Received: 14 August 2022 | Revised: 21 November 2022 | Accepted: 1 December 2022

DOI: 10.1111/jocd.15576

REVIEW ARTICLE

The impact of blue light and digital screens on the skin

Jyoti Kumari MBBS, MD1 | Kinnor Das MD2 | Mahsa Babaei MD3 |
Ghasem Rahmatpour Rokni MD4 | Mohamad Goldust MD5

1
Silchar Medical College and Hospital,
Silchar, Assam, India Abstract
Introduction: The skin is frequently subjected to a variety of environmental trauma
2
Consultant Dermatolgist, Apollo clinic,
Silchar, Assam, India
3
and stress. It is unavoidably subjected to blue light due to the increased use of elec-
School of Medicine, Stanford University,
Stanford, California, USA tronic equipment, including indoor lighting and digital gadgets like smartphones and
4
Department of Dermatology, Faculty laptops, which have a range of detrimental effects. The method of action and nu-
of Medicine, Mazandaran University of
merous harmful consequences of blue light on the skin are the main subjects of this
Medical Sciences, Sari, Iran
5
Department of Dermatology, University review.
Medical Center Mainz, Mainz, Germany Materials and Methods: A literature search has been performed using PubMed,
Correspondence GoogleScholar and EmBase databases and an updated review on the topic has been
Mohamad Goldust, Department of presented.
Dermatology, University Medical Center
Mainz, Mainz, Germany. Results: Numerous studies have shown that being exposed to blue light accelerates
Email: mgoldust@uni-mainz.de the aging process and produces cutaneous hyperpigmentation. It also modifies the
circadian rhythm. The two main molecules that mediate cellular responses to blue
light are nitric oxide (NO) and reactive oxygen species. However, the precise process
is still not fully known.
Conclusion: These negative consequences may eventually cause more general skin
damage, which may hasten the aging process. At times, skin protection may be crucial
for protection against blue light.

KEYWORDS
blue light, dermatology, digital screens, skin

1 | I NTRO D U C TI O N digitization, which has led to light pollution. To make the days lon-
ger for work or for modern life, artificial light has been produced.
Humans have been exposed to varying levels of visible and invisible Therefore, our body no longer gets the cues it previously did to
light since the beginning of their development on earth. Moreover, get ready for sleep and act according to normal circadian rhythm.
the inescapable consequences of industrialization and global mod- The change in the evening and night time light has also an adverse
ernization have caused enormous changes in people's lifestyles in effect on our body circadian rhythm and general health. The skin,
both developing and developed countries during the past few de- as the biggest organ in the body, is immediately exposed to both
cades. Humans are now overexposed to artificial light during days artificial and environmental light and the outside trauma. It serves
and nights and do not receive adequate natural light during the day. as the initial line of protection against environmental hazards. The
Artificial lights have been incorporated into daily life as a result of skin has also shown to have a substantial circadian rhythm due to

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium,
provided the original work is properly cited.
© 2023 The Authors. Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.

J Cosmet Dermatol. 2023;22:1185–1190.  wileyonlinelibrary.com/journal/jocd | 1185

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1186 KUMARI et al.

