Red light therapy
and migraines

A condition that medicine still doesn't fully understand

If you have migraines, you already know that "it's just a headache" doesn't begin to cover it. The nausea, the light sensitivity, the hours or days of being completely non-functional - it's a neurological event, not a head complaint. And despite decades of research, the options remain limited. Triptans work for some people and not others. Preventive beta-blockers or topiramate come with side effects that can feel almost as disabling as the migraines themselves. Botox injections, every three months, for the rest of your life. CGRP inhibitors are the newest addition and genuinely effective, but expensive and not available to everyone on the NHS.

A lot of people with migraines spend years cycling through treatments, looking for something that works consistently without making their daily life harder. That's the context in which light therapy research is worth paying attention to - not as a miracle alternative, but as a genuine non-pharmaceutical option with a clinical evidence base that is more developed than most people realise.

One thing worth knowing upfront: the green light story is separate from the red light story, the mechanism is completely different, and the results in some studies are striking in their own right.

The scale of it

Migraine is the second leading cause of disability globally according to the World Health Organisation. More than a billion people worldwide are affected, a figure that has grown by over 58% in the past 30 years. In the UK, the Migraine Trust puts the number at approximately ten million people, with more than a million of those living with chronic migraine - defined as 15 or more headache days per month. Women are three times more likely to be affected than men, and the condition is most prevalent in people aged 20-40, which means a significant proportion of sufferers are managing it through their working years.

Only about half of people with migraine have seen a healthcare provider for it in the last 12 months, according to WHO data. The reasons are familiar: misdiagnosis, being told to just manage it with over-the-counter medication, or being in a cycle where preventive treatments either don't work well enough or cause side effects that make them impractical. It's a condition that is simultaneously extremely common and extremely poorly served.

What actually happens during a migraine

The full biology of migraines is still being worked out - which is part of why treating them is so difficult. What we do know is that a migraine involves a cascade of neurological events, not just blood vessel dilation. The current understanding centres on a few key processes that are relevant to why light therapy has any plausible effect at all.

None of this means red light therapy is targeting migraines the way a CGRP inhibitor does - that would be an overstatement. What it means is that the mechanisms PBM is known to affect are directly relevant to migraine pathophysiology. The question is whether that translates into clinical benefit, and that's what the trials were designed to answer.

What the red and near-infrared light trials found

The most notable piece of clinical evidence here is a 2018 randomised controlled trial published in Arquivos de Neuropsiquiatria (Loeb et al., PMID 30427505). Thirty-six patients with chronic migraine were split into two groups - one received low-level laser therapy, the other received botulinum toxin A injections (Botox). Both groups kept pain diaries for 30 days before treatment, 30 days during, and 30 days after.

Both treatments reduced headache days, acute medication intake, and pain intensity. There was no statistically significant difference between them. Botox had the edge on reducing anxiety; laser therapy had the edge on reducing sleep disturbance. The authors concluded that both treatments are efficient against chronic migraine, with no difference between them in overall outcomes.

That finding deserves a moment. Botox for chronic migraine is a licensed, NICE-recommended treatment that costs several hundred pounds per round of injections and needs repeating every three months. Being comparable to it in a head-to-head RCT is not a small thing, even accounting for the study's limitations - 36 patients total, single-centre, clinical laser rather than home panel.

A 2022 systematic review registered on PROSPERO (CRD42021223429) pulled together the available RCTs on PBM for primary headache. Positive results appeared across included studies for both pain reduction and headache frequency, but the authors rated certainty of evidence as very low - mainly because the trials were small and properly blinding participants to light therapy is difficult. No adverse events were reported across any included study.

Separately, a 2024 paper in Scientific Reports (Campos et al., DOI 10.1038/s41598-024-82412-9) examined vascular photobiomodulation for tension-type headache and orofacial pain in post-COVID patients. PBM was applied over blood vessels rather than the head directly, and pain scores dropped significantly versus sham (p=0.010). A different delivery approach, but the same underlying mechanism.

What this means if you have migraines

None of this supports replacing prescribed migraine treatment with light therapy. What it does support is treating light therapy as an adjunct - something that addresses mechanisms conventional treatments don't fully cover, with essentially no downside in terms of side effects.

For panel use, the protocol that makes most sense based on the clinical data is preventive: regular sessions on the upper face, temples, and back of the neck - the areas where the trigeminovascular and cervicogenic components of migraine originate. The Loeb study used clinical laser equipment, but the wavelengths (red and NIR) and the mechanisms they target are identical to what a full-body panel delivers. Ten to twenty minutes, several times a week, built into a consistent routine rather than used reactively when a migraine is already underway.

Green light is a different approach entirely - and not something a NovaThera panel delivers. You're not applying it to tissue; you're sitting in ambient green light for 1-2 hours a day. The Arizona protocol used narrow-band green LEDs at approximately 520nm in a dimly lit room. A dedicated green LED lamp is the right tool here, available cheaply online. It works through retinal pathways, not tissue photobiomodulation, and the two approaches address different parts of the migraine picture without overlapping.

Migraine management is personal in a way that few conditions match. What triggers one person's attacks doesn't trigger another's. Give any new approach enough time to evaluate - weeks, not a handful of sessions - and keep your neurologist or GP in the loop. None of this is a substitute for medical care.

Where this sits in the bigger picture

Migraines are one of those conditions where the gap between how debilitating they are and how well medicine addresses them remains frustratingly wide. The newer CGRP inhibitors are a real step forward, but they're not available to everyone and they don't work for everyone. For the majority of migraine sufferers who are navigating a patchwork of partially effective options, something safe with an actual evidence base and a negligible barrier to trying is worth knowing about.

Light therapy across both wavelengths clears that bar. The Botox comparison trial is a real and meaningful data point. The green light work from Arizona is hard to dismiss. The certainty of evidence needs to improve before anyone should be recommending this with the same confidence as a CGRP inhibitor - but that's a different question from whether it's worth trying as part of a broader approach. For most people with migraines, it probably is.