Photobiomodulation, Bio-Machines, and the Future of Dermatology

An expansive look at how dermatology may evolve alongside rapid advances in biology, engineering, and light-based therapies was delivered in the “Innovation in Dermatology 2026” presentation given by Rox Anderson, MD, professor of dermatology at Harvard Medical School, director of the Wellman Center for Photomedicine, and adjunct professor of health sciences and technology at Massachusetts Institute of Technology.¹ The conversations at Maui Derm Hawaii 2026 have centered around new dermatologic therapies,² particularly biologics along with combination therapy,³ and precision medicine in pediatric care.⁴ Anderson’s talk went beyond treatment updates, positioning dermatology within a broader scientific shift that could fundamentally reshape clinical practice.¹

He framed the field as entering a new “biological revolution,” comparable in scope to past industrial, electronic, and digital revolutions. Advances in genetics, molecular biology, and material science now allow scientists to design and manipulate living systems in ways that were impossible even a few decades ago. Dermatology, he argued, will inevitably intersect with these developments, especially as engineered tissues and living therapeutic systems move closer to clinical reality.

“Incredible new drugs and changes that we're seeing from molecular biology and dermatology are just beginning in our field, but they’re actually a small piece of a very large revolution that we are within,” Anderson said.

A central concept in his talk was the rise of so-called “bio-machines,” engineered living systems capable of performing specific functions while retaining advantages of biology, such as self-repair and operation using natural metabolic fuels. Skin, Anderson suggested, could become a key platform for such innovation. Potential future applications include engineered skin capable of secreting therapeutic molecules like insulin, tissues with enhanced sensory functions, or hybrid skin incorporating both biological and synthetic components. Even if dermatologists are not leading these innovations, he noted, clinicians will eventually need to manage patients presenting with such technologies.

Anderson also highlighted a translational concept involving indoleamine-2,3-dioxygenase (IDO), an enzyme that helps create immune tolerance during pregnancy by suppressing T-cell activity. He proposed that topical delivery of IDO, or mRNA instructing skin cells to produce it, could one day help manage autoimmune and inflammatory skin diseases by locally inducing immune tolerance. Emerging work on transdermal delivery of proteins suggests such strategies may become feasible.

Artificial intelligence (AI) also briefly entered the discussion. Anderson referenced AI-generated scientific publications and predictions about dermatology’s future, noting both their impressive capabilities and the need for skepticism. He used AI’s often self-congratulatory language about cosmetic dermatology to caution against overhyping innovation and emphasized maintaining critical evaluation as AI becomes more integrated into research and clinical practice.

A major portion of the lecture focused on photobiomodulation (PBM), the therapeutic use of red and near-infrared light to influence cellular function. PBM is already FDA-cleared or widely used for conditions including hair loss, chronic pain, oral mucositis, and, more recently, age-related macular degeneration. Investigational work also suggests potential benefits in traumatic brain injury.

Mechanistically, PBM acts largely through mitochondrial pathways. Near-infrared light displaces nitric oxide from cytochrome c oxidase in the electron transport chain, restoring oxygen utilization and adenosine triphosphate production in stressed tissues. Anderson emphasized that wavelengths around 810 nm offer deeper tissue penetration and reduced melanin absorption, making them particularly useful across diverse skin types. Other wavelengths, such as 980 nm, interact with transient receptor potential ion channels involved in pain and heat sensation, opening additional therapeutic possibilities.

Beyond dermatology, experimental data show PBM may improve muscle performance in metabolically compromised animals and even promote structural brain repair after injury, although Anderson cautioned against overselling early findings.

The session concluded with a discussion of neurofibromatosis type 1, a genetic condition marked by numerous cutaneous tumors. Anderson’s team has explored both laser therapy and injections of 1% deoxycholate to shrink neurofibromas, showing meaningful tumor volume reductions. Early intervention and repeated treatments may offer patients options beyond the traditional “wait-and-remove” surgical approach.

Dermatology stands at the intersection of engineering, biology, and photomedicine, according to Anderson, and the specialty must prepare for rapid and sometimes unexpected technological change in the years ahead.

References

1. Anderson R. Innovation in dermatology 2026. Presented at: Maui Derm 2026; January 25-29, 2026; Maui, HI.
2. Grossi G. New dermatologic therapies make waves at Maui Derm 2026. AJMC^®. January 27, 2026. Accessed January 29, 2026. https://www.ajmc.com/view/new-dermatologic-therapies-make-waves-at-maui-derm-hawaii-2026
3. Grossi G. Combination therapy, biologics, and surgery redefine HS care in 2026. AJMC. January 29, 2025. Accessed January 30, 2026. https://www.ajmc.com/view/combination-therapy-biologics-and-surgery-redefine-hs-care-in-2026
4. Grossi G. Advances in pediatric dertmatology spotlight diagnostic precision and new systemics. AJMC. January 28, 2026. Accessed January 30, 2026. https://www.ajmc.com/view/advances-in-pediatric-dermatology-spotlight-diagnostic-precision-and-new-systemics