its many activities. During the day, these functions are more pro- 3 | W H AT E FFEC T S D O E S TH E B LU E
tected, while at night or during darkness, they are more suited for LI G HT H AV E O N YO U R B O DY ?
repair. The effect of light on the skin has also therapeutic indica-
tions. Digital screens are among the latest methods of nonther- The circadian rhythm, or the body's natural sleep cycle, is regulated
mal light treatment that dermatologists may use. LEDs also emit by blue light. The body's sleep cycle is regulated by exposure to the
a significant amount of blue light, with both positive and negative blue light during the day, which also encourages the generation of
effects on the body and the skin.1 Here, we are presenting a brief melatonin at night. The body's circadian rhythm is hampered by the
literature review on the various mechanisms by which, blue light increased use of gadgets like laptops and phones, even late into the
damages skin as well as various preventative methods. The focus night. The body's capacity to create melatonin is compromised by
of this article is on the particular cell-­signaling routes involved as increasing the amount of blue light exposure before night, which re-
well as how the processes at work might be used to treat a range sults in difficulty falling asleep and drowsiness during the day.5
of cutaneous issues. Blue light improves mood, memory, and cognitive function while
increasing alertness. According to studies, youngsters who aren't ex-
posed to enough sunshine may experience problems with the eyes and
2 | B LU E LI G HT: W H AT I S IT ? visual development as well as growth. Research has also suggested that
less exposure to blue light may be linked to an increase in myopia.6,7
Different wavelengths make up all the light that we see. Selected High-­intensity blue light, a form of “visible light,” penetrates the
wavelengths exhibit some selected hues. The visible spectrum of skin more deeply than UVB and UVA rays do. Moreover, emerging
light is made up of the colors including red, orange, yellow, green, scientific evidence suggests that the blue light can permanently
blue, indigo, and violet. The electromagnetic spectrum's ultraviolet harm skin cells in the dermis and epidermis. This has the side conse-
region is closest to blue light, which has the shortest wavelength. quence of damaging the DNA within these cells and stimulating the
These wavelengths have the highest energy and the shortest wave- breakdown of the support fibers for the skin. This may cause fine
length, while red light has the least energy and the longest wave- lines, wrinkles, and premature aging over time.8
length. Depending on the source, the spectrum of this blue light
typically ranges from 420 to 490 nm, with a peak emission between
440 and 460 nm. Infrared light and ultraviolet (UV) light are also two 4 | B LU E LI G HT ' S M EC H A N I S M O F
different types of light that have different wavelengths from those AC TI O N
found in the visible spectrum.
At homes and inside the commercial buildings, LED lights are While UVA penetrates deeper layers of the skin and affects immune
becoming more popular and taking the place of incandescent bulbs cells in the epidermis and dermis, UVB interacts with epidermis cells.
due to their high efficiency, compact size, and extended lifespan. 2 Visible light penetrates the skin deeper than infrared radiation, while
The main source of blue light is sunlight. There are also synthetic also acting more superficially than UV. The epidermis's hemoglobin
sources, though. Prior to the development of LED lighting, the and melanin are very effective in absorbing visible light. Blue light
main source of illumination was incandescent bulbs, which re- can penetrate as far as 0.07 to 1 mm. Endogenous nucleic acids,
leased light with wavelengths comparable to those that the sun aromatic amino acids, urocanic acid, tryptophan, tyrosine, NADPH,
naturally emits. Incandescent lighting sources were gradually NADH cofactors, cytochromes, riboflavins, porphyrins, melanin and
phased out as the cost of LED lighting continued to drop. 3 Many melanin precursors, protoporphyrin IX, bilirubin, hemoglobin, caro-
businesses utilize LED lights in liquid crystal displays (LCDs) and tene, or water molecules are examples of chromophores, which are
lighting fixtures due to their tiny size, compact design, energy ef- the molecules that absorb the blue light. Consequently, the impact
ficiency, and dependability. 2 It has a wide range of uses, including of blue light depends on various chromophores (photo acceptors).
flashes in cameras, smartphones, current computer screens, tele- Opsins, flavins, porphyrins, and nitrosated proteins are the primary
visions, smartwatches, and traffic signals. These LEDs also create and most significant photo acceptors (e.g., S-­nitro-­albumin).9
a good amount of blue light, which is toxic and damaging to the The activation of flavins and flavoproteins is one such putative blue
eyes and skin. Concerns about the safety of these light sources light pathway. When exposed to radiation, flavin mononucleotides
have been raised by the fast-­growing use of cellphones, tablets, (FMN) and flavin adenine dinucleotides (FAD) double the amount of
laptops, and desktop computers, particularly during the COVID-­19 superoxide that is produced when reactive oxygen species (ROS) are
lockdown, when people kept themselves occupied by browsing the formed. ROS signaling is mediated in a variety of ways. One of these
Internet and watching televised programs. There is a growing con- is an Nrf2-­dependent process, which involves the production of anti-
cern about the long-­term consequences, because of the proximity oxidant factors through the action of a “basic leucine zipper protein.”
to the screen and the exposure time spent staring at the screen, Nrf2 has anti-­inflammatory properties because it inhibits NF-­kB,
even if the effects of blue light generated from electronic device which controls the proinflammatory response. Flavin-­containing pro-
screens are fewer than that of sun exposure.4 teins are present in many different types of cells. Cryptochromes are
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KUMARI et al. 1187

