure skin under medical supervision. Its effects are mediated, in part, through modulation of pro-inflammatory cytokines rather than suppression or stimulation via chemical means.

The Long-term, Skin-first Approach to Ageing

In clinical practice, red light therapy should be positioned as a long-term skin health intervention, not a cosmetic shortcut. Its role is not to erase ageing, but to support the skin’s capacity to function, repair, and respond over time.

By supporting mitochondrial energy production and reducing inflammatory signalling, red light therapy helps maintain healthy cellular responses, such as collagen turnover, barrier repair, and microvascular function. These processes underpin resilient ageing, supporting skin that tolerates stress and is able to adapt continuously.

Consistency is key. The photo-biochemical signalling effects of photobiomodulation are transient and require repeated exposure to support structural change. When used regularly, red light therapy can help strengthen the biological foundations of skin health, making it a valuable adjunct in a skin-first, longevity-focused approach to ageing.

Rather than asking how we can make skin look younger, red light therapy invites a more meaningful question: how can we help skin age better?