Effects of blue light exposure on human skin at the molecular, cellular, and clinical levels: A systematic review

Background: High-energy visible (HEV) blue light (400–500 nm) is increasingly recognized as a contributor to skin damage beyond ultraviolet (UV) radiation. Evidence links HEV exposure to oxidative stress, extracellular matrix degradation, pigmentation disorders, and circadian rhythm disruption, all of which accelerate photoaging. Despite growing interest, clinical awareness and protective strategies remain limited. Methods: A systematic PubMed search was conducted for studies published between 2008 and 2025. Eligible publications included in vitro , in vivo , and clinical investigations assessing HEV-induced oxidative stress, deoxyribonucleic acid (DNA) damage, pigmentation, circadian rhythm alterations, and photoaging mechanisms. Interventions such as antioxidants, HEV-blocking sunscreens, and pigment-containing formulations were also evaluated. Data extraction and study selection were performed independently by all reviewers. Given heterogeneity of study designs and outcomes, results were synthesized narratively. Results: In vitro studies demonstrated HEV-induced reactive oxygen species (ROS) generation, matrix metalloproteinase (MMP) activation, fibroblast proliferation impairment, and DNA damage, leading to collagen degradation and premature aging. Opsin-3-mediated melanogenesis contributed to hyperpigmentation. High-energy visible exposure disrupted circadian regulation and weakened antioxidant defenses. In vivo and clinical evidence showed alterations in skin biomechanics and fibroblast migration. Photoprotective formulations containing pigments and antioxidants reduced oxidative stress, MMP activity, and pigmentation, although study designs were small and short-term. Conclusions: High-energy visible significantly affects skin physiology at multiple levels and contributes to photoaging and pigmentary disorders. Photoprotection should extend beyond UV filters to include HEV-targeted strategies. Standardized clinical trials are needed to establish exposure thresholds and optimize prevention.