one of these proteins.10 In a recent study, Buscone et al. hypothesized transcription of the PER1 gene in keratinocytes. It is a clock gene
that blue light via cryptochrome 1 (CRY1), which is found in the hair that plays a role in the circadian rhythm, which may imply that skin
follicle following exposure to 453 nm light, may have a beneficial in- cells have the ability to regulate the production of the clock gene in
fluence on hair development. Ex vivo hair follicles showed a length- response to light perception. It is hypothesized that blue light would
ening of the anagen phase, which may be related to the rise in CRY1 interfere with skin cells' nightly rhythm, which is crucial for skin cell
11,12
levels brought on by blue light exposure. regeneration and repair. Cells may experience the night as being
In the dermis, blue light also causes the release of free nitric sunlight.5
oxide NO. At physiological pH, blue light at 420 or 453 nm caused Human skin exposed to blue light may produce free radicals as a
a large amount of NO to develop from S-­nitroso albumin as well as result of the decline in carotenoids. It is thought that this oxidative
from aqueous nitrite solutions via a Cu(1+)-­dependent process, as stress on melanogenic precursors causes pigmentation alterations,
measured by chemiluminescence detection (CLD). Blue light irradi- such as sudden and persistent darkening of the skin. The coloration
ation considerably raised the intradermal levels of free NO, as dis- is consistent and gets darker. It was supported by Melan-­A-­positive
covered by electron paramagnetic resonance spectrometry in vitro cells discovered in skin exposed to blue light. The amount of blue
with human skin specimens. Blue light irradiation of human skin re- light that is applied to the skin interrupts the function of the mela-
sulted in significant NO emanation from the irradiated skin area as nocytes, causing hyperpigmentation, melasma, and uneven and ex-
well as significant NO translocation from the skin surface into the cessive dark blotches on the skin. However, only people with darker
underlying tissue, as detected by CLD in vivo in healthy volunteers. skin tones respond to and show hyperpigmentation from exposure
NO reacts with superoxide to form peroxynitrite, which may cause to visible light. The tyrosinase and dopachrome tautomerase pro-
DNA damage that results in cell damage but no apoptosis has been tein complex, which is more prevalent in melanocytes seen in darker
seen. Yoo et al. discovered that human keratinocyte and cutaneous skin types, can be used to explain this phenomenon. Additionally,
fibroblast proliferation was inhibited by blue light.13 blue light increases the production of the proinflammatory cytokine
According to some theories, the complex IV of the electron TNF—­by activating the activator protein 1 (AP-­1) and nuclear factor
transport chain called cytochrome c oxidase, which is located in the b (NF-­B), as demonstrated by Yoo et al. This results in redness and
mitochondrial membrane, maybe the mechanism through which blue swelling when the same person's skin was exposed to comparable
light influences mitochondrial activity. After being inhibited by NO, levels of UVA rays.13
Dungel et al. showed that blue light at a wavelength of 430 nm reac- Roughly speaking, blue light can produce reactive oxygen spe-
tivates the mitochondrial respiratory function.14 cies. A reactive oxygen species is an unstable molecule that contains
Since blue light activates opsin (OPN), which are G-­protein re- oxygen and interacts with other molecules. The primary free radi-
ceptors, their function is also studied. There are various categories cal brought on by exposure to blue light is superoxide (O2), a highly
of opsins, depending on where they are expressed. In the epidermis, reactive anion radical that is created by the flavins. According to
OPN2, OPN3, and OPN4 are expressed. Blue light may activate the research, the creation of superoxide by blue light may play a substan-
opsin receptor, triggering transient receptor potential channels that tial role in the aging and carcinogenesis of the skin. Overexposure to
then release calcium, activating calcium/calmodulin-­
dependent ROS can harm skin cells, accelerate aging, cause hyperpigmentation,
protein kinase-­II (CAMKII), which in turn alters gene transcription. and cause melisma. By generating DNA damage, these unstable
OPN2 (Rhodopsin) and OPN3 (Panopsin, Encephalopsin) were dis- chemicals also cause inflammation and the destruction of the skin's
covered to be expressed in the anagen hair follicle in addition to healthy collagen and elastin, which furthers skin laxity, early aging
the skin. In an ex vivo study, Buscone et al. showed that blue light of the skin, and wrinkles. In skin cells, blue light activates the en-
irradiation (3.2 J/cm2, 453 nm) lengthened the anagen phase in hair zyme matrix metalloproteinases (MMPs), which have been shown to
follicles. Opsin's function in controlling melanogenesis and pigmen- break down collagen and speed up the aging process. These MMPs
tation has also been studied, although only in Fitzpatrick skin types not only break down the existing collagen but also impede the syn-
III and higher. It was discovered that blue light directly affects me- thesis of new collagen, preventing healing.1 Antioxidant levels in
lanocytes and indirectly affects calcium-­dependent melanogenesis cells with ROS are also affected. These species are eliminated by
through OPN3. Tyrosinase stimulation occurs in melanocytes of the antioxidants in the skin, thus after exposure to blue light, they be-
higher Fitzpatrick phototype as a result of the formation of multim- come depleted in the body. It could take up to 24 h for the endog-
eric tyrosinase, which is triggered by blue light.15–­17 enous repair. Exogenous antioxidants used topically, orally, or both
have been found to be advantageous in the case of UV radiation;
however, the impact of blue light has not yet been established. The
5 | H OW C A N B LU E LI G HT H U RT YO U R majority of superoxide is quickly changed into hydrogen peroxide.
S K I N? Blue light may not primarily harm cells by overpowering their antiox-
idant defenses, but rather by continuously producing small amounts
Several research demonstrate the harmful effects of blue light. of radicals that may slip past the body's regular defenses and harm
According to Dong et al., blue light at 410 nm decreased the DNA permanently.18
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1188 KUMARI et al.

6 | TH E A DVA NTAG E S O F B LU E LI G HT devices (such as a phone, tablet, or computer), which can block
or tame blue light. Numerous businesses have created blue light-­
Blue light not only can damage the skin in a number of ways, but it blocking eyewear that makes the same claims about improving sleep
also has certain healing effects. According to the literature, it has and reducing eye strain. The effectiveness of these lenses is still up
been used to cure a variety of skin conditions. for question among scientists, despite the fact that laboratory tests
indicate that they should be beneficial. To decrease the emission of
• Mild to moderate plaque psoriasis: assistance in the reduction of the blue light, switch your computer, smartphone, and other devices
the redness and the size of the patch without any side effects into “night mode”.1,25 The amount of blue light emitted by screen
after a 4-­week treatment term. In their study of the impact of blue technology is influenced by several variables, including program
light on keratinocytes, Becker et al. found that the proliferation code, the mobile operating system, and screen engineering (Calvo-­
of these cells decreased with exposure time, with a reduction in Sanz & Tapia-­Ayuga, 2020). 26 Melatonin levels were inhibited with
keratinocyte proliferation being seen after 15 min of irradiation. all types of lightning, according to a study evaluating the effective-
Another potential reason for a decrease in keratinocyte prolif- ness of a program published by Apple Inc. termed “night-­shift” mode
eration is nitric oxide (NO)-­mediated beginning of keratinocyte settings on iPad 2019. 27 Therefore, it is suggested to decrease all
19,20
differentiation. types of lightning as well as blue light over nights to decrease the
• Atopic Dermatitis: Blue light therapy for atopic dermatitis and ec- suppression of melatonin. 27
zema revealed a 54% reduction in the disease severity following a Headphones can be used so the phone can be kept in the pocket
6-­month treatment period. ROS signaling is mediated in a variety and away from your cheek and face.
of ways. One of these is an Nrf2-­dependent process, which in- Observe the 20-­20-­20 Rule: Spend 20 min looking at a screen,
volves the production of antioxidant factors through the action of then 20 s looking at something 20 feet away. 28
a “basic leucine zipper protein.” Nrf2 has anti-­inflammatory prop-
erties, because it inhibits NF-­kB, which controls the proinflamma-
tory response. 21 8 | SUNSCREEN
• Acne: Reduced number of open and closed comedones has been
observed in mild to moderate acne. The primary theory postu- People should always wear sunscreen every day. Unfortunately,
lates that the beneficial effect is connected to a decrease in not all sunscreens offer blue light protection. TiO2 (a component in
Propionibacterium acnes follicular colonization, which may be re- physical sunscreen) has been determined to have blue light blocking
lated to the activation of endogenous bacterial porphyrins by blue properties based on several assessments. 29
light. Blue and red light may prevent sebocytes from producing Physical and chemical sunscreens are the two primary cate-
lipids, which suggests that treating acne by preventing sebum gories of sunscreens. Physical sunscreens have active, physical
production could be beneficial. 22,23 components that are iron oxide, tungsten dioxide, zinc oxide and
• Photodynamic treatment: Another medical application of the many more. Other ingredients include talc, red veterinary petrola-
blue light is regarding the photodynamic treatment, which uses a tum, kaolin, calamine, and iron oxide. By reflecting, dispersing, or
photosensitizing chemical along with light and oxygen to produce absorbing UV radiation, inorganic materials work. Their inherent
highly reactive singlet oxygen and treat some cancer-­causing and drawbacks of being opaque and having a “whitening effect” can
noncancerous skin disorders. Aminolevulinic acid (ALA) and blue be lessened by using micronized or ultrafine particles. As soon
light are frequently used for the treatment of proliferative and as its applied, it rests on top of the skin. Physical sunscreens do
inflammatory diseases of the skin. When performed properly, provide blue light protection since the ingredients is made to re-
photodynamic treatment using blue light for photorejuvenation is flect UV and blue light away from the skin. Chemical compounds
thought to be both efficient and secure. The use of photodynamic that really absorb UV rays and may even hurt the skin are used to
therapy and other blue light therapies is currently being used in make chemical sunscreens. Blue light protection is not provided by
24
the clinics. chemical sunscreens. 30,31
Additionally, a number of substances—­often referred to as “sys-
temic sunscreens”—­have a systemic photoprotective action like
7 | H OW TO AVO I D P OTE NTI A L S K I N green tea polyphenols, PABA, antihistamines, aspirin, indomethacin,
DA M AG E FRO M TH E B LU E LI G HT corticosteroids, beta-­carotene, antimalarials, ascorbic acid, and to-
copherols (i.e., vitamins A, C, and E) (Table 1).33,34
The best treatment is prevention. It is more crucial to try to take
preventative measures through various treatment. The simplest ap-
proach to minimize blue light damage is to restrict exposure and re- 9 | A NTI OX I DA NT S
duce screen time by taking frequent pauses from your device to rest
your eyes. Attempt to take five-­minute rests every 30 min. Invest The development of ROS is one of blue light exposure's most harm-
in blue light screen filters or screen protectors for your electronic ful side effects. Fortunately, antioxidants are substances that, by
 |

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KUMARI et al. 1189

TA B L E 1 FDA-­approved active ingredients of sunscreens32

Cinoxate X X and blue light are close neighbors on the light spectrum. 25,37

Dioxybenzone X X
Ecamsule X
10 | CO N C LU S I O N
Homosalate X
Menthyl anthranilate X
The majority of frequently used electronic devices, including smart-
Octocrylene X X
phones, computers, and other devices, generate blue light. The
Octyl methoxycinnamate X wavelength and intensity of blue light exposure have been proved to
Octyl salicylate X have a significant impact on the skin's reaction. In many dermatolog-
Oxybenzone X X ical illnesses, it has a curative impact with minimal exposure; on the
p-­Aminobenzoic acid X other hand, long-­term exposure has numerous detrimental effects,
Padimate O X including DNA damage, oxidative stress, increased melanogenesis
Phenylbenzimidazole sulfonic acid X leading to pigmentation, photoaging, etc. In the near future, as we
Sulisobenzone X X learn more about the mechanism of harm that blue light exposure

Titanium dioxide X causes to the skin, we may anticipate seeing a rise in the number of
compounds introduced for blue light protection and new method-
Trolamine salicylate X
ologies created to test goods for blue light protection claims. People
Zinc oxide X X
who are frequently exposed to blue light pollution must take various
precautionary steps because exposure to blue light is inevitable.
neutralizing reactive oxygen species in biological tissues, can halt
oxidative chain reactions and postpone oxidative damage (Gülçin, AU T H O R C O N T R I B U T I O N S
2010).35 It was found in a study by Bapary et al. (2019) that anti- Jyoti Kumari: Writing and revising the manuscript. Kinnor Das,
oxidants and a drop in ROS were directly correlated, supporting the Mahsa Babaei, and Ghasem Rahmatpour Rokni: Review and revis-
idea that antioxidants have ROS lowering properties.36 ing the manuscript. Mohamad Goldust: Conception, writing, review,
The skin makes use of a variety of antioxidative defense mecha- and revising the manuscript
nisms, including the enzymes catalase and superoxide dismutase as
well as natural products like L-­ascorbate, beta-­carotene, and gluta- C O N FL I C T O F I N T E R E S T
thione, to control the production of ROS. None.
A diet high in antioxidants, including fruits and vegetables, is
strongly advised in addition to topical application of antioxidant-­ DATA AVA I L A B I L I T Y S TAT E M E N T
rich products. This is the healthiest and most long-­lasting method of Data sharing not applicable to this article as no datasets were gener-
avoiding blue light harm to the skin. ated or analysed during the current study.
Oral antioxidants, such as supplements of the vitamins C and E
and glutathione, since all antioxidants work to scavenge free radicals. DISCL AIMER
The diet should include foods high in antioxidants like fresh fruits We confirm that the manuscript has been read and approved by all
and vegetables like beans, spinach, beets, strawberries, blues, and the authors, that the requirements for authorship as stated earlier in
raspberries, which can help the skin fight off free radicals. Plants this document have been met and that each author believes that the
produce red, orange, and yellow carotenoids, which have antioxidant manuscript represents honest work.
characteristics. Carotene, lutein, zeaxanthin, and lycopene are a few
typical carotenoids. Beta-­carotene can be obtained in diet by eat- E T H I C A L A P P R OVA L
ing dark green, red, yellow, and orange vegetables like spinach and No ethical approval was required as this research did not involve
carrots. The carrot root and extract, as well as a subtropical fruit ex- human subjects or animals.
tract, both contain carotene and are available as topical ingredients.
Another carotenoid called lutein, which makes up a large portion of ORCID
the macular pigment, is renowned for its capacity to block blue light. Mohamad Goldust https://orcid.org/0000-0002-8646-1179
As was already noted, vitamins are also often used as ingredients in